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Olowoselu O, Okunade KS, Oyedeji OA, Davies NO, Ajie OI, Adewoyin A, Kharya G. Long-Term Ovarian Function Assessment After Haematopoietic Stem Cell Transplantation in Female Sickle Cell Anaemia Survivors. Cureus 2024; 16:e58195. [PMID: 38741860 PMCID: PMC11090072 DOI: 10.7759/cureus.58195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Haematopoietic stem cell transplantation (HSCT) is a potentially curative treatment for sickle cell anaemia (SCA). While HSCT offers the possibility of disease remission, it can also lead to long-term complications, including gonadal dysfunction and premature menopause. METHODS We conducted a retrospective cohort study of female survivors who had hydroxyurea therapy and those who underwent post-HSCT follow-up for SCA at a teaching hospital in Lagos, Nigeria, between January 2019 and December 2022. Participants were eligible if they were at least five years post-HSCT or hydroxyurea treatment and had available serum samples for markers of ovarian function measurement. Demographic and clinical data were collected from the hospital register and patients' medical records. Serum levels of oestradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and anti-Müllerian hormone (AMH) were measured using the Abbott Architect i1000SR chemiluminescent immunoassay analyzer (Abbott Diagnostics, Abbott Park, IL). Descriptive statistics and inferential analyses were used to assess the relationship between markers of ovarian function (FSH and AMH) and clinical parameters. RESULTS There were statistically significant differences in the median serum levels of all the assessed endocrine hormones between the HSCT and non-HSCT (hydroxyurea) groups of SCA survivors. Up to 82.6% of the SCA survivors experienced ovarian dysfunction after HSCT treatment. Impaired ovarian function in SCA survivors was associated with a longer median follow-up duration than in SCA survivors who had normal ovarian function (12.0 vs. 7.5 years, p = 0.048). There were higher odds of impaired ovarian function in the SCA survivors who had myeloablative regimens than in those who had reduced intensity conditioning regimens (94.1% vs. 50.0%, p = 0.040). CONCLUSION Our study highlights the significant impact of HSCT on long-term ovarian function in female SCA survivors. However, further prospective studies with larger sample sizes and longer follow-up periods are required to confirm our findings and elucidate the factors influencing ovarian function in SCA survivors of HSCT. In addition, studies are also needed to further elucidate the optimal transplant protocols and fertility preservation strategies to minimize gonadal toxicity and preserve reproductive potential in female SCA patients undergoing HSCT.
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Affiliation(s)
- Olusola Olowoselu
- Haematology and Blood Transfusion, College of Medicine, University of Lagos, Lagos, NGA
| | - Kehinde S Okunade
- Obstetrics and Gynaecology, Lagos University Teaching Hospital, Lagos, NGA
- Obstetrics and Gynaecology, College of Medicine, University of Lagos, Lagos, NGA
| | - Olufemi A Oyedeji
- Haematology and Blood Transfusion, College of Medicine, University of Lagos, Lagos, NGA
| | - Nosimot O Davies
- Haematology and Blood Transfusion, College of Medicine, University of Lagos, Lagos, NGA
| | - Obiefuna I Ajie
- Chemical Pathology, College of Medicine, University of Lagos, Lagos, NGA
| | - Ademola Adewoyin
- Haematology and Blood Transfusion, College of Medicine, University of Lagos, Lagos, NGA
| | - Gaurav Kharya
- Haematology, Oncology, and Bone Marrow Transplant (BMT) Unit, Apollo Hospitals, New Delhi, IND
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Copp T, Thompson R, Hammarberg K, Lensen S, Augustine L, Doust J, Peate M, Cvejic E, Mol BW, Lieberman D, McCaffery KJ. Attitudes, knowledge and practice regarding the anti-müllerian hormone test among general practitioners and reproductive specialists: A cross-sectional study. BJOG 2024. [PMID: 38196321 DOI: 10.1111/1471-0528.17741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/14/2023] [Accepted: 12/10/2023] [Indexed: 01/11/2024]
Abstract
OBJECTIVE To describe clinicians' attitudes, knowledge and practice relating to the anti-müllerian hormone (AMH) test. DESIGN Cross-sectional nationwide survey. SETTING Australia. POPULATION OR SAMPLE A total of 362 general practitioners (GPs), gynaecologists and reproductive specialists. METHODS Clinicians were recruited through relevant professional organisations, with data collected from May 2021 to April 2022. MAIN OUTCOME MEASURES Clinicians' attitudes, knowledge and practice relating to the AMH test, measured using multiple choice, Likert scales and open-ended items. RESULTS Fifteen percent of GPs (n = 27) and 40% of gynaecologists and other specialists (n = 73) order at least one AMH test per month. Specialists reported raising the idea of testing most of the time, whereas GPs reported that patient request was more common. Half of clinicians lacked confidence interpreting (n = 182, 51%) and explaining (n = 173, 48%) an AMH result to their patients. Five percent (n = 19) believed the test was moderately/very useful in predicting natural conception/birth and 22% (n = 82) believed the same for predicting premature menopause, despite evidence that the test cannot reliably predict either. Forty percent (n = 144) had previously ordered the test to help with reproductive planning and 21% (n = 75) to provide reassurance about fertility. CONCLUSIONS Clinicians reported use of AMH testing in clinical circumstances not supported by the evidence. With the proliferation of direct-to-consumer testing, efforts to support clinicians in the judicious use of testing and effectively navigating patient requests are needed.
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Affiliation(s)
- Tessa Copp
- Sydney Health Literacy Lab, Faculty of Medicine and Health, School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Rachel Thompson
- Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Camperdown, New South Wales, Australia
| | - Karin Hammarberg
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Sarah Lensen
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Lidiya Augustine
- Sydney Health Literacy Lab, Faculty of Medicine and Health, School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Jenny Doust
- Australian Women and Girls' Health Research Centre, School of Public Health, The University of Queensland, St Lucia, Queensland, Australia
| | - Michelle Peate
- Department of Obstetrics and Gynaecology, Royal Women's Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Erin Cvejic
- Sydney Health Literacy Lab, Faculty of Medicine and Health, School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Ben W Mol
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
- Aberdeen Centre for Women's Health Research, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Devora Lieberman
- City Fertility Centre Pty Ltd, Sydney, New South Wales, Australia
| | - Kirsten J McCaffery
- Sydney Health Literacy Lab, Faculty of Medicine and Health, School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
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Jiang L, Ruan X, Li Y, Gu M, Cheng J, Wang Y, Yang Y, Xu C, Wang Z, Liu L, Mueck AO. Diagnostic value of anti-Müllerian hormone combined with androgen-levels in Chinese patients with polycystic ovary syndrome. Gynecol Endocrinol 2023; 39:2206927. [PMID: 37141919 DOI: 10.1080/09513590.2023.2206927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
OBJECTIVE To establish a cutoff level of AMH which could help for the diagnosis of PCOS, to investigate the predictive value of AMH combined with androgens in Chinese women to diagnose PCOS. MATERIALS AND METHODS This is a prospective case control study, 550 women recruited (aged 20-40 years), in which 450 PCOS women recruited according to the Rotterdam criteria and 100 non-PCOS women in the control group were from the women for the pregnancy preparation examination. AMH were measured by the Elecsys AMH Plus immunoassay. Androgens and other sex hormone were measured. The validity of AMH toward the diagnosis of PCOS, or AMH combined with total testosterone, free testosterone, bioavailable testosterone and androstenedione was estimated by receiver operating characteristic (ROC)curves, and correlations between paired variables was estimated by Spearman's rank correlation coefficient. RESULTS The cutoff value of AMH in Chinese reproductive-age women with PCOS is 4.64 ng/mL, AUC under the curve is 0.938, with 81.6% sensitivity, and 92.0% specificity. Total testosterone, free testosterone, bioactive testosterone, and androstenedione are significantly higher in women with PCOS of reproductive age than in controls. The combination of AMH and free testosterone resulted in a higher AUC of 94.8%, with higher sensitivity (86.1%) and excellent specificity (90.3%) for the prediction of PCOS. CONCLUSION The Elecsys AMH Plus immunoassay, with a cutoff of 4.64 ng/mL, is a robust method for identifying PCOM to aid in PCOS diagnosis. The combination of AMH and free testosterone resulted in a higher AUC of 94.8% for the diagnose of PCOS.
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Affiliation(s)
- Lingling Jiang
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Xiangyan Ruan
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
- Department for Women's Health, University Women's Hospital and Research Centre for Women's Health, University of Tuebingen, Tuebingen, Germany
| | - Yanqiu Li
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Muqing Gu
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Jiaojiao Cheng
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Yuejiao Wang
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Yu Yang
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Che Xu
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Zhikun Wang
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Lili Liu
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Alfred O Mueck
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
- Department for Women's Health, University Women's Hospital and Research Centre for Women's Health, University of Tuebingen, Tuebingen, Germany
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Jiang M, Gao Y, Qu T, Ji Y, Niu Y, Zhang J, Huang L. Dose inhibin B or anti-Müllerian hormone relate to precocious puberty in girls? result of a systematic review and meta-analysis. J Ovarian Res 2023; 16:227. [PMID: 37996919 PMCID: PMC10668349 DOI: 10.1186/s13048-023-01302-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 10/24/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUNDS Existing studies have investigated the relationship between the levels of serum inhibin B (INHB), anti-müllerian hormone (AMH) and precocious puberty in girls, but the results are inconsistent. OBJECTIVE The aim of this meta-analysis was to assess whether the INHB and AMH levels changed in girls with precocious puberty relative to healthy controls. METHODS PubMed, Embase, Cochrane Library and Web of Science were searched through June 2022. We included observational clinical studies reporting the serum levels INHB and AMH in girls with precocious puberty. Conference articles and observational study abstracts were included if they contained enough information regarding study design and outcome data. Case series and reports were excluded. An overall standard mean difference (SMD) between precocious puberty and healthy controls was estimated using a DerSimonian-Laird random-effects model. RESULTS A total of 11 studies featuring 552 girls with precocious puberty and 405 healthy girls were selected for analysis. The meta-analysis showed that the INHB level of precocious puberty [including central precocious puberty (CPP) and premature the larche (PT)] were significantly increased. While there was no significant association between precocious puberty [including CPP, PT, premature pubarche (PP) and premature adrenarche (PA)] and the level of serum AMH. CONCLUSION Scientific evidence suggested that the INHB level, but not the AMH level, altered in girls with precocious puberty compared with healthy controls. Through our results we think that INHB level might be a marker for the auxiliary diagnosis of precocious puberty (especially CPP and PT). Therefore, it is important to evaluate and thoroughly investigate the clinical indicators (e.g., INHB) in order to ensure early diagnosis and medical intervention, and the risk of physical, psychological and social disorders in immature girls with precocious puberty is minimized.
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Affiliation(s)
- Mei Jiang
- Beijing Research Institute of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Ying Gao
- Department of Acupuncture, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Tiange Qu
- Department of Dermatology, Dongzhimen Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Yuechen Ji
- School of traditional Chinese Medicine, Beijing University of Chinese Medicine, No.11 Beisanhuandong Road, Chaoyang, Beijing, 100029, P. R. China
| | - Yiwen Niu
- School of traditional Chinese Medicine, Beijing University of Chinese Medicine, No.11 Beisanhuandong Road, Chaoyang, Beijing, 100029, P. R. China
| | - Jiaxin Zhang
- Department of Gastroenterology, Dongzhimen Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Ling Huang
- School of traditional Chinese Medicine, Beijing University of Chinese Medicine, No.11 Beisanhuandong Road, Chaoyang, Beijing, 100029, P. R. China.
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Chaabouni K, Makhlouf R, Khanfir F, Mezghani C, Elleuch A, Ben Ayed H, Abid M, Jamoussi K, Chaabene K, Mseddi MF, Ayadi FM. The anti-Müllerian hormone: A useful tool for diagnosis of Polycystic Ovary Syndrome. Ann Biol Clin (Paris) 2023; 81:410-416. [PMID: 37791507 DOI: 10.1684/abc.2023.1830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
BACKGROUND Polycystic Ovary Syndrome (PCOS) is the most frequent endocrine disorder that affects reproductive-age women with important long-term health implications. As such, the anti-Müllerian hormone (AMH) was proposed as a helpful test to identify women with PCOS. The aim of this study was to determine an AMH cut-off value for the diagnosis of PCOS. METHODS This was a two-year cross-sectional study including women of reproductive age, diagnosed with PCOS according to Rotterdam criteria (2003). The control group of healthy women was age-matched. AMH was performed using an electrochemiluminescence immunoassay. AMH levels were compared and evaluated with the receiver operating characteristic curve analysis. RESULTS A total of 130 women were enrolled in this study. Of these, 65 were diagnosed with PCOS, and 65 were healthy. No significant difference was detected in body mass index between the two groups. AMH levels were significantly higher in women with PCOS (p = < 0.001). No significant difference in AMH levels was detected between PCOS phenotypes. A cut-off of 25.1 pmol/L (3.5 ng/mL) could discriminate women with PCOS from controls with a sensitivity of 74% and specificity of 72.3%. The area under the curve was 0.811 (95% CI: 0.73-0.88). CONCLUSIONS Our study suggests that AMH had good diagnostic potential as a complement to Rotterdam criteria for PCOS diagnosis in reproductive-age women of Tunisian origin.
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Affiliation(s)
- Khansa Chaabouni
- Clinical Chemistry Laboratory, Habib Bourguiba Hospital, Ferdaous street, Sfax, 3029, Tunisia
| | - Rihab Makhlouf
- Clinical Chemistry Laboratory, Habib Bourguiba Hospital, Ferdaous street, Sfax, 3029, Tunisia
| | - Fatma Khanfir
- Department of Obstetrics and Gynecology, Hedi Chaker Hospital, Tunisia
| | - Chema Mezghani
- Clinical Chemistry Laboratory, Habib Bourguiba Hospital, Ferdaous street, Sfax, 3029, Tunisia
| | - Aida Elleuch
- Clinical Chemistry Laboratory, Habib Bourguiba Hospital, Ferdaous street, Sfax, 3029, Tunisia
| | - Houda Ben Ayed
- Preventative Medicine and Hospital Hygiene Department, Hedi Chaker Hospital, Tunisia
| | - Mohamed Abid
- Department of Endocrinology, Hedi Chaker Hospital, Tunisia
| | - Kamel Jamoussi
- Research Laboratory of Molecular Bases of Human Diseases, Faculty of Medicine of Sfax, University of Sfax, Tunisia
| | - Kais Chaabene
- Department of Obstetrics and Gynecology, Hedi Chaker Hospital, Tunisia
| | | | - Fatma Makni Ayadi
- Clinical Chemistry Laboratory, Habib Bourguiba Hospital, Ferdaous street, Sfax, 3029, Tunisia
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Jin J, Ruan X, Hua L, Mueck AO. Prevalence of diminished ovarian reserve in Chinese women with follicular cysts and menstrual disorders. Gynecol Endocrinol 2023; 39:2250004. [PMID: 37607568 DOI: 10.1080/09513590.2023.2250004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/28/2023] [Accepted: 08/14/2023] [Indexed: 08/24/2023] Open
Abstract
OBJECTIVES To assess the prevalence of diminished ovarian reserve (DOR) in Chinese women with follicular cysts and menstrual disorders and relationship to hormonal markers. METHODS 117 women with follicular cysts and menstrual disorders, aged 24 ∼ 53 (39.19 ± 6.61) years; measurements of height, weight, follicle-stimulating hormone (FSH), luteinizing hormone (LH), E2, progesterone (Po), prolactin (PRL), total testosterone, AMH, follicular cyst diameter, endometrial thickness. Three age groups were compared: 1) 21 ∼ 30 years, 2) 30 ∼ 40 years, 3) > 40 years. RESULTS Total prevalence of DOR 86.3%, in the groups 50%, 81.6%, and 98.4%, in group-3 significantly higher than in group-1 and 2. 34.2% of the 117 patients complained of cessation of regular menstruations or amenorrhea, 65.8% of abnormal uterine bleeding. Follicular cysts disappeard in cycle-1 for 98 (83.8%) and in cycle-2 for 117 (100%) patients. AMH decreased with age, significantly different between the three groups. Total testosterone in group-1 and 2 was significantly higher than in group-3. In total AMH had a negative correlation with age and E2 (p < 0.01) and positive correlation with total testosterone (p < 0.05). CONCLUSIONS Assessing ovarian reserve with follicular cysts and menstrual disorders is important because often pointing to DOR. The overall prevalence of DOR was high; even young women (<40 years) with follicular cysts and menstrual disorders had a low level of AMH. So AMH can be used as a marker to define DOR with higher sensitivity than other markers like FSH and E2. Primarily, these results only apply to Chinese women and should be confirmed in further studies.
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Affiliation(s)
- Jing Jin
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Xiangyan Ruan
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
- Department for Women's Health, University Women's Hospital and Research Centre for Women's Health, University Hospitals of Tuebingen, Tuebingen, Germany
| | - Lin Hua
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Alfred O Mueck
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, China
- Department for Women's Health, University Women's Hospital and Research Centre for Women's Health, University Hospitals of Tuebingen, Tuebingen, Germany
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Siegel DR, Fresia J, Fought A, Sheeder J, Hampanda K, Appiah L. The Effect of Hormonal Contraception Use on Ovarian Reserve Markers and the Uptake of Assisted Reproductive Technology in Individuals Seeking an Infertility Evaluation. Cureus 2023; 15:e40927. [PMID: 37496533 PMCID: PMC10368143 DOI: 10.7759/cureus.40927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2023] [Indexed: 07/28/2023] Open
Abstract
Background and objective The effects of hormonal contraception (HC) use on ovarian reserve (OR) markers in individuals seeking an infertility evaluation and the success of assisted reproductive technology (ART) warrant further investigation. Therefore, the aim of this study was to determine if women seeking an evaluation for unexplained infertility who used long-term (≥2 years) HC have lower ovarian reserve (OR) markers and higher uptake of ART compared to short-term (<2 years) or never HC users. Methods We performed a cross-sectional patient survey involving a retrospective medical chart review of patients seeking an evaluation for unexplained infertility at the University of Colorado Advanced Reproductive Medicine (CU ARM) clinic. Results Most participants (87%; 107/123) reported a history of HC use with 98 (79.7%) reporting long-term continuous use for two or more years. Median OR markers were similar between long-term and short-term/never HC users [anti-Müllerian hormone (AMH): 2.4 vs. 3.2, p=0.20; antral follicle count (AFC): 18 vs. 26, p=0.10; follicle-stimulating hormone (FSH): 7.6 vs. 6.3, p=0.26] and remained so after adjusting for age and diagnosis of polycystic ovarian syndrome (PCOS) or primary ovarian insufficiency (POI) in linear regression models. However, among HC users aged less than 30 years (n=9), those who had discontinued HC between two and three years prior to the assessment of their OR markers had a 6.20 ng/mL increase in AMH level compared to those who had discontinued HC less than two years prior to the assessment (p=0.02). Additionally, there was a marginally increased use of ART overall among long-term HC users compared to short-term/never HC users (64.3% vs. 44.0%, p=0.06), specifically in the use of in vitro fertilization (IVF) (58.7% vs. 18.2%, p=0.01). Among long-term HC users, ovulation induction was less likely to result in live birth compared to short-term/never HC users (8.9% vs. 62.5%, p<0.001); however, after adjusting for age, PCOS, POI, and type of ART used, there was no difference in the odds of live birth after ART between long-term HC users and short-term/never users. Conclusion While long-term HC users report increased use of ART, in particular IVF, the overall conception rates and live birth outcomes among ART users do not appear to be significantly affected by a history of long-term HC use.
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Affiliation(s)
- Dana R Siegel
- Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, USA
| | - Joellen Fresia
- Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, USA
| | - Angela Fought
- Biostatistics and Informatics, University of Colorado School of Medicine, Aurora, USA
| | - Jeanelle Sheeder
- Obstetrics and Gynecology/Clinical Research, University of Colorado School of Medicine, Aurora, USA
| | - Karen Hampanda
- Center for Global Health, Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, USA
| | - Leslie Appiah
- Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, USA
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Van Ommen CE, Hsieh AYY, Albert AY, Kimmel ER, Cote HCF, Maan EJ, Prior JC, Pick N, Murray MCM; CIHR Team on Cellular Aging, HIV Comorbidities in Women, Children (CARMA-Endo; CIHR CTN 277). Lower anti-Müllerian hormone levels are associated with HIV in reproductive age women and shorter leukocyte telomere length among late reproductive age women. AIDS 2023; 37:769-78. [PMID: 36726239 DOI: 10.1097/QAD.0000000000003481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES We sought to better understand factors associated with ovarian aging in women with HIV (WWH). DESIGN HIV has been associated with diminished fertility, younger age at menopause, and shorter leukocyte telomere length (LTL), a marker of cellular aging. We herein examine cross-sectional and longitudinal associations between LTL, anti-Müllerian hormone (AMH), and HIV. METHODS We included WWH and HIV-negative women 12-50 years of age in the CARMA cohort with one or more study visit(s). LTL and AMH were measured by qPCR and ELISA, respectively. Women were analyzed in peak reproductive (<35 years) vs. late reproductive (≥35 years) life phases. Using multivariable mixed-effect linear or logistic regressions, we assessed factors associated with AMH and ΔAMH/year while adjusting for relevant confounders. RESULTS WWH had shorter LTL and lower AMH levels compared to HIV-negative controls despite being of similar age. After adjusting for relevant factors, HIV was associated with 20% lower AMH levels in women under 35 years of age and shorter LTL was associated with AMH levels below 2 ng/ml among women aged 35 years or older. Longitudinally, ΔAMH/year was largely related to initial AMH level among older women, and to age in younger women. CONCLUSIONS Factors associated with AMH change across women's reproductive lifespan. Lower AMH among peak reproductive aged WWH suggests that HIV may have an initial detrimental effect on ovarian reserve, an observation that may warrant counseling around pregnancy planning. In women aged 35 years or older, the association between shorter LTL and lower AMH suggests that the immune and reproductive aging connections are more important in this age group.
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McCredie S, An B, McShane M, Ledger W, Venetis CA. Serum anti-müllerian hormone (AMH) concentration during pregnancy: a longitudinal study. Reprod Fertil 2023; 4:RAF-22-0128. [PMID: 36952428 PMCID: PMC10160537 DOI: 10.1530/raf-22-0128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/23/2023] [Indexed: 03/25/2023] Open
Abstract
A prospective longitudinal cohort study aimed to longitudinally examine the kinetics of Anti-müllerian hormone (AMH) during the first two trimesters of pregnancy. Pregnant women with stored 1st trimester serum samples were recruited at 24-28 weeks gestation during their gestational diabetes testing, where they provided an additional serum sample. The samples were analysed for AMH, oestradiol and progesterone concentrations. A decrease in serum AMH was observed in 40 out of 45 (88.9%) (95% CI 75.9% to 96.3%) of the participants in this study. The median serum AMH concentration was 10.9 pmol/L in the 1st trimester and 6.5 pmol/L during the 2nd trimester, with a significantly different distribution of the values between the 1st and the 2nd trimester AMH samples (p<0.001). The median percentage of AMH difference of -39.8%. This study demonstrated a significant decrease in serum AMH levels from the 1st to the 2nd trimester of pregnancy. The absolute decrease in AMH levels seems to be positively associated with 1st trimester AMH levels, whereas the percentage of AMH difference is not. Further studies are required to elucidate the potential physiological mechanisms of this finding.
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Affiliation(s)
- Sarah McCredie
- School of Women’s and Children’s Health, UNSW Medicine, UNSW, New South Wales, Australia
| | - Belinda An
- School of Women’s and Children’s Health, UNSW Medicine, UNSW, New South Wales, Australia
| | - Monika McShane
- Royal Hospital for Women, Randwick, New South Wales, Australia
| | - William Ledger
- School of Women’s and Children’s Health, UNSW Medicine, UNSW, New South Wales, Australia
- Royal Hospital for Women, Randwick, New South Wales, Australia
| | - Christos A Venetis
- School of Women’s and Children’s Health, UNSW Medicine, UNSW, New South Wales, Australia
- Royal Hospital for Women, Randwick, New South Wales, Australia
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Deng CY, Liu DF, Zhao LM, Lin HC, Mao JM, Zhang Z, Yang YZ, Zhang HT, Hong K, Xu HY, Jiang H. Development of a predictive model for increasing sperm retrieval success by microdissection testicular sperm extraction in patients with nonobstructive azoospermia. Asian J Androl 2023; 25:369254. [PMID: 36814170 PMCID: PMC10521962 DOI: 10.4103/aja2022111] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/15/2022] [Indexed: 02/11/2023] Open
Abstract
Microdissection testicular sperm extraction (micro-TESE) is widely used to treat nonobstructive azoospermia. However, a good prediction model is required to anticipate a successful sperm retrieval rate before performing micro-TESE. This retrospective study analyzed the clinical records of 200 nonobstructive azoospermia patients between January 2021 and December 2021. The backward method was used to perform binary logistic regression analysis and identify factors that predicted a successful micro-TESE sperm retrieval. The prediction model was constructed using acquired regression coefficients, and its predictive performance was assessed using the receiver operating characteristic curve. In all, 67 patients (sperm retrieval rate: 33.5%) underwent successful micro-TESE. Follicle-stimulating hormone, anti-Müllerian hormone, and inhibin B levels varied significantly between patients who underwent successful and unsuccessful micro-TESE. Binary logistic regression analysis yielded the following six predictors: anti-Müllerian hormone (odds ratio [OR] = 0.902, 95% confidence interval [CI]: 0.821-0.990), inhibin B (OR = 1.012, 95% CI: 1.001-1.024), Klinefelter's syndrome (OR = 0.022, 95% CI: 0.002-0.243), Y chromosome microdeletion (OR = 0.050, 95% CI: 0.005-0.504), cryptorchidism with orchiopexy (OR = 0.085, 95% CI: 0.008-0.929), and idiopathic nonobstructive azoospermia (OR = 0.031, 95% CI: 0.003-0.277). The prediction model had an area under the curve of 0.720 (95% CI: 0.645-0.794), sensitivity of 65.7%, specificity of 72.2%, Youden index of 0.379, and cut-off value of 0.305 overall, indicating good predictive value and accuracy. This model can assist clinicians and nonobstructive azoospermia patients in decision-making and avoiding negative micro-TESE results.
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Affiliation(s)
- Chen-Yao Deng
- Department of Urology, Peking University Third Hospital, Beijing 100191, China
- Department of Andrology, Peking University Third Hospital, Beijing 100191, China
| | - De-Feng Liu
- Department of Andrology, Peking University Third Hospital, Beijing 100191, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing 100191, China
| | - Lian-Ming Zhao
- Department of Urology, Peking University Third Hospital, Beijing 100191, China
- Department of Andrology, Peking University Third Hospital, Beijing 100191, China
- Department of Human Sperm Bank, Peking University Third Hospital, Beijing 100191, China
| | - Hao-Cheng Lin
- Department of Urology, Peking University Third Hospital, Beijing 100191, China
- Department of Andrology, Peking University Third Hospital, Beijing 100191, China
- Department of Human Sperm Bank, Peking University Third Hospital, Beijing 100191, China
| | - Jia-Ming Mao
- Department of Andrology, Peking University Third Hospital, Beijing 100191, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing 100191, China
| | - Zhe Zhang
- Department of Urology, Peking University Third Hospital, Beijing 100191, China
- Department of Andrology, Peking University Third Hospital, Beijing 100191, China
| | - Yu-Zhuo Yang
- Department of Andrology, Peking University Third Hospital, Beijing 100191, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing 100191, China
| | - Hai-Tao Zhang
- Department of Urology, Peking University Third Hospital, Beijing 100191, China
- Department of Andrology, Peking University Third Hospital, Beijing 100191, China
- Department of Human Sperm Bank, Peking University Third Hospital, Beijing 100191, China
| | - Kai Hong
- Department of Urology, Peking University Third Hospital, Beijing 100191, China
- Department of Andrology, Peking University Third Hospital, Beijing 100191, China
- Department of Human Sperm Bank, Peking University Third Hospital, Beijing 100191, China
| | - Hui-Yu Xu
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing 100191, China
| | - Hui Jiang
- Department of Urology, Peking University Third Hospital, Beijing 100191, China
- Department of Andrology, Peking University Third Hospital, Beijing 100191, China
- Department of Human Sperm Bank, Peking University Third Hospital, Beijing 100191, China
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Li H, Hart JE, Mahalingaiah S, Nethery RC, James P, Bertone-Johnson E, Eliassen AH, Laden F. Environmental Exposures and Anti-Müllerian Hormone: A Mixture Analysis in the Nurses' Health Study II. Epidemiology 2023; 34:150-161. [PMID: 36455251 PMCID: PMC9720700 DOI: 10.1097/ede.0000000000001547] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND Previous studies have linked environmental exposures with anti-Müllerian hormone (AMH), a marker of ovarian reserve. However, associations with multiple environment factors has to our knowledge not been addressed. METHODS We included a total of 2,447 premenopausal women in the Nurses' Health Study II (NHSII) who provided blood samples during 1996-1999. We selected environmental exposures linked previously with reproductive outcomes that had measurement data available in NHSII, including greenness, particulate matter, noise, outdoor light at night, ultraviolet radiation, and six hazardous air pollutants (1,3-butadiene, benzene, diesel particulate matter, formaldehyde, methylene chloride, and tetrachloroethylene). For these, we calculated cumulative averages from enrollment (1989) to blood draw and estimated associations with AMH in adjusted single-exposure models, principal component analysis (PCA), and hierarchical Bayesian kernel machine regression (BKMR). RESULTS Single-exposure models showed negative associations of AMH with benzene (percentage reduction in AMH per interquartile range [IQR] increase = 5.5%, 95% confidence interval [CI] = 1.0, 9.8) and formaldehyde (6.1%, 95% CI = 1.6, 10). PCA identified four major exposure patterns but only one with high exposure to air pollutants and light at night was associated with lower AMH. Hierarchical BKMR pointed to benzene, formaldehyde, and greenness and suggested an inverse joint association with AMH (percentage reduction comparing all exposures at the 75th percentile to median = 8.2%, 95% CI = 0.7, 15.1). Observed associations were mainly among women above age 40. CONCLUSIONS We found exposure to benzene and formaldehyde to be consistently associated with lower AMH levels. The associations among older women are consistent with the hypothesis that environmental exposures accelerate reproductive aging.
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Affiliation(s)
- Huichu Li
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Jaime E. Hart
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Shruthi Mahalingaiah
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Rachel C. Nethery
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Peter James
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Elizabeth Bertone-Johnson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
| | - A. Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Francine Laden
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
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12
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Muacevic A, Adler JR. Effects of Levonorgestrel-Releasing Intrauterine Device Therapy on Ovarian Reserve in Menorrhagia. Cureus 2022; 14:e31721. [PMID: 36569727 PMCID: PMC9768696 DOI: 10.7759/cureus.31721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 11/22/2022] Open
Abstract
Objective This study aimed to investigate the effects of levonorgestrel-releasing intrauterine device (LNG-IUD) treatment on ovarian reserve in women of reproductive age diagnosed with menorrhagia. Methods This was a prospective controlled trial involving 50 women with menorrhagia and a control group comprising age-matched 50 healthy women. Women who satisfied the LNG group criteria underwent an endometrial pipelle biopsy and LNG-IUD insertion. Ovarian reserve tests were performed prior to and six months after LNG-IUD insertion in the LNG group cases. Results Follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), anti-Müllerian hormone (AMH), endometrial thickness (ET), total antral follicle count (AFC), and mean ovarian volume values before LNG-IUD insertion did not differ between the LNG and control groups. When the final measurements were compared, FSH, AMH, total AFC, and average ovarian volume increased (p=0.05, 0.046, 0.022, and 0.022, respectively), E2 and ET decreased (p=0.034 and 0.001, respectively) in the LNG group, while LH did not differ significantly between the groups (p=0.71). Conclusion We observed that LNG-IUD use effectively improves fertility capacity. In this study, LNG-IUD use in reproductive-age women diagnosed with menorrhagia decreased E2 levels, did not change LH levels, and increased FSH, AFC, and AMH levels.
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13
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Davidson S, Jahnke S, Jung AM, Burgess JL, Jacobs ET, Billheimer D, Farland LV. Anti-Müllerian Hormone Levels among Female Firefighters. Int J Environ Res Public Health 2022; 19:5981. [PMID: 35627519 PMCID: PMC9141260 DOI: 10.3390/ijerph19105981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 02/04/2023]
Abstract
Female firefighters have occupational exposures which may negatively impact their reproductive health. Anti-müllerian hormone (AMH) is a clinical marker of ovarian reserve. We investigated whether AMH levels differed in female firefighters compared to non-firefighters and whether there was a dose-dependent relationship between years of firefighting and AMH levels. Female firefighters from a pre-existing cohort completed a cross-sectional survey regarding their occupational and health history and were asked to recruit a non-firefighter friend or relative. All participants provided a dried blood spot (DBS) for AMH analysis. Linear regression was used to assess the relationship between firefighting status and AMH levels. Among firefighters, the influence of firefighting-related exposures was evaluated. Firefighters (n = 106) and non-firefighters (n = 58) had similar age and BMI. Firefighters had a lower mean AMH compared to non-firefighters (2.93 ng/mL vs. 4.37 ng/mL). In multivariable adjusted models, firefighters had a 33% lower AMH value than non-firefighters (-33.38%∆ (95% CI: -54.97, -1.43)). Years of firefighting was not associated with a decrease in AMH. Firefighters in this study had lower AMH levels than non-firefighters. More research is needed to understand the mechanisms by which firefighting could reduce AMH and affect fertility.
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Affiliation(s)
- Samantha Davidson
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (S.D.); (A.M.J.); (E.T.J.); (D.B.)
| | - Sara Jahnke
- Center for Fire, Rescue & EMS Health Research, NDRI-USA, Inc., Leawood, KS 66224, USA;
| | - Alesia M. Jung
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (S.D.); (A.M.J.); (E.T.J.); (D.B.)
- Department of Community, Environment & Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA;
| | - Jefferey L. Burgess
- Department of Community, Environment & Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA;
- Cancer Prevention and Control Program, University of Arizona Cancer Center, Tucson, AZ 85719, USA
| | - Elizabeth T. Jacobs
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (S.D.); (A.M.J.); (E.T.J.); (D.B.)
- Cancer Prevention and Control Program, University of Arizona Cancer Center, Tucson, AZ 85719, USA
| | - Dean Billheimer
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (S.D.); (A.M.J.); (E.T.J.); (D.B.)
| | - Leslie V. Farland
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (S.D.); (A.M.J.); (E.T.J.); (D.B.)
- Cancer Prevention and Control Program, University of Arizona Cancer Center, Tucson, AZ 85719, USA
- Department of Obstetrics and Gynecology, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA
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14
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Yu X, Li Z, Zhao X, Hua L, Liu S, He C, Yang L, Davis JS, Liang A. Anti-Müllerian Hormone Inhibits FSH-Induced Cumulus Oocyte Complex In Vitro Maturation and Cumulus Expansion in Mice. Animals (Basel) 2022; 12:1209. [PMID: 35565634 PMCID: PMC9103408 DOI: 10.3390/ani12091209] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 01/27/2023] Open
Abstract
Anti-Müllerian hormone (AMH) is secreted by the ovaries of female animals and exerts its biological effects through the type II receptor (AMHR2). AMH regulates follicular growth by inhibiting the recruitment of primordial follicles and reducing the sensitivity of antral follicles to FSH. Despite the considerable research on the actions of AMH in granulosa cells, the effect of AMH on the in vitro maturation of oocytes remains largely unknown. In the current study, we showed that AMH is only expressed in cumulus cells, while AMHR2 is produced in both cumulus cells and oocytes. AMH had no significant effect on COCs nuclear maturation, whereas it inhibited the stimulatory effects of FSH on COCs maturation and cumulus expansion. Moreover, AMH treatment effectively inhibited the positive effect of FSH on the mRNA expressions of Hyaluronan synthase 2 (Has2), Pentraxin 3 (Ptx3), and TNF-alpha-induced protein 6 (Tnfaip 6) genes in COCs. In addition, AMH significantly decreased the FSH-stimulated progesterone production, but did not change estradiol levels. Taken together, our results suggest that AMH may inhibit the effects of FSH-induced COCs in vitro maturation and cumulus expansion. These findings increase our knowledge of the functional role of AMH in regulating folliculogenesis.
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Affiliation(s)
- Xue Yu
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China; (X.Y.); (Z.L.); (X.Z.); (L.H.); (S.L.); (C.H.); (L.Y.)
- Shandong Provincial Key Laboratory of Biophysics, Institute of Biophysics, Dezhou University, Dezhou 253023, China
| | - Zan Li
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China; (X.Y.); (Z.L.); (X.Z.); (L.H.); (S.L.); (C.H.); (L.Y.)
| | - Xinzhe Zhao
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China; (X.Y.); (Z.L.); (X.Z.); (L.H.); (S.L.); (C.H.); (L.Y.)
| | - Liping Hua
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China; (X.Y.); (Z.L.); (X.Z.); (L.H.); (S.L.); (C.H.); (L.Y.)
| | - Shuanghang Liu
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China; (X.Y.); (Z.L.); (X.Z.); (L.H.); (S.L.); (C.H.); (L.Y.)
| | - Changjiu He
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China; (X.Y.); (Z.L.); (X.Z.); (L.H.); (S.L.); (C.H.); (L.Y.)
- National Center for International Research on Animal Genetics, Breeding and Reproduction (NCIRAGBR), Wuhan 430070, China
| | - Liguo Yang
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China; (X.Y.); (Z.L.); (X.Z.); (L.H.); (S.L.); (C.H.); (L.Y.)
- National Center for International Research on Animal Genetics, Breeding and Reproduction (NCIRAGBR), Wuhan 430070, China
| | - John S. Davis
- Olson Center for Women’s Health, Department of Obstetrics and Gynecology, University of Nebraska Medical Center, Omaha, NE 68198, USA;
| | - Aixin Liang
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China; (X.Y.); (Z.L.); (X.Z.); (L.H.); (S.L.); (C.H.); (L.Y.)
- National Center for International Research on Animal Genetics, Breeding and Reproduction (NCIRAGBR), Wuhan 430070, China
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Tehrani FR, Firouzi F, Behboudi-Gandevani S. Investigating the Clinical Utility of the Anti-Mullerian Hormone Testing for the Prediction of Age at Menopause and Assessment of Functional Ovarian Reserve: A Practical Approach and Recent Updates. Aging Dis 2022; 13:458-467. [PMID: 35371603 PMCID: PMC8947835 DOI: 10.14336/ad.2021.0825] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/25/2021] [Indexed: 11/17/2022] Open
Abstract
Low ovarian reserve is a serious condition, leading to sterility in up to 10% of women in their mid-thirties. According to current knowledge, serum anti-Müllerian hormone (AMH) levels for age are the best available marker for the screening the quantity of a woman's functional ovarian reserve, better than age alone or other reproductive markers. This review summarizes recent findings, clinical utility and limitations in the application of serum AMH testing as an accurate marker for the screening of functional ovarian reserves and predicting age at menopause. AMH assessment hold promise in helping women make informed decisions about their future fertility and desired family size. However, screening of the functional ovarian reserve could be offered to all women at 26 years of age or older who seek to assess future fertility or in case of personal request, ovarian reserve screening may be considered beyond 30 years; however, it has never been advocated beyond 35 years, since it is not advisable to delay childbearing beyond this age. In this respect, an age-specific serum AMH levels lower than the 10th percentile may be used as a threshold for the identification of a low functional ovarian reserve in an individual woman. Its level should be interpreted with caution in the adolescent and young women aged below 25 years (since AMH levels peak at this age); recent users of hormonal contraceptives (since AMH levels transiently decrease until two months after discontinuation); and women with PCOS (which dramatically increases AMH levels). However, the ability of AMH levels to predict the time to menopause is promising but requires further investigation and routine AMH testing for the purposes of predicting the time to menopause is not recommended.
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Affiliation(s)
- Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Faezeh Firouzi
- Pathology Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Samira Behboudi-Gandevani
- Pathology Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Correspondence should be addressed to: Dr. Samira Behboudi-Gandevani, Faculty of Health Sciences, Nord University, Bodø, Norway.
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Abstract
Over seventy years ago it was proposed that the fetal testis produces a hormone distinct from testosterone that is required for complete male sexual development. At the time the hormone had not yet been identified but was invoked by Alfred Jost to explain why the Müllerian duct, which develops into the female reproductive tract, regresses in the male fetus. That hormone, anti-Müllerian hormone (AMH), and its specific receptor, AMHR2, have now been extensively characterized and belong to the transforming growth factor-β families of protein ligands and receptors involved in growth and differentiation. Much is now known about the downstream events set in motion after AMH engages AMHR2 at the surface of specific Müllerian duct cells and initiates a cascade of molecular interactions that ultimately terminate in the nucleus as activated transcription factors. The signals generated by the AMH signaling pathway are then integrated with signals coming from other pathways and culminate in a complex gene regulatory program that redirects cellular functions and fates and leads to Müllerian duct regression.
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Langton CR, Whitcomb BW, Purdue-Smithe AC, Sievert LL, Hankinson SE, Manson JE, Rosner BA, Bertone-Johnson ER. Association of oral contraceptives and tubal ligation with antimüllerian hormone. Menopause 2021; 29:225-230. [PMID: 34873106 PMCID: PMC8795476 DOI: 10.1097/gme.0000000000001905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Oral contraceptives (OCs) and tubal ligation are commonly used methods of contraception that may impact ovarian function. Few studies have examined the association of these factors with antimüllerian hormone (AMH), a marker of ovarian aging. METHODS We examined the association of OC use and tubal ligation with AMH in the Nurses' Health Study II prospective cohort among a subset of 1,420 premenopausal participants who provided a blood sample in 1996-1999. History of OC use and tubal ligation were reported in 1989 and updated every 2 years until blood collection. We utilized generalized linear models to assess whether mean AMH levels varied by duration of and age at first use of OCs and history, age, and type of tubal ligation. RESULTS In multivariable models adjusted for smoking, reproductive events, and other lifestyle factors, we observed a significant, inverse association between duration of OC use and mean AMH levels (P for trend = 0.036). Compared to women without a tubal ligation, AMH levels were significantly lower when the procedure included a clip, ring, or band (1.04 ng/ml vs 1.72 ng/ml, P < 0.01). AMH levels were not associated with age at first use of OCs or age at tubal ligation. CONCLUSIONS Our analysis found an association between duration of OC use and certain types of tubal ligation with mean AMH levels. Further research is warranted to confirm the long-term association of these widely used contraceptive methods with AMH.
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Affiliation(s)
- Christine R. Langton
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA 01003, USA
| | - Brian W. Whitcomb
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA 01003, USA
| | - Alexandra C. Purdue-Smithe
- Division of Women’s Health, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Lynnette L. Sievert
- Department of Anthropology, University of Massachusetts, Amherst, MA 01003, USA
| | - Susan E. Hankinson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA 01003, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - JoAnn E. Manson
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Division of Preventive Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Bernard A. Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Elizabeth R. Bertone-Johnson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA 01003, USA
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA 01003, USA
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Merlini E, Tincati C, Sacchi V, Augello M, Bono V, Cannizzo ES, Allegrini M, Gazzola L, Monforte AD, Marconi AM, Ravizza M, Marchetti G. Predictors of low ovarian reserve in cART-treated women living with HIV. Medicine (Baltimore) 2021; 100:e27157. [PMID: 34596114 PMCID: PMC8483860 DOI: 10.1097/md.0000000000027157] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 08/19/2021] [Indexed: 01/05/2023] Open
Abstract
Ovarian dysfunction and lower circulating anti-Müllerian hormone (AMH) feature women living with HIV (WLWH). Because treated human immunodeficiency virus (HIV) infection is characterized by a pro-inflammatory/oxidative phenotype resulting in residual comorbidity, we sought to investigate possible associations between plasma AMH and markers of inflammation, immune activation/senescence/exhaustion, oxidative stress as well as comorbidities in a cohort of combined anti-retroviral therapy (cART)-treated WLWH versus age-matched HIV-uninfected, healthy women.Eighty WLWH on effective cART aged 25 to 50 years and 66 age-matched healthy women were enrolled. We measured: plasma AMH, IL-6, reactive oxygen species modulator 1 (ROMO1) (ELISA); plasma tumor necrosis factor α, IL-10, soluble vascular cell adhesion molecule 1, osteopontin (Luminex); CD4/CD8 activation (CD38/CD69), apoptosis (CD95), exhaustion (PD1), maturation (CD45RA/CD45R0/CD127/CCR7), recent thymic emigrants (CD31/CD103) (flow cytometry). Mann Whitney and chi-squared tests were used. Univariate and multivariate logistic regression analyses were used to assess factors associated with low AMH (≤1 ng/mL).Compared to healthy women, WLWH were more frequently non-Caucasian, drug/alcohol abusers, with history of late menarche, lower hormonal contraceptive use, with higher gravidity and lower parity. WLWH showed significantly lower AMH (P = .004) as well as higher ROMO1 (P = .0003) and tumor necrosis factor α (P < .0001). The multivariate analyses revealed ROMO1 (adjusted odds ratio [AOR]: 1.42, P = .03) and HIV infection (AOR: 8.1, P = .0001) as independently associated with low AMH. The logistic regression model with both HIV status and ROMO1 (a marker of oxidative stress) confirmed HIV as the only predictor of low AMH (AOR: 17, P = .0003).Despite effective cART, WLWH showed lower AMH compared to age-matched peers, indicating pre-mature ovarian ageing. Both HIV and oxidative stress are independently associated with low AMH, emphasizing the impact of HIV-associated oxidative stress on reproductive aging.
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Affiliation(s)
- Esther Merlini
- Clinic of Infectious Diseases and Tropical Medicine, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
- Gilead Sciences, Milan, Italy
| | - Camilla Tincati
- Clinic of Infectious Diseases and Tropical Medicine, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Valentina Sacchi
- Clinic of Obstetrics and Gynecology, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Matteo Augello
- Clinic of Infectious Diseases and Tropical Medicine, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Valeria Bono
- Clinic of Infectious Diseases and Tropical Medicine, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Elvira Stefania Cannizzo
- Clinic of Infectious Diseases and Tropical Medicine, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Marina Allegrini
- Clinic of Infectious Diseases and Tropical Medicine, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Lidia Gazzola
- Clinic of Infectious Diseases and Tropical Medicine, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Antonella d’Arminio Monforte
- Clinic of Infectious Diseases and Tropical Medicine, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Anna Maria Marconi
- Clinic of Obstetrics and Gynecology, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Marina Ravizza
- Clinic of Obstetrics and Gynecology, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Giulia Marchetti
- Clinic of Infectious Diseases and Tropical Medicine, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
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Abstract
BACKGROUND In a previous exploratory study, we reported lower concentrations of the ovarian reserve biomarker anti-Müllerian hormone (AMH) in adulthood with prenatal farm exposure. We now examine this association as well as childhood farm exposure using enrollment data from the Sister Study, a large US cohort of women. METHODS We collected prenatal and childhood farm exposure data by questionnaire and telephone interview. However, serum AMH data were available only for a nested subset: premenopausal women ages 35-54 subsequently diagnosed with breast cancer (n = 418 cases) and their matched controls (n = 866). To avoid potential bias from restricting analyses to only premenopausal controls, we leveraged the available cohort data. We used data from both premenopausal cases and controls as well as postmenopausal women ages 35-54 (n = 3,526) (all presumed to have undetectable AMH concentrations) and applied weights to produce a sample representative of the cohort ages 35-54 (n = 17,799). The high proportion of undetectable AMH concentrations (41%) was addressed using reverse-scale Cox regression. An adjusted hazard ratio (HR) <1.0 indicates that exposed individuals had lower AMH concentrations than unexposed individuals. RESULTS Prenatal exposure to maternal residence or work on a farm was associated with lower AMH concentrations (HR 0.66; 95% confidence intervals [CI] = 0.48 to 0.90). Associations between childhood farm residence exposures and AMH were null or weak, except childhood contact with pesticide-treated livestock or buildings (HR 0.69; 95% CI = 0.40 to 1.2). CONCLUSIONS Replication of the prenatal farm exposure and lower adult AMH association raises concern that aspects of prenatal farm exposure may result in reduced adult ovarian reserve.
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Affiliation(s)
- Kristen Upson
- Department of Epidemiology and Biostatistics, College of
Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Clarice R. Weinberg
- Biostatistics & Computational Biology Branch, National
Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Hazel B. Nichols
- Department of Epidemiology, Gillings School of Global
Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Gregg E. Dinse
- Clinical and Public Health Sciences, Social &
Scientific Systems, Durham, NC, USA
| | - Aimee A. D’Aloisio
- Clinical and Public Health Sciences, Social &
Scientific Systems, Durham, NC, USA
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental
Health Sciences, Research Triangle Park, NC, USA
| | - Donna D. Baird
- Epidemiology Branch, National Institute of Environmental
Health Sciences, Research Triangle Park, NC, USA
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Shahrokhi SZ, Kazerouni F, Ghaffari F, Hadizadeh M, Zolfaghary Z. The effect of A1298c polymorphism of the MTHFR gene on anti-Müllerian hormone levels: experimental and Web-based analysis. J Clin Lab Anal 2021; 35:e23948. [PMID: 34369004 PMCID: PMC8418515 DOI: 10.1002/jcla.23948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 07/21/2021] [Accepted: 07/29/2021] [Indexed: 11/24/2022] Open
Abstract
Background The 5,10‐methylenetetrahydrofolate reductase (MTHFR) is an important enzyme of folate and methionine metabolism, which is expressed in human oocytes and preimplantation. Due to the involvement of MTHFR in female reproduction, we tend to evaluate the influence of MTHFR A1298C polymorphism on ovarian marker reserves such as serum anti‐Müllerian hormone (AMH) levels in women after in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). Methods A total of 100 women, who underwent ART treatment due to male factor infertility, were recruited into this study. MTHFR A1298C polymorphism was detected by polymerase chain reaction‐restriction fragment length polymorphism (PCR‐RFLP) technique, and serum AMH concentrations were measured by an ultrasensitive enzyme‐linked immunosorbent assay (ELISA). Results Women with the CC genotype had higher AMH levels (4.15 ± 1.67 ng/ml), albeit not significant, than carriers with other genotypes after ovarian stimulation. No significant differences existed in terms of miscarriage and live birth rates among different genotype groups. Conclusion The presence of the C mutant allele of the 1298 polymorphism in the MTHFR gene led to an increasing trend in serum AMH concentrations; however, the numbers of oocytes retrieved decreased in women with mutated genotypes. The influence of the MTHFR C677T polymorphism on embryo quality and pregnancy rate after ART cycles remains unclear.
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Affiliation(s)
- Seyedeh Zahra Shahrokhi
- Department of Laboratory Medicine, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Faranak Kazerouni
- Department of Laboratory Medicine, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Firouzeh Ghaffari
- Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Morteza Hadizadeh
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Zahra Zolfaghary
- Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
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21
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Papas M, Govaere J, Peere S, Gerits I, Van de Velde M, Angel-Velez D, De Coster T, Van Soom A, Smits K. Anti-Müllerian Hormone and OPU-ICSI Outcome in the Mare. Animals (Basel) 2021; 11:ani11072004. [PMID: 34359132 PMCID: PMC8300260 DOI: 10.3390/ani11072004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/27/2021] [Accepted: 07/02/2021] [Indexed: 11/16/2022] Open
Abstract
Anti-Müllerian hormone (AMH) reflects the population of growing follicles and has been related to mammalian fertility. In the horse, clinical application of ovum pick-up and intracytoplasmic sperm injection (OPU-ICSI) is increasing, but results depend largely on the individuality of the mare. The aim of this study was to assess AMH as a predictor for the OPU-ICSI outcome in horses. Therefore, 103 mares with a total follicle count above 10 were included in a commercial OPU-ICSI session and serum AMH was determined using ELISA. Overall, the AMH level was significantly correlated with the number of aspirated follicles and the number of recovered oocytes (p < 0.001). Mares with a high AMH level (≥2.5 µg/L) yielded significantly greater numbers of follicles (22.9 ± 1.2), oocytes (13.5 ± 0.8), and blastocysts (2.1 ± 0.4) per OPU-ICSI session compared to mares with medium (1.5-2.5 µg/L) or low AMH levels (<1.5 µg/L), but no significant differences in blastocyst rates were observed. Yet, AMH levels were variable and 58% of the mares with low AMH also produced an embryo. In conclusion, measurement of serum AMH can be used to identify mares with higher chances of producing multiple in vitro embryos, but not as an independent predictor of successful OPU-ICSI in horses.
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Affiliation(s)
- Marion Papas
- Department of Reproduction, Obstetrics and Herd Health, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium; (J.G.); (S.P.); (I.G.); (M.V.d.V.); (D.A.-V.); (T.D.C.); (A.V.S.); (K.S.)
- Correspondence:
| | - Jan Govaere
- Department of Reproduction, Obstetrics and Herd Health, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium; (J.G.); (S.P.); (I.G.); (M.V.d.V.); (D.A.-V.); (T.D.C.); (A.V.S.); (K.S.)
| | - Sofie Peere
- Department of Reproduction, Obstetrics and Herd Health, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium; (J.G.); (S.P.); (I.G.); (M.V.d.V.); (D.A.-V.); (T.D.C.); (A.V.S.); (K.S.)
| | - Ilse Gerits
- Department of Reproduction, Obstetrics and Herd Health, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium; (J.G.); (S.P.); (I.G.); (M.V.d.V.); (D.A.-V.); (T.D.C.); (A.V.S.); (K.S.)
| | - Margot Van de Velde
- Department of Reproduction, Obstetrics and Herd Health, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium; (J.G.); (S.P.); (I.G.); (M.V.d.V.); (D.A.-V.); (T.D.C.); (A.V.S.); (K.S.)
| | - Daniel Angel-Velez
- Department of Reproduction, Obstetrics and Herd Health, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium; (J.G.); (S.P.); (I.G.); (M.V.d.V.); (D.A.-V.); (T.D.C.); (A.V.S.); (K.S.)
- Research Group in Animal Sciences-INCA-CES, Universidad CES, 050021 Medellin, Colombia
| | - Tine De Coster
- Department of Reproduction, Obstetrics and Herd Health, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium; (J.G.); (S.P.); (I.G.); (M.V.d.V.); (D.A.-V.); (T.D.C.); (A.V.S.); (K.S.)
| | - Ann Van Soom
- Department of Reproduction, Obstetrics and Herd Health, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium; (J.G.); (S.P.); (I.G.); (M.V.d.V.); (D.A.-V.); (T.D.C.); (A.V.S.); (K.S.)
| | - Katrien Smits
- Department of Reproduction, Obstetrics and Herd Health, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium; (J.G.); (S.P.); (I.G.); (M.V.d.V.); (D.A.-V.); (T.D.C.); (A.V.S.); (K.S.)
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Won S, Hwang JY, Lee N, Kim M, Kim MK, Kim ML, Yun BS, Seong SJ, Jung YW. Anti-Müllerian hormone level may predict successful pregnancy after adenomyomectomy in patients with infertility due to adenomyosis. Medicine (Baltimore) 2021; 100:e26075. [PMID: 34032737 PMCID: PMC8154495 DOI: 10.1097/md.0000000000026075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 05/03/2021] [Indexed: 01/04/2023] Open
Abstract
We aimed to determine clinical factors predicting successful pregnancy by comparing pregnancy failure and success groups after adenomyomectomy. Additionally, we analyzed fertility outcomes after adenomyomectomy.The medical records of 43 patients who had undergone adenomyomectomy and received in vitro fertilization treatment from 2017 to 2020 were retrospectively reviewed. Patients were divided into pregnancy failure (n = 28) and pregnancy success (n = 15) groups. Patients' demographic factors were evaluated and compared between the groups.The age of patients was higher (39.0 [32.0-45.0] vs. 37.0 [33.0-42.0] years, P = .006) whereas the level of anti-Müllerian hormone (anti-Müllerian hormone [AMH]; 0.54 [0.01-8.54] vs. 2.91 [0.34-7.92] ng/mL, P = .002) lower in the pregnancy failure group compared to the pregnancy success group. The operative time was longer (220.0 [68.0-440.0] vs. 175.0 [65.0-305.0] min, P = .048) while the estimated blood loss higher (750 [100-2500] vs. 500 [50-2000] mL, P = .016) in the pregnancy failure group compared to the pregnancy success group. No significant difference was observed in body mass index, symptoms, cancer antigen 125, preoperative uterine volume, or type of adenomyosis. In the multivariate analysis, age and AMH were significant predictive factors for successful pregnancy.Ovarian reserve (age and AMH) and disease severity might be predictive factors for successful pregnancy in patients who have undergone adenomyomectomy. Adenomyomectomy should be considered for women desiring pregnancy and having appropriate ovarian reserve. Our results would be beneficial for patients and clinicians before deciding on adenomyomectomy. Larger prospective studies are required to confirm our findings.
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Affiliation(s)
- Seyeon Won
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University College of Medicine
| | - Ji Young Hwang
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University, Seoul, Republic of Korea
| | - Nara Lee
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University College of Medicine
| | - Miseon Kim
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University College of Medicine
| | - Mi Kyoung Kim
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University College of Medicine
| | - Mi-La Kim
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University College of Medicine
| | - Bo Seong Yun
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University College of Medicine
| | - Seok Ju Seong
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University College of Medicine
| | - Yong Wook Jung
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University College of Medicine
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Zhou SJ, Sun TC, Song LL, Yang M, Sun XP, Tian L. The status and comparison of ovarian reserve between fertile and infertile healthy Chinese women of reproductive age. Medicine (Baltimore) 2021; 100:e25361. [PMID: 33907092 PMCID: PMC8084010 DOI: 10.1097/md.0000000000025361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 11/30/2022] Open
Abstract
ABSTRACT We aimed to investigate ovarian reserve status, and explore differences in ovarian reserve between fertile and infertile healthy Chinese women of reproductive age.We recruited 442 fertile women aged 23 to 49 years (mean: 35.22 ± 4.91 years) as subjects, and 196 infertile women aged 23 to 46 years (mean: 32.34 ± 4.34 years) as controls. For all participants, a number of parameters were tested on days 2 to 4 of a spontaneous cycle, including basal serum follicle-stimulating hormone (FSH), estradiol (E2), luteinizing hormone (LH), total testosterone, anti-Müllerian hormone (AMH), ovarian response prediction index (ORPI), and antral follicle count (AFC).There were significant differences in terms of AFC, serum AMH levels, and ORPI among subject subgroups (10.58 ± 5.80; 2.533 ± 2.146 ng/mL; 1.28 ± 1.87; respectively), and among control subgroups (12.44 ± 5.69; 3.189 ± 2.551 ng/mL; 1.88 ± 2.68; respectively) (P < .01 for all). For both subjects and controls, AFC, AMH levels, and ORPI decreased gradually with increasing age, and presented with similar age-related trends; there were positive correlations between AMH and AFC (P < .001), and negative correlations between age and AFC, AMH, ORPI (P < .05 for all). There was a significant difference in age (P < .001), serum E2 (P < .01), and AMH (P < .01) levels between subjects and controls; however, when controlling for confounding factors (age, body mass index, total testosterone, and LH), we found no differences between the 2 groups with regards to the serum levels of AMH, FSH, E2, and AFC (P > .05 for all). Moreover, receiver operating characteristic curve analysis indicated that the significant variables of subjects and controls for evaluating ovarian reserve included age, AMH and ORPI, and ORPI was more valuable than other variables.A diminished ovarian reserve was one of the manifestations caused by female aging. When confounding factors were controlled for, we found no differences in ovarian reserve when compared between fertile and infertile women, and no correlation with infertility.
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Affiliation(s)
- Shan-Jie Zhou
- Reproductive Medicine Center, Department of Gynecology and Obstetrics
| | - Tie-Cheng Sun
- Reproductive Medicine Center, Department of Gynecology and Obstetrics
| | - Ling-Li Song
- Reproductive Medicine Center, Department of Gynecology and Obstetrics
| | - Ming Yang
- Department of Clinical Laboratory, Peking University International Hospital, Beijing, China
| | - Xin-Ping Sun
- Department of Clinical Laboratory, Peking University International Hospital, Beijing, China
| | - Li Tian
- Reproductive Medicine Center, Department of Gynecology and Obstetrics
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Chen J, Huang D, Zhang J, Shi L, Li J, Zhang S. The effect of laparoscopic excisional and ablative surgery on ovarian reserve in patients with endometriomas: A retrospective study. Medicine (Baltimore) 2021; 100:e24362. [PMID: 33607770 PMCID: PMC7899828 DOI: 10.1097/md.0000000000024362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 12/21/2020] [Indexed: 01/05/2023] Open
Abstract
This study investigates the effect of 2 laparoscopic methods on ovarian reserve in patients of reproductive age with endometriomas.This was a retrospective study performed at a tertiary medical center from Jan 1st to Dec 31st, 2016. Laparoscopic cystectomy (group 1, 46 patients) and laparoscopic ovarian drainage and ablation with bipolar coagulation at low power (group 2, 30 patients) were performed to treat endometriomas larger than 3 cm. Anti-Müllerian hormone was used to assess ovarian reserve before and after surgery.There were no statistically significant differences in patients' baseline clinical characteristics, endometriotic stage, operative time, and follow-up time between the groups. The mean serum anti-Müllerian hormone concentration decreased significantly from 4.25 ng/ml to 3.40 ng/ml in group 1 compared with 4.47 ng/ml to 3.95 ng/ml in group 2 (P = .04). Pregnancy rates were 71.05% in group 1 and 73.08% in group 2, with a mean follow-up of 30.40 months and 32.35 months (P > .99), respectively. Although there was no statistical significance, the recurrence rate in group 1 was lower than that in group 2 (4.35% vs 16.67%, respectively; P = .11). The mean diameter of recurrent cysts was 1.75 cm in group 1 and 1.54 cm in group 2 (P = .13).Appropriate laparoscopic electrocautery of the endometrioma wall with a bipolar instrument may be a valid alternative to traditional laparoscopic cystectomy, with less effects on ovarian reserve.
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Hu KL, Gan K, Ying Y, Zheng J, Chen R, Xue J, Wu Y, Liu Y, Zhu Y, Xing L, Zhang D. Oligo/Amenorrhea Is an Independent Risk Factor Associated With Low Ovarian Response. Front Endocrinol (Lausanne) 2021; 12:612042. [PMID: 34177795 PMCID: PMC8220146 DOI: 10.3389/fendo.2021.612042] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 05/11/2021] [Indexed: 12/04/2022] Open
Abstract
CAPSULE Oligo/amenorrhea is an independent risk factor of low ovarian response but not high ovarian response, particularly in women with low AMH levels. OBJECTIVE To investigate the association of menstrual cycle length (MCL) with anti-Müllerian hormone (AMH) and ovarian response. METHODS This was a retrospective cohort study. A total of 7471 women who underwent ovarian stimulation and oocyte retrieval were enrolled. The main outcome was the number of oocytes retrieved. MAIN RESULTS A total of 5734 patients were eligible for analysis. In women without polycystic ovary syndrome (PCOS), serum AMH levels and antral follicle count were significantly lower in women with short cycles and higher in women with oligo/amenorrhea than those with a normal menstrual cycle. In women with PCOS, compared to women with a normal menstrual cycle, women with short cycles and women with oligo/amenorrhea showed higher antral follicle count and higher serum AMH levels. Compared with the 0-25th range group of AMH levels, 75-100th percentile groups showed a significantly increased rate of oligo/amenorrhea in women with and without PCOS [adjusted odds ratio (OR) =1.9 (1.04, 3.46), 2.4 (1.70, 3.35)]. In women without PCOS, the low ovarian response was more common in women with short cycles and less common in women with oligo/amenorrhea compared to women with normal cycles [OR=3.0 (2.38, 3.78), 0.7 (0.55, 0.96), respectively]. When adjusted for AMH levels, both short cycles and oligo/amenorrhea were associated with an increased risk of low response [adjusted OR=1.3 (1.02, 1.75), 1.3 (0.93, 1.86), respectively]. In women without PCOS and with low AMH levels, the low ovarian response was more common in women with short cycles as well as in women with oligo/amenorrhea [OR=1.5 (1.08, 1.98), 1.7 (1.08, 2.69), adjusted OR=1.2 (0.86, 1.74), 2.2 (1.31, 3.82), respectively]. CONCLUSION AMH levels are significantly associated with increased risk of oligo/amenorrhea in women with and without PCOS. AMH is an indispensable confounder in the association between MCL and ovarian response in women without PCOS. Oligo/amenorrhea is an independent risk factor associated with a low ovarian response in women without PCOS, particularly those with low AMH levels.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Dan Zhang
- *Correspondence: Dan Zhang, ; orcid.org/0000-0003-1295-4795
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Huang SJ, Purevsuren L, Jin F, Zhang YP, Liang CY, Zhu MQ, Wang F, Jia CL, Wei ZH. Effect of anti-müllerian hormone on the development and selection of ovarian follicle in hens. Poult Sci 2021; 100:100959. [PMID: 33518314 DOI: 10.1016/j.psj.2020.12.056] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 11/10/2020] [Accepted: 12/01/2020] [Indexed: 11/24/2022] Open
Abstract
To elucidate the role of anti-müllerian hormone (AMH) in regulating the development of ovarian follicles in laying hens, the expressions of follicle-stimulating hormone receptor (FSHR), AMH receptor type 2 (AMHR2), steroidogenic-related genes steroidogenic acute regulatory protein (STAR), cytochrome P450 side-chain cleavage (CYP11A1), and 3β-hydroxysteroid dehydrogenase (HSD3B1) genes were measured from different sized follicles and granulosa cells. The results showed that the expressions of FSHR and AMHR2 genes were higher in small follicles and decreased after follicular selection. Oppositely, the expressions of STAR, CYP11A1, and HSD3B1 were significantly increased after follicular selection. It indicated that AMHR2 might mediate AMH suppression in the stimulating effects of follicle-stimulating hormone (FSH) on steroidogenic-related genes expression. To make sure the effects of AMH in this process, a total of 40 hens were treated (negative control, sham operation, 150 ng AMH/d or 300 ng AMH/d) for 25 d. We analyzed ovarian morphology, progesterone concentration in blood plasma, and the expressions of steroidogenic genes in ovaries and follicles. The AMH300 group had significantly lower weight of ovary and hierarchical follicles. Egg weight and ovary weight in AMH150 group were higher than those of sham operation and AMH300 groups, so did hierarchical follicles weight. The steroidogenic genes expressions showed an increase in ovarian tissue and the largest follicle of AMH150 and AMH300 groups. However, progesterone level in the blood was reduced by AMH injection with different concentrations. To further verify the above results, granulosa cells from 6 to 8 mm follicles were cultured with AMH (0, 5, 10, 20, 40, or 80 ng/mL). The results revealed that excessive AMH (80 ng/mL) exerted an inhibitory effect on progesterone synthesis and the expressions of STAR, CYP11A1, and HSD3B1. However, these genes expressions showed a significant increase in 20 ng/mL AMH-treated group. In summary, AMH inhibited the development of prehierarchical follicles in laying hens. The effects of AMH treatment with different concentrations on follicle development showed the follicle was selected by changing FSH responsiveness of prehierarchical follicles.
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Kim J, You S. After cyclophosphamide exposure, granulosa cells recover their anti-müllerian hormone-producing ability but not their numbers. Cytometry A 2020; 99:807-813. [PMID: 33342073 PMCID: PMC8451832 DOI: 10.1002/cyto.a.24297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/07/2020] [Accepted: 12/16/2020] [Indexed: 12/13/2022]
Abstract
Anti‐müllerian hormone (AMH) produced by granulosa cells (GCs), reserves the ovarian follicle pool for future recruitment and ovulation. However, women who have undergone cyclophosphamide (Cy) treatment have decreased AMH levels due to damaged GCs. This study establishes flow cytometry protocols for identification of GCs and investigates the cause of the Cy‐induced AMH decrease by analyzing the number of GCs and their AMH production at the single cell level. Over 2 weeks, C57BL/6 mice were intraperitoneally injected 6 times with 100 mg/kg Cy and sacrificed either immediately or 4 weeks after Cy treatment. Twenty‐four hours post‐Cy exposure, a decrease in serum AMH levels was seen due to a reduction in the number of follicle‐stimulating hormone receptor (FSHR)+AMH+ GCs and their ability to produce AMH. However, 4 weeks after Cy treatment, serum AMH levels were still decreased due to the decreased number of FSHR+AMH+ GCs, however, their AMH‐producing ability was unaltered. Consistently, in vitro, Cy‐induced low AMH production in FSHR+AMH+ hGL5 cells (immortalized human GCs) was restored 24 h after Cy treatment, although their numbers remained decreased. Thus, the surviving GCs after Cy exposure had intact AMH‐producing ability. In future, an effort to minimize GC death by Cy treatment is required, while maintaining its therapeutic effects.
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Affiliation(s)
- Jihyun Kim
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Sooseong You
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Korea
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Zhou SJ, Zhao MJ, Li C, Su X. The comparison of evaluative effectiveness between antral follicle count/age ratio and ovarian response prediction index for the ovarian reserve and response functions in infertile women. Medicine (Baltimore) 2020; 99:e21979. [PMID: 32899038 PMCID: PMC7478524 DOI: 10.1097/md.0000000000021979] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Aim of the present study was to explore the evaluative effectiveness of age, ovarian volume (OV), antral follicle count (AFC), serum follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH), AFC/Age ratio, AMH/Age ratio, FSH/luteinizing hormone (LH) ratio, and ovarian response prediction index (ORPI) to determine which could more advantageously assess ovarian reserve and response.This research enrolled 319 consecutive infertile women who had undergone in vitro fertilization-ET/intracytoplasmic sperm injection (IVF-ET/ICSI) treatments. Abovementioned variables were measured and calculated. Receiver operating characteristic (ROC) curve analysis was used to analyze the predictive accuracy of variables and to calculate cut-off values and corresponding sensitivity and specificity.Our study revealed that the significant variables for evaluating a decline in ovarian reserve include age, OV, FSH, AFC/Age ratio, AMH/Age ratio, and ORPI. Moreover, the area under the curve (AUC) of AFC/Age ratio was higher than other 5 variables (AUC = 1.000), and the cut-off value of AFC/Age ratio was 0.111 (sensitivity 100.00%, specificity 100.00%). The significant variables forecasting excessive ovarian response were age, AFC, AMH, FSH, AFC/Age ratio, AMH/Age ratio, FSH/LH ratio, and ORPI, and the significant variables forecasting poor ovarian response were AMH, LH, OV, AFC/Age ratio, AMH/Age ratio, and FSH/LH ratio. When ORPI was used to predict excessive response, the cut-off value of ORPI was 0.880 (sensitivity 84.72%, specificity 67.32%) and ORPI presented better effectiveness. When used to predict poor response, the evaluative effectiveness of 6 variables was almost similar, although the AUC of AFC/Age ratio presented the largest value.Regarding the infertile women, AFC/Age ratio performed better than did the other variables in evaluating ovarian reserve, and it offered excellent effectiveness in predicting poor ovarian response, however, ORPI presented better effectiveness in predicting excessive ovarian response.
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Affiliation(s)
- Shan-Jie Zhou
- Reproductive Medicine Center, Department of Gynecology and Obstetrics, Peking University International Hospital, Beijing
| | - Ming-Jia Zhao
- Department of Reproduction and Genetics, Tangshan Maternity and Child Healthcare Hospital, Tangshan, China
| | - Cui Li
- Department of Reproduction and Genetics, Tangshan Maternity and Child Healthcare Hospital, Tangshan, China
| | - Xing Su
- Department of Reproduction and Genetics, Tangshan Maternity and Child Healthcare Hospital, Tangshan, China
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Kadiroğulları P, Demir E, Bahat PY, Kıyak H, Seckin KD. Evaluation of relationship between HbA1c levels and ovarian reserve in patients with type 1 diabetes mellitus. Gynecol Endocrinol 2020; 36:426-430. [PMID: 31909635 DOI: 10.1080/09513590.2019.1708893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
In organ or non-organ-specific autoimmune disorders, human ovary is usually the target of the autoimmune attack. We aimed to demonstrate the correlation between ovarian reserve and DM1, based on the view that women with type-1 diabetes mellitus (DM1) will have lower AMH levels secondary to poor glycemic control and autoimmune attacks. Ovarian functions of 42 patients diagnosed with DM1 who use insulin and 65 healthy volunteers were analyzed. Basal hormone and AMH levels were measured during the follicular phase. Fasting and postprandial blood glucose concentrations, HbA1c and C-peptide levels were evaluated. The mean antral follicle count (AFC) was significantly lower in DM1 patients than in healthy controls (p = .001). The AMH levels were lower in women with DM1 than in the controls (p = .001). The HbA1c values of DM1 patients, who formed the study group, was significantly higher than the control group. Ovarian reserve that is evaluated with serum AMH level is affected by poor glycemic control in type 1 diabetes. Due to the time of the autoimmune damage in the ovaries and the observable effects of this damage, more comprehensive and longer-term studies are needed to be conducted for the follow-up of reproductive abnormalities.
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Affiliation(s)
- Pınar Kadiroğulları
- Department of Obstetrics and Gynecology, Istanbul Health Sciences University, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
| | - Esra Demir
- Department of Internal Medicine, Istanbul Health Sciences University, Kanuni Sultan Süleyman Research and Training Hospital, Istanbul, Turkey
| | - Pinar Yalcin Bahat
- Department of Obstetrics and Gynecology, Istanbul Health Sciences University, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
| | - Huseyin Kıyak
- Department of Obstetrics and Gynecology, Istanbul Health Sciences University, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
| | - Kerem Doga Seckin
- Department of Obstetrics and Gynecology, Istanbul Health Sciences University, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
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Dewailly D, Barbotin AL, Dumont A, Catteau-Jonard S, Robin G. Role of Anti-Müllerian Hormone in the Pathogenesis of Polycystic Ovary Syndrome. Front Endocrinol (Lausanne) 2020; 11:641. [PMID: 33013710 PMCID: PMC7509053 DOI: 10.3389/fendo.2020.00641] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 08/06/2020] [Indexed: 01/10/2023] Open
Abstract
Besides its interest for diagnosis, the finding of an elevated serum AMH level in PCOS has open major pathophysiological issues. This review addresses the three most important issues: 1- the role of AMH in the disturbed folliculogenesis of PCOS; 2- the role of AMH in the gonadotropin dysregulation of PCOS and 3- the role of AMH in the trans-generational transmission of PCOS. For each of those issues, the clinical and experimental evidences currently available are discussed and pathophysiological hypothesis are proposed.
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Affiliation(s)
- Didier Dewailly
- Inserm, Laboratory of Development and Plasticity of the Neuroendocrine Brain, Jean-Pierre Aubert Research Centre, Lille, France
- *Correspondence: Didier Dewailly
| | - Anne-Laure Barbotin
- Inserm, Laboratory of Development and Plasticity of the Neuroendocrine Brain, Jean-Pierre Aubert Research Centre, Lille, France
- CHU Lille, Institut de Biologie de la Reproduction-Spermiologie-CECOS, Hôpital Jeanne de Flandre, Lille, France
| | - Agathe Dumont
- CHU Lille, Unité Fonctionnelle de Gynécologie Endocrinienne, Service de Gynécologie Médicale, Orthogénie et Sexologie, Hôpital Jeanne de Flandre, Lille, France
- CHU Lille, Service d'Assistance Médicale à la Procréation et Préservation de la Fertilité, Hôpital Jeanne de Flandre, Lille, France
| | - Sophie Catteau-Jonard
- Inserm, Laboratory of Development and Plasticity of the Neuroendocrine Brain, Jean-Pierre Aubert Research Centre, Lille, France
- CHU Lille, Unité Fonctionnelle de Gynécologie Endocrinienne, Service de Gynécologie Médicale, Orthogénie et Sexologie, Hôpital Jeanne de Flandre, Lille, France
| | - Geoffroy Robin
- CHU Lille, Unité Fonctionnelle de Gynécologie Endocrinienne, Service de Gynécologie Médicale, Orthogénie et Sexologie, Hôpital Jeanne de Flandre, Lille, France
- CHU Lille, Service d'Assistance Médicale à la Procréation et Préservation de la Fertilité, Hôpital Jeanne de Flandre, Lille, France
- Lille University, EA 4308 “Gametogenesis and Gamete Quality”, Lille, France
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Abstract
Puberty is a defining phase of human development where growth ends and the ability to reproduce begins. An understanding of the events leading up to puberty highlights the fact that this is the culmination of a process of skeletal and gonadal activity that has been ongoing since conception. Although there is natural variation in the timing of events in and around puberty the basic underlying processes are common to all healthy human beings. This chapter is intended to outline the mechanisms underlying normal growth and development before and during puberty. By understanding normality the pathological processes that give rise to abnormalities of pubertal development can be understood more easily.
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Affiliation(s)
- Claire L Wood
- Institute of Genetic Medicine, Newcastle University, Central Parkway, Newcastle Upon Tyne, NE1 3BZ, UK; Great North Children's Hospital, Royal Victoria Infirmary, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP, UK.
| | - Laura C Lane
- Institute of Genetic Medicine, Newcastle University, Central Parkway, Newcastle Upon Tyne, NE1 3BZ, UK; Great North Children's Hospital, Royal Victoria Infirmary, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP, UK.
| | - Tim Cheetham
- Institute of Genetic Medicine, Newcastle University, Central Parkway, Newcastle Upon Tyne, NE1 3BZ, UK; Great North Children's Hospital, Royal Victoria Infirmary, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP, UK.
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Gemici A, Şükür YE, Tülek F, Taşkın S, Atabekoğlu CS. Post-partum tubal ligation at time of cesarean delivery or via laparoscopy as an interval sterilization has similar effects on ovarian reserve. J Turk Ger Gynecol Assoc 2018; 21:24-28. [PMID: 30362334 PMCID: PMC7075397 DOI: 10.4274/jtgga.galenos.2018.2018.0087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: To observe and compare the effect of postpartum tubal ligation (TL) procedures on ovarian reserve at women desiring TL as a contraceptive method at the end of pregnancy. Material and Methods: Eighty-one women were included in the prospective study. TL was performed at the time of cesarean delivery (CD) (n=49) and as an interval procedure by laparoscopy (LS) in the postpartum period (n=32). Anti-müllerian hormone (AMH) was used to determine ovarian reserve. Blood samples were taken twice from each subject; the first sample was taken before delivery from all subjects and the second sample was taken 4 months after sterilization. AMH level differences were compared in each group and between groups. Results: The preoperative AMH values of CD and LS groups were similar 2.30 (maximum: 5.20, minimum: 0.42) ng/mL and 1.80 (maximum: 3.50, minimum: 0.40) ng/mL, respectively (p=0.262). The postoperative AMH values of the CD and LS groups were 1.30 (maximum: 2.60, minimum: 0.30) ng/mL and 0.90 (maximum: 2.50, minimum: 0.20) ng/mL, respectively (p=0.284). When the preoperative and postoperative values of each group were compared the change was statistically significant for both groups p<0.001. The decrease in mean AMH values in the CD and LS groups were 37.83% and 44.15%, respectively. The percentage changes of AMH values were not statistically significant (p=0.286). Conclusion: TL at the time of CD and interval sterilization with LS have similar effects on ovarian reserve.
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Affiliation(s)
- Ali Gemici
- Ankara University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Yavuz Emre Şükür
- Ankara University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Fırat Tülek
- Ankara University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Salih Taşkın
- Ankara University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Cem Somer Atabekoğlu
- Ankara University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
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Purdue-Smithe AC, Whitcomb BW, Manson JE, Hankinson SE, Troy LM, Rosner BA, Bertone-Johnson ER. Vitamin D Status Is Not Associated with Risk of Early Menopause. J Nutr 2018; 148:1445-1452. [PMID: 30107585 PMCID: PMC6454521 DOI: 10.1093/jn/nxy129] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 05/31/2018] [Indexed: 12/31/2022] Open
Abstract
Background Early natural menopause, the cessation of ovarian function before age 45 y, is positively associated with cardiovascular disease and other conditions. Dietary vitamin D intake has been inversely associated with early menopause; however, no previous studies have evaluated risk with regard to plasma 25-hydroxyvitamin D [25(OH)D] concentrations. Objective We prospectively evaluated associations of total and free 25(OH)D and vitamin D-binding protein (VDBP) concentrations and the risk of early menopause in a case-control study nested within the Nurses' Health Study II (NHS2). We also considered associations of 25(OH)D and VDBP with anti-Müllerian hormone (AMH) concentrations. Methods The NHS2 is a prospective study in 116,430 nurses, aged 25-42 y at baseline (1989). Premenopausal plasma blood samples were collected between 1996 and 1999, from which total 25(OH)D and VDBP concentrations were measured and free 25(OH)D concentrations were calculated. Cases experienced menopause between blood collection and age 45 y (n = 328) and were matched 1:1 by age and other factors to controls who experienced menopause after age 48 y (n = 328). Conditional logistic regression models were used to estimate ORs and 95% CIs for early menopause according to each biomarker. Generalized linear models were used to estimate AMH geometric means according to each biomarker. Results After adjusting for smoking and other factors, total and free 25(OH)D were not associated with early menopause. Quartile 4 compared with quartile 1 ORs were 1.04 (95% CI: 0.60, 1.81) for total 25(OH)D and 0.70 (95% CI: 0.41, 1.20) for free 25(OH)D. 25(OH)D was unrelated to AMH concentrations. VDBP was positively associated with early menopause; the OR comparing the highest with the lowest quartile of VDBP was 1.80 (95% CI: 1.09, 2.98). Conclusions Our findings suggest that total and free 25(OH)D are not importantly related to the risk of early menopause. VDBP may be associated with increased risk, but replication is warranted.
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Affiliation(s)
| | | | - JoAnn E Manson
- Channing Division of Network Medicine,Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA,Departments of Epidemiology
| | - Susan E Hankinson
- Departments of Biostatistics and Epidemiology,Channing Division of Network Medicine,Departments of Epidemiology
| | - Lisa M Troy
- Nutrition, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Amherst, MA
| | - Bernard A Rosner
- Biostatistics, Harvard TH Chan School of Public Health, Boston, MA
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Sun S, Chen H, Zheng X, Ma C, Yue R. Analysis on the level of IL-6, IL-21, AMH in patients with auto-immunity premature ovarian failure and study of correlation. Exp Ther Med 2018; 16:3395-3398. [PMID: 30233686 PMCID: PMC6143894 DOI: 10.3892/etm.2018.6592] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 07/31/2018] [Indexed: 11/06/2022] Open
Abstract
Expression of interleukin-6 (IL-6), interleukin-21 (IL-21) and anti-müllerian hormone (AMH) in premature ovarian failure (POF) patients were observed to explore the correlation of each indicator and its significance in POF. One hundred and forty-two patients diagnosed with POF in Binzhou City Center Hospital from June 2014 to December 2015 were selected as the observation group. At the same time, another 140 healthy women were selected as the control group. The serum levels of IL-6, IL-2l, AMH, follicle stimulating hormone (FSH) and luteinizing hormone (LH), estradiol (E2), testosterone (T) and basal antral follicle count (AFC), and mean ovarian volume (MOV) were determined and compared; correlation analysis of IL-6, IL-2l and AMH with other indicators was performed. Compared to the control group, the serum levels of IL-6, IL-21, FSH and LH in the observation group were significantly higher (P<0.05), while E2, T, AMH levels in the serum, AFC and MOV were significantly lower (P<0.05). Spearman's correlation analysis showed that IL-6, IL-21 was positively correlated with FSH and LH (P<0.05), but negatively correlated with E2, T and MOV (P<0.05). AMH was negatively correlated with FSH and LH, but positively correlated with E2, T and MOV. Our results showed that the expression of IL-6, IL-21 and AMH were related to the occurrence and development of POF, IL-6, IL-21 and AMH can be used as the primary screening indexes for POF patients.
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Affiliation(s)
- Shulan Sun
- Department of Gynaecology, Binzhou City Center Hospital, Binzhou, Shandong 251700, P.R. China
| | - Hong Chen
- Department of Gynaecology, Binzhou City Center Hospital, Binzhou, Shandong 251700, P.R. China
| | - Xiaoxia Zheng
- Department of Gynaecology, Binzhou City Center Hospital, Binzhou, Shandong 251700, P.R. China
| | - Chuanyan Ma
- Department of Obstetrics, Binzhou City Center Hospital, Binzhou, Shandong 251700, P.R. China
| | - Ruiqin Yue
- Department of Gynaecology, The Second People's Hospital of Liaocheng, Linqing, Shandong 252600, P.R. China
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Lee H, Choi TY, Shim EH, Choi J, Joo JK, Joo BS, Lee MS, Choi JY, Ha KT, You S, Lee KS. A randomized, open phase IV exploratory clinical trial to evaluate the efficacy and safety of acupuncture on the outcome of induction of ovulation in women with poor ovarian response: A study protocol for a randomized controlled trial. Medicine (Baltimore) 2018; 97:e11813. [PMID: 30142768 PMCID: PMC6113045 DOI: 10.1097/md.0000000000011813] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Women with infertility who have a poor ovarian responder (POR), characterized by a low number of retrieved oocytes after ovulation induction, often have a significantly reduced pregnancy rate after in vitro fertilization-embryo transfer (IVF-ET), due to the few transferred embryos. Acupuncture is a form of Korean Traditional Medicine. It involves the insertion of a microscopic needle at a specific point in the body, known as an acupuncture point or an acupoint. In this study, our purpose is to investigate how acupuncture affects the retrieval of mature oocytes after ovulation induction in patients with POR. METHODS AND ANALYSIS This study will be a randomized clinical trial comprising an IVF-ET trial and an IVF-ET trial after acupuncture. Seventy patients will by enrolled and randomly assigned to either of the 2 groups. The study subjects will be required to be diagnosed as having POR. Participants will be divided into 2 groups: IVF-ET single treatment group, and acupuncture and IVF-ET combined treatment group. The study subjects will be required to participate in a 15-week trial involving 16 acupuncture treatments over a period of approximately 2 months before ovulation induction for oocyte retrieval. The primary assessment of all participants will be comparing the number of oocytes. RESULT This treatment will be a therapeutic model for POR. DISCUSSION Our results will provide patients with POR as well as complementary and alternative medicine professionals, such as Korean medicine doctors, about the potential role of acupuncture in the treatment of POR. This will improve the quality of life in women with infertility and provide an important treatment option for patients with POR. Further studies can be performed to determine the optimal treatment for POR.
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Affiliation(s)
- Hoyoung Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon
| | - Tae-Young Choi
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon
| | - Eun Hyoung Shim
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon
| | - Jiae Choi
- Integrative Health Promotion Team, Korea Health Promotion Institute, Jung-gu, Seoul
| | - Jong Kil Joo
- Department of Obstetrics and Gynecology, Pusan National University, Seo-gu, Busan
| | - Bo Sun Joo
- Infertility Institute, Pohang Women's Hospital, Pohang-si, Gyenonsangbuk-do
| | - Myeong Soo Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon
| | - Jun-Yong Choi
- Department of Internal Medicine, Korean Medicine Hospital of Pusan National University, Yangsan, Gyeongsangnam
| | - Ki-Tae Ha
- Department of Korean Medical Science, School of Korean Medicine and Korean Medical Research Center for Healthy Aging, Pusan National University, Yangsan, Gyeongsangnam, Republic of Korea
| | - Sooseong You
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon
| | - Kyu Sup Lee
- Department of Obstetrics and Gynecology, Pusan National University, Seo-gu, Busan
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Sathyapalan T, Al-Qaissi A, Kilpatrick ES, Dargham SR, Atkin SL. Anti-Müllerian hormone measurement for the diagnosis of polycystic ovary syndrome. Clin Endocrinol (Oxf) 2018; 88:258-262. [PMID: 29144548 DOI: 10.1111/cen.13517] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 10/11/2017] [Accepted: 11/09/2017] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Anti-Müllerian hormone (AMH) is derived from the small antral follicles, and an elevated level has been suggested to add value to the Rotterdam criteria for the diagnosis of PCOS in cases of diagnostic uncertainty. Therefore, the role of AMH in the classical phenotype of PCOS was defined within a Caucasian population. DESIGN This was a cross-sectional study. PATIENTS Sixty Five women without PCOS and 110 women with PCOS fulfilling all 3 diagnostic Rotterdam criteria. MEASUREMENTS The main outcomes were the utility of serum AMH for the diagnosis of PCOS and its relationship to the metabolic parameters. RESULTS Anti-Müllerian hormone was increased in PCOS compared to controls (P < .001). Areas under the receiver operator curve showed AMH to be predictive of PCOS (0.76) using a cut-off AMH of 46 pmol/L, which is derived from the 95th percentile of the controls that gave a 41% sensitivity and 86% specificity; an AMH cut-off of 35 pmol/L gave a 55% sensitivity and 79% specificity. Age- and BMI-adjusted multiple logistic regression showed that AMH was more predictive of PCOS independently of either serum testosterone (T) (OR = 4.04; 95% CI 1.42-11.11; P = .007) or free androgen index (FAI) (OR = 3.90; 95% CI 1.40-10.83; P = .009). CONCLUSION Whilst an elevated AMH has poor sensitivity, it is fourfold more likely to be associated with a diagnosis of PCOS, and supplementary to biochemical parameters will make a positive diagnosis of PCOS in 22% of patients when neither serum testosterone nor FAI is elevated.
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Affiliation(s)
| | - Ahmed Al-Qaissi
- Department of Diabetes and Endocrinology, University of Hull, Hull, UK
| | | | - Soha R Dargham
- Infectious Disease Epidemiology Group, Weill Cornell Medicine, Doha, Qatar
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Sarkar M, Dodge JL, Greenblatt RM, Kuniholm MH, DeHovitz J, Plankey M, Kovacs A, French AL, Seaberg EC, Ofotokun I, Fischl M, Overton E, Kelly E, Bacchetti P, Peters MG. Reproductive Aging and Hepatic Fibrosis Progression in Human Immunodeficiency Virus/Hepatitis C Virus-Coinfected Women. Clin Infect Dis 2017; 65:1695-1702. [PMID: 29020239 PMCID: PMC5850524 DOI: 10.1093/cid/cix643] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 07/24/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Severity of hepatic fibrosis is greater in postmenopausal than in premenopausal women, perhaps owing to protective effects of estrogens. However, prior studies of estrogen and liver fibrosis lack serial fibrosis measures, adjustment for age, or longitudinal observations in coinfected populations. METHODS In a longitudinal cohort of women coinfected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV), we assessed fibrosis progression across reproductive age, using validated serum fibrosis markers, aminotransferase platelet ratio index (APRI) and fibrosis 4 (FIB-4). Fibrosis rate was evaluated within each woman as she transitioned from pre- to postmenopause, defined by a biomarker of ovarian function. RESULTS The median follow-up (n = 405) was 9.1 years (interquartile range, 5.0-15.2 years), with a median menopausal age of 49 years (47-52 years). When fully controlled for chronologic aging, the fibrosis progression rate was accelerated during perimenopause, as shown using FIB-4 (0.12 units per year faster than during premenopause; 95% confidence interval [CI], .02-.21; P = .01) and APRI (0.05 units per year faster; -.002 to .09; P = .06). Accelerated fibrosis was also observed during postmenopause compared with premenopause, for FIB-4 (0.14 units per year faster; 95% CI, -.01 to .29; P = .07) and APRI (0.07 units per year faster; -.003 to .15; P = .06). Accelerated fibrosis in perimenopause persisted after adjustment for Hispanic ethnicity, antiretroviral use, and alcohol (0.10 FIB-4 units per year faster than during premenopause; 95% CI, .008-.20; P = .03). CONCLUSIONS In HIV/HCV-coinfected women, hepatic fibrosis accelerates with reproductive aging. Accelerated fibrosis begins in perimenopause, highlighting a previously unrecognized group of women at increased risk for advanced fibrosis and associated complications. Longitudinal analyses of fibrosis rates across reproductive age should be conducted in non-HCV-related liver diseases, given potential implications in a broader spectrum of women.
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Affiliation(s)
| | | | - Ruth M Greenblatt
- Department of Pharmacy, University of California, San Francisco (UCSF)
| | - Mark H Kuniholm
- Department of Epidemiology & Biostatistics, University at Albany, State University of New York
| | - Jack DeHovitz
- Division of Infectious Diseases, SUNY Downstate, Brooklyn, New York
| | - Michael Plankey
- Division of Infectious Diseases, Georgetown University, Washington D.C
| | - Andrea Kovacs
- Division of Infectious Diseases, University of Southern California, Los Angeles
| | - Audrey L French
- Division of Infectious Diseases, Cook County Hospital, Chicago, Illinois
| | - Eric C Seaberg
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Igho Ofotokun
- Division of Infectious Diseases, Emory University, Atlanta, Georgia
| | - Margaret Fischl
- Division of Infectious Diseases, University of Miami, Florida
| | - Edgar Overton
- Infectious Diseases, University of Alabama, Birmingham
| | - Erin Kelly
- Division of GI/Hepatology, University of Ottawa, Ontario, Canada
| | - Peter Bacchetti
- Department of Epidemiology & Biostatistics, University of California, San Francisco (UCSF)
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Zheng H, Chen S, Du H, Ling J, Wu Y, Liu H, Liu J. Ovarian response prediction in controlled ovarian stimulation for IVF using anti-Müllerian hormone in Chinese women: A retrospective cohort study. Medicine (Baltimore) 2017; 96:e6495. [PMID: 28353597 PMCID: PMC5380281 DOI: 10.1097/md.0000000000006495] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The predictive value of anti-Müllerian hormone (AMH) in Chinese women undergoing in vitro fertilization (IVF) treatment is data deficient. To determine the attributes of AMH in IVF, oocyte yield, cycle cancellation, and pregnancy outcomes were analyzed. All patients initiating their first IVF cycle with gonadotropin-releasing hormone agonist treatment in our center from October 2013 through December 2014 were included, except patients diagnosed with polycystic ovarian syndrome. Serum samples collected prior to IVF treatment were used to determine serum AMH levels. A total of 4017 continuous cycles were analyzed. The AMH level was positively correlated with the number of oocytes retrieved. Overall, AMH was significantly correlated with risk of cycle cancellation, poor ovarian response (POR, 3, or fewer oocytes retrieved) and high response (>15 oocytes), with an area under the curve (AUC) of 0.83, 0.89, and 0.82 respectively. An AMH cutoff of 0.6 ng/mL had a sensitivity of 54.0% and a specificity of 90.0% for the prediction of cycle cancellation, and cutoff of 0.8 ng/mL with a sensitivity of 55.0% and a specificity of 94.0% for the prediction of POR. Compared with AMH >2.0 ng/mL, patients with AMH < 0.6 ng/mL had a 53.6-fold increased risk of cancellation (P < 0.001), and AMH <0.80 ng/mL were 17.5 times more likely to experience POR (P < 0.001). However, AMH was less predictive of pregnancy and live birth, with AUCs of 0.55 and 0.53, respectively. Clinical pregnancy rate, ongoing pregnancy rate, and live birth rate per retrieval according to the AMH level (≤0.40, 0.41-0.60, 0.61-0.80, 0.81-1.00, 1.01-1.50, 1.51-2.00, and >2.00 ng/mL) showed no significant differences. Even with AMH≤0.4 ng/mL, 50.0% of all the patients achieved pregnancy and 34.8% of patients achieved live birth after transfer. Our results suggested that AMH is a fairly robust metric for the prediction of cycle cancellation and oocyte yield for Chinese women, but it is a relatively poor test for prediction of pregnancy outcomes. Patients with low levels of AMH still can achieve reasonable treatment outcomes and low AMH levels in isolation do not represent an appropriate marker for withholding fertility treatment.
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Karakus S, Sahin A, Durmaz Y, Aydin H, Yildiz C, Akkar O, Dogan M, Cengiz A, Cetin M, Cetin A. Evaluation of ovarian reserve using anti-müllerian hormone and antral follicle count in Sjögren's syndrome: Preliminary study. J Obstet Gynaecol Res 2016; 43:303-307. [PMID: 27987339 DOI: 10.1111/jog.13216] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 09/22/2016] [Indexed: 12/17/2022]
Abstract
AIM The aim of this study was to determine ovarian reserve status using anti-müllerian hormone (AMH) level and antral follicle count (AFC) in patients with Sjögren's syndrome (SS). METHODS Twenty-four women with SS diagnosed according to the classification criteria proposed by the American-European Consensus Group and 25 healthy women as controls were enrolled in this study. Ovarian reserve was assessed on clinical findings, AFC, and serum AMH and reproductive hormone levels. RESULTS Compared with the healthy controls, in the SS patients, the duration of menstrual cycle was significantly shorter (P = 0.043); serum AMH (P = 0.001) and AFC (P = 0.001) were significantly lower, and serum luteinizing hormone (LH) was significantly higher (P = 0.019). The right (P = 0.555) and left ovarian (P = 0.386) volumes were also lower but this did not reach statistical significance. Serum follicle-stimulating hormone (P = 0.327), estradiol (P = 0.241), and prolactin (P = 0.55) were similar between the two groups. CONCLUSIONS Ovarian reserve may be reduced in SS patients. For the assessment of ovarian reserve, serum AMH and ovarian AFC with serum LH may be useful. Further studies with long-term follow-up are required to determine the course of ovarian reserve abnormalities and best possible biomarkers of reduced ovarian reserve in SS patients.
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Affiliation(s)
- Savas Karakus
- Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Ali Sahin
- Department of Rheumatology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Yunus Durmaz
- Department of Rheumatology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Huseyin Aydin
- Department of Biochemistry, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Caglar Yildiz
- Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Ozlem Akkar
- Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Mansur Dogan
- Department of Otolaryngology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Ahmet Cengiz
- Department of Rheumatology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Meral Cetin
- Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Ali Cetin
- Department of Obstetrics and Gynecology, Cumhuriyet University School of Medicine, Sivas, Turkey
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Yetim A, Yetim Ç, Baş F, Erol OB, Çığ G, Uçar A, Darendeliler F. Anti-Müllerian Hormone and Inhibin-A, but not Inhibin-B or Insulin-Like Peptide-3, may be Used as Surrogates in the Diagnosis of Polycystic Ovary Syndrome in Adolescents: Preliminary Results. J Clin Res Pediatr Endocrinol 2016; 8:288-97. [PMID: 27125339 PMCID: PMC5096492 DOI: 10.4274/jcrpe.3253] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 04/28/2016] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE Polycystic ovary syndrome (PCOS) is a common endocrine problem in adolescents with an increasing prevalence of 30%. Pursuing new biomarkers with high specificity and sensitivity in the diagnosis of PCOS in adolescents is currently an active area of research. We aimed to investigate the diagnostic value of anti-Müllerian hormone (AMH), insulin-like peptide-3 (INSL3), inhibin-A (INH-A), and inhibin-B (INH-B) in adolescents with PCOS and also to determine the association, if any, between these hormones and clinical/laboratory findings related with hyperandrogenism. METHODS The study group comprised 53 adolescent girls aged between 14.5 and 20 years who were admitted to our outpatient clinic with symptoms of hirsutism and/or irregular menses and diagnosed as having PCOS in accordance with the Rotterdam criteria. Twenty-six healthy peers, eumenorrheic for at least two years and body mass index-matched, constituted the controls. Fasting blood samples for hormones [luteinizing hormone (LH), follicle-stimulating hormone (FSH), dehydroepiandrosterone-sulfate (DHEAS), androstenedione (D4-A), total/free testosterone (T/fT), sex hormone binding globulin (SHBG), AMH, INSL3, INH-A, INH-B] were drawn after an overnight fast. RESULTS In the PCOS group, 83% of the subjects were oligomenorrheic/amenorrheic and 87% had hirsutism. The LH, LH/FSH ratio, total T, fT, free androgen-index (FAI), DHEAS levels were significantly higher (p=0.005, p=0.042, p=0.047, p<0.001, p=0.007, p=0.014, respectively) and SHBG was significantly lower (p=0.004) in PCOS patients as compared to the controls. Although the INSL-3 and INH-B levels showed no difference between the groups (p>0.05), AMH and INH-A levels were found to be significantly higher in the PCOS group compared to the controls (p<0.001, p<0.001, respectively). In multiple linear regression analysis, WC SDS (p=0.028), logD4-A (p=0.033), logSHBG (p=0.031), and total ovarian volume (p=0.045) had significant effects on AMH levels, and LH (p=0.003) on INH-A levels. In receiver-operating characteristic analysis, the cut-off values for AMH and INH-A were 6.1 ng/mL (sensitivity 81.1%) and 12.8 pg/mL (sensitivity 86.8%), respectively, to diagnose PCOS. When AMH and INH-A were used in combination, the sensitivity (96.2%) increased. CONCLUSION INSL3 and INH-B were not found to have diagnostic value in adolescents with PCOS. On the other hand, it was shown that INH-A could be used as a new diagnostic biomarker in addition to AMH.
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Affiliation(s)
- Aylin Yetim
- İstanbul University İstanbul Faculty of Medicine, Department of Pediatrics, Division of Adolescent Medicine, İstanbul, Turkey, Phone: +90 505 369 00 35 E-mail:
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Cao SS, Shan XO, Hu YY. [Impact of unilateral cryptorchidism on the levels of serum anti-müllerian hormone and inhibin B]. Zhonghua Nan Ke Xue 2016; 22:805-808. [PMID: 29071877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To investigate the influence of unilateral cryptorchidism on the levels of serum anti-müllerian hormone (AMH) and inhibin B in children. METHODS We enrolled 65 patients with unilateral cryptorchidism and 45 healthy children in this study. We measured the length and circumference of the penis, the testis volume in the cryptorchidism side, and the levels of serum AMH and inhibin B at the age of 6 and 12 months, respectively. RESULTS Compared with the healthy controls, the patients with unilateral cryptorchidism showed significant decreases at 12 months in serum AMH ([108.06±12.40] vs [103.26±17.57] ng/ml, P<0.05) and inhibin B ([77.43±5.66] vs [70.21±5.69] pg/ml, P<0.05). No statistically significant differences were found in the length and circumference of the penis and the testis volume in the cryptorchidism side at 6 and 12 months (P>0.05), or in the levels of serum AMH and inhibin B at 6 months (P>0.05). CONCLUSIONS Unilateral cryptorchidism affects the gonadal function of the patient, and orchiopexy should be timely performed in order to reduce its impact.
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Affiliation(s)
- Shun-Shun Cao
- Department of Endocrinology and Inherited Metabolism of Children, The Second Hospital Affiliated to Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Xiao-Ou Shan
- Department of Endocrinology and Inherited Metabolism of Children, The Second Hospital Affiliated to Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Yang-Yang Hu
- Center of Reproductive Medicine, The Second Hospital Affiliated to Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
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Abstract
We prospectively investigated anti-Müllerian hormone (AMH) as a measure of ovarian insult in young females during and after treatment for Wilms tumor (WT), osteosarcoma (OS), and Ewing sarcoma (ES).Twenty-one female childhood cancer patients, with a mean age of 7.9 years (range 0.6-17), entered the study. Levels of AMH, follicle-stimulating hormone (FSH), and luteinizing hormone were monitored at diagnosis and every 3 to 4 months during, and regularly for a mean of 2.6 years after treatment.A profound decline in AMH was seen in the majority of the 21 study patients 3 to 4 months after the beginning of treatment, the exception being patients with WT, of whom 60% showed no such decline. During the remaining treatment, all patients except those with WT not treated with whole abdominal radiotherapy or stem cell transplantation (SCT) had AMH below detection limit.After completion of treatment, patients with OS and WT (without whole abdominal radiotherapy and SCT) recovered in AMH and had FSH in the normal range. In contrast, ES patients showed no AMH recovery and highly fluctuating FSH in the first years of follow-up, except for the 2 youngest patients, who had a late, slow AMH recovery.In conclusion, young female ES patients already showed signs of severe ovarian dysfunction during the first years after cancer treatment similar to patients treated with SCT and abdominal radiotherapy, in contrast to females with WT and OS. Fertility counseling and information concerning fertility preservation procedures should be considered before starting to treat young females with ES.
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Affiliation(s)
- Helena Mörse
- Department of Pediatrics, Pediatric Oncology and Hematology
- Correspondence: Helena Mörse, Department of Pediatrics, Pediatric Oncology and Hematology, Skane University Hospital, Lund University, Lund, Sweden (e-mail: )
| | | | - Aleksandra Turkiewicz
- Department of Orthopedics, Clinical Epidemiology Unit, Skane University Hospital, Lund University, Lund, Sweden
| | - Claus Yding Andersen
- Laboratory of Reproductive Biology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ingrid Øra
- Department of Pediatrics, Pediatric Oncology and Hematology
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Plouvier P, Peigné M, Gronier H, Robin G, Catteau-Jonard S, Dewailly D. Is the suppressive effect of cyproterone acetate on serum anti-Müllerian-hormone levels in women with polycystic ovary syndrome stronger than under oral contraceptive pill? Gynecol Endocrinol 2016; 32:612-616. [PMID: 26890873 DOI: 10.3109/09513590.2016.1145647] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To compare the suppressive effect of anti-androgen therapy by cyproterone acetate (CPA) and by oral contraceptive pill (OCP) on anti-müllerian hormone (AMH) levels in women with polycystic ovary syndrome (PCOS) in order to detect a putative direct anti-androgen effect on AMH excess. METHODS This is a prospective longitudinal study including 58 women with PCOS between January 2010 and April 2014 at the Lille University Hospital. A total of 47 women with clinical hyperandrogenism were treated by CPA (50 mg/d was administered 20 days out of 28) and 11 women with PCOS but without clinical hyperandrogenism received OCP. RESULT(S) Serum AHM levels at baseline were similar in CPA and OCP groups (median [5-95th percentiles]: 60.4 pmol/l [25.1-200.2] versus 58 pmol/l [27.6-100], respectively, p = 0.39). After 3 months of treatment, serum AMH levels decreased significantly by 28% ± 20% and by 22% ± 27% in CPA and OCP groups, respectively. The decrease under both treatments was similar (p = 0.48). CONCLUSION(S) That any anti-androgen effect could be observed on AMH in our CPA group in addition to the gonadotropin-suppressing effect suggests that either androgens are not involved in AMH regulation or that they act by interfering with gonadotropin effects on granulosa cells.
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Affiliation(s)
- Pauline Plouvier
- a Department of Endocrine Gynaecology and Reproductive Medicine , Hôpital Jeanne De Flandre , Lille , France and
| | - Maëliss Peigné
- a Department of Endocrine Gynaecology and Reproductive Medicine , Hôpital Jeanne De Flandre , Lille , France and
| | - Héloïse Gronier
- b Department of Reproductive Medicine , Hôpital Jean Verdier , Bondy , France
| | - Geoffroy Robin
- a Department of Endocrine Gynaecology and Reproductive Medicine , Hôpital Jeanne De Flandre , Lille , France and
| | - Sophie Catteau-Jonard
- a Department of Endocrine Gynaecology and Reproductive Medicine , Hôpital Jeanne De Flandre , Lille , France and
| | - Didier Dewailly
- a Department of Endocrine Gynaecology and Reproductive Medicine , Hôpital Jeanne De Flandre , Lille , France and
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Abstract
OBJECTIVE This study was oriented to investigate the benefit of anti-Müllerian hormone (AMH) level in the management of polycystic ovary syndrome (PCOS). To assess the impact of metformin and oral contraceptives (OC) on serum AMH levels in a cohort of adolescents with PCOS. METHODS Forty-nine adolescents with PCOS were recruited to the study. Twenty-nine patients without insulin resistance were treated with OC (group 1), and 20 patients with insulin resistance were treated with metformin and OC (group 2). AMH and androgen levels were measured prior to and 6 months after the initiation of treatment. RESULTS AMH levels were significantly decreased with treatment in both group 1 (p=0.006) and group 2 (p=0.0048). There was a significant correlation between pre- and post-treatment AMH and left ovarian volume (pretreatment: rho=0.336, p=0.018; post-treatment: rho=0.310, p=0.034). CONCLUSION This study investigated two different treatment regimens in adolescents with PCOS and revealed that AMH levels decreased with treatment. AMH levels were correlated with ovarian volume.
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Affiliation(s)
- Fatma Dursun
- Ümraniye Education and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey, Phone: +90 505 267 14 03 E-mail:
| | - Ayla Güven
- Göztepe Education and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
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Prof. Dr. Güven and Dr. Dursun have equal rights in this study.
| | - Metin Yıldız
- Göztepe Education and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
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Pearson K, Long M, Prasad J, Wu YY, Bonifacio M. Assessment of the Access AMH assay as an automated, high-performance replacement for the AMH Generation II manual ELISA. Reprod Biol Endocrinol 2016; 14:8. [PMID: 26879773 PMCID: PMC4754992 DOI: 10.1186/s12958-016-0143-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 02/08/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The manual Generation II (Gen II) ELISA method used to measure Anti-Müllerian Hormone (AMH) from Beckman Coulter has recently been superseded by a fully automated AMH immunoassay. The aim of this study was to evaluate the performance of the Access AMH assay and directly compare it to the modified Gen II ELISA method. A secondary aim was to verify that the fertile age-related AMH range previously established using the Gen II ELISA could be used to interpret results from the new automated Access assay. METHODS The precision, stability, linearity, measurement range and detection limits were determined using recombinant AMH and patient serum samples. Different diluents and their effects on AMH concentration were compared. A correlation study was performed on patient samples to compare the Access AMH assay to the ELISA method on the Access2 and DxI800 analysers. The fertile AMH range was verified by comparing the 10th, 50th and 90th percentile values from both methods obtained from 489 natural conception pregnant women. RESULTS The Access AMH assay showed good performance across the measuring range for both intra-assay (CV 1.41-3.30 %) and inter-assay (CV 3.04-5.76 %) precision and acceptable sample stability. Dilution of the high concentration samples with the recommended diluent resulted in a small but significant downward shift in values. The assay was linear over the range of values recommended by the manufacturer, allowing for accurate reporting within the reported range. The two assay types were highly correlated (R(2) = 0.9822 and 0.9832 for Access2 and DxI800, respectively), and the differences observed between the Access2 and DxI800 analysers were within clinically acceptable ranges, indicating that the methods are interchangeable. Furthermore, we demonstrated that results from the published reference range for the Gen II ELISA correlate with those from the automated Access AMH assay. CONCLUSION Here, we verified the published performance of the Access AMH assay and showed excellent correlation with the Gen II ELISA method. Moreover, we validated this correlation by confirming that the results from a fertile AMH reference range established using the preceding Gen II ELISA are interchangeable with the new automated Access AMH assay.
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Affiliation(s)
- Kylie Pearson
- Genea-Canberra, 17B/2 King Street, Deakin, ACT 2600, Australia.
| | - Matthew Long
- Genea-Sydney City, Level 3/321 Kent Street, Sydney, NSW, 2000, Australia
| | - Josephine Prasad
- Genea-Sydney City, Level 3/321 Kent Street, Sydney, NSW, 2000, Australia
| | - Ye Ying Wu
- Genea-South West, 173-175 Bigge Street, Liverpool, NSW, 2170, Australia
| | - Michael Bonifacio
- Genea-Sydney City, Level 3/321 Kent Street, Sydney, NSW, 2000, Australia
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Delesalle AS, Robin G, Thomas-Desrousseaux P, Dewailly D, Catteau-Jonard S. Anti-Müllerian hormone serum level and other markers associated with pregnancy outcome in oocyte donation. Reprod Biol Endocrinol 2016; 14:4. [PMID: 26787450 PMCID: PMC4717601 DOI: 10.1186/s12958-016-0138-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 01/12/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Oocyte donation is a medical technique used principally for woman with ovarian failure. Optimizing donor recruitment is essential to obtain the best results with this technique. Understanding how donor parameters influence outcome for the recipients is fundamental. The aim of this study was to determine whether clinical and/or biological parameters in the donors influence the chance of pregnancy in recipients. Our objective was also to verify whether the outcomes of controlled ovarian stimulation (COS) are predictive of pregnancy in the recipients. METHODS A retrospective observational study was conducted in the Department of Reproductive Medicine in the Lille University Hospital. Between September 2005 and April 2014, COS was performed in 145 donors for 308 recipients' cycles. We compared the cycles whose outcome was pregnancy to the cycles without pregnancy. Quantitative variables were compared using the nonparametric Mann-Whitney test. Qualitative variables were compared using a Chi-2 test or Fisher exact test, according to the numbers. Covariance analysis was performed to adjust for potential confounding factors. RESULTS The donors who produced at least one pregnancy had a mean baseline serum anti-Müllerian hormone (AMH) level significantly higher than those who did not (p = 0.001). The mean antral follicle count did not differ between the 2 groups. After covariance analysis controlling for the number of couples attributed to a given donor, this difference remained significant (p = 0.029). Mature follicle number, estradiol serum level at the trigger day, number of mature oocytes and embryo number were significantly higher in the donors who produced pregnancy. CONCLUSION Serum AMH level is associated with pregnancy outcome after oocyte donation.
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Affiliation(s)
- Anne-Sophie Delesalle
- Departments of Endocrine Gynaecology and Reproductive Medicine, Hôpital Jeanne de Flandre, C.H.R.U., Faculty of Medicine, Université de Lille II, F-59000, Lille, France.
| | - Geoffroy Robin
- Departments of Endocrine Gynaecology and Reproductive Medicine, Hôpital Jeanne de Flandre, C.H.R.U., Faculty of Medicine, Université de Lille II, F-59000, Lille, France.
| | - Patricia Thomas-Desrousseaux
- Departments of Endocrine Gynaecology and Reproductive Medicine, Hôpital Jeanne de Flandre, C.H.R.U., Faculty of Medicine, Université de Lille II, F-59000, Lille, France.
| | - Didier Dewailly
- Departments of Endocrine Gynaecology and Reproductive Medicine, Hôpital Jeanne de Flandre, C.H.R.U., Faculty of Medicine, Université de Lille II, F-59000, Lille, France.
- INSERM U1172 Team 2, JPARC, Université de Lille II, F-59000, Lille, France.
| | - Sophie Catteau-Jonard
- Departments of Endocrine Gynaecology and Reproductive Medicine, Hôpital Jeanne de Flandre, C.H.R.U., Faculty of Medicine, Université de Lille II, F-59000, Lille, France.
- INSERM U1172 Team 2, JPARC, Université de Lille II, F-59000, Lille, France.
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Knez J, Kovačič B, Medved M, Vlaisavljević V. What is the value of anti-Müllerian hormone in predicting the response to ovarian stimulation with GnRH agonist and antagonist protocols? Reprod Biol Endocrinol 2015; 13:58. [PMID: 26059906 PMCID: PMC4470079 DOI: 10.1186/s12958-015-0049-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 05/21/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anti-Müllerian hormone (AMH) is a marker of the ovarian reserve with promising prognostic potential in reproductive medicine. We aimed to evaluate the prognostic ability of AMH for predicting excessive or poor responses to ovarian stimulation using gonadotrophin-releasing hormone (GnRH) agonist and GnRH antagonist protocols in patients undergoing medically assisted reproduction (MAR) procedures. METHODS This retrospective analysis included 623 women who underwent ovarian stimulation for medically assisted reproduction. AMH level measurements were acquired from all couples within six months of the initiation of ovarian stimulation. RESULTS AMH was significantly correlated with the number of retrieved oocytes, and age was not relevant in a multivariate regression analysis (unstandardized regression coefficient of 1.130, 95 % confidence interval 0.977-1.283). AMH was a better predictor of both excessive (>19 oocytes) and poor (<4 oocytes) ovarian response than age (areas under the curve (AUCs) of 0.882 and 0.816, respectively). When stratified according to the stimulation protocol (a long GnRH agonist versus a GnRH antagonist protocol), AMH retained its high predictive value for excessive and poor responses in both groups. Serum AMH levels exhibited a strong correlation with the level of the response to ovarian stimulation. CONCLUSIONS AMH is an independent and an accurate predictor of excessive and poor responses to GnRH agonist and GnRH antagonist protocols for ovarian stimulation.
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Affiliation(s)
- Jure Knez
- Department of Reproductive Medicine and Gynaecologic Endocrinology, University Medical Centre Maribor, Ljubljanska 5, 2000, Maribor, Slovenia.
| | - Borut Kovačič
- Department of Reproductive Medicine and Gynaecologic Endocrinology, University Medical Centre Maribor, Ljubljanska 5, 2000, Maribor, Slovenia.
| | - Maruška Medved
- Department of Reproductive Medicine and Gynaecologic Endocrinology, University Medical Centre Maribor, Ljubljanska 5, 2000, Maribor, Slovenia.
| | - Veljko Vlaisavljević
- Department of Reproductive Medicine and Gynaecologic Endocrinology, University Medical Centre Maribor, Ljubljanska 5, 2000, Maribor, Slovenia.
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Kollmann Z, Bersinger NA, McKinnon BD, Schneider S, Mueller MD, von Wolff M. Anti-Müllerian hormone and progesterone levels produced by granulosa cells are higher when derived from natural cycle IVF than from conventional gonadotropin-stimulated IVF. Reprod Biol Endocrinol 2015; 13:21. [PMID: 25889012 PMCID: PMC4379743 DOI: 10.1186/s12958-015-0017-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 03/06/2015] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The study was designed to compare the effect of in vitro FSH stimulation on the hormone production and gene expression profile of granulosa cells (GCs) isolated from single naturally matured follicles obtained from natural cycle in vitro fertilization (NC-IVF) with granulosa cells obtained from conventional gonadotropin-stimulated IVF (c-IVF). METHODS Lutein granulosa cells from the dominant follicle were isolated and cultured in absence or presence of recombinant FSH. The cultures were run for 48 h and six days. Messenger RNA (mRNA) expressions of anti-Müllerian hormone (AMH) and FSH receptor were measured by quantitative polymerase chain reaction (qPCR). AMH protein and progesterone concentration (P4) in cultured supernatant were measured by ELISA and RIA. RESULTS Our results showed that the mRNA expression of AMH was significantly higher in GCs from NC- than from c-IVF on day 6 after treatment with FSH (1 IU/mL). The FSH stimulation increased the concentration of AMH in the culture supernatant of GCs from NC-IVF compared with cells from c-IVF. In the culture medium, the AMH level was correlated significantly and positively to progesterone concentration. CONCLUSIONS Differences in the levels of AMH and progesterone released into the medium by cultured GC as well as in AMH gene expression were observed between GCs obtained under natural and stimulated IVF protocols. The results suggest that artificial gonadotropin stimulation may have an effect on the intra-follicular metabolism. A significant positive correlation between AMH and progesterone may suggest progesterone as a factor influencing AMH secretion.
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Affiliation(s)
- Zahraa Kollmann
- Department of Obstetrics and Gynecology, Inselspital Berne, Berne University Hospital, Effingerstrasse 102, 3010, Berne, Switzerland.
| | - Nick A Bersinger
- Department of Obstetrics and Gynecology, Inselspital Berne, Berne University Hospital, Effingerstrasse 102, 3010, Berne, Switzerland.
- Department of Clinical Research, University of Berne, Murtenstrasse 35, 3010, Berne, Switzerland.
| | - Brett D McKinnon
- Department of Clinical Research, University of Berne, Murtenstrasse 35, 3010, Berne, Switzerland.
| | - Sophie Schneider
- Department of Obstetrics and Gynecology, Inselspital Berne, Berne University Hospital, Effingerstrasse 102, 3010, Berne, Switzerland.
| | - Michael D Mueller
- Department of Obstetrics and Gynecology, Inselspital Berne, Berne University Hospital, Effingerstrasse 102, 3010, Berne, Switzerland.
| | - Michael von Wolff
- Department of Obstetrics and Gynecology, Inselspital Berne, Berne University Hospital, Effingerstrasse 102, 3010, Berne, Switzerland.
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Vija L, Ferlicot S, Paun D, Bry-Gauillard H, Berdan G, Abd-Alsamad I, Lombès M, Young J. Testicular histological and immunohistochemical aspects in a post-pubertal patient with 5 alpha-reductase type 2 deficiency: case report and review of the literature in a perspective of evaluation of potential fertility of these patients. BMC Endocr Disord 2014; 14:43. [PMID: 24885102 PMCID: PMC4041634 DOI: 10.1186/1472-6823-14-43] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 05/06/2014] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Testicular morphology and immunohistochemical studies have never been reported in genetically documented adult patients with 5 alpha-reductase type 2 deficiency (5α-R2 deficiency). CASE PRESENTATION We describe the testicular histopathology of a 17-year-old XY subject with 5α-R2 deficiency caused by the recurrent homozygous Gly115Asp loss of function mutation of the SRD5A2 gene.We also performed an immunohistochemical analysis in order to further study the relationship between seminiferous tubules structure, Sertoli cell differentiation and androgenic signaling impairment in this case. We thus evaluated the testicular expression of the anti-Müllerian hormone (AMH), androgen receptor (AR) and 3β-hydroxysteroid dehydrogenase (3βHSD). Histological analysis revealed a heterogeneous aspect with a majority (92%) of seminiferous tubules (ST) presenting a mature aspect but containing only Sertoli cells and devoid of germ cells and spermatogenesis. Focal areas of immature ST (8%) were also found. Testicular AR and 3βHSD expression were detected in adult male control, 5α-R2 deficiency and CAIS subjects. However, AMH expression was heterogeneous (detectable only in few AR negative prepubertal ST, but otherwise repressed) in the 5α-R2 deficiency, conversely to normal adult testis in which AMH was uniformly repressed and to an adult CAIS testis in which AMH was uniformly and strongly expressed. CONCLUSION Intratesticular testosterone can repress AMH by itself, independently of its metabolism into dihydrotestosterone. We also compare our results to the few post pubertal cases of 5α-R2 deficiency with available histological testicular description, reported in the literature. We will discuss these histological findings, in the more general context of evaluating the fertility potential of these patients if they were raised as males and were azoospermic.
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Affiliation(s)
- Lavinia Vija
- Faculté de Médecine Paris-Sud, Univ Paris-Sud, UMR-S693, Le Kremlin-Bicêtre F-94276, France
- Inserm, U693, Le Kremlin-Bicêtre F-94276, France
- “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
- Service de Biophysique et Médecine Nucleaire, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Le Kremlin-Bicêtre F-94275, France
| | - Sophie Ferlicot
- Univ Paris-Sud, Assistance Publique-Hôpitaux de Paris, Service d’Anatomo-Pathologie, Hôpital Bicêtre, Le Kremlin-Bicêtre F-94276, France
| | - Diana Paun
- “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Hélène Bry-Gauillard
- Service d’Endocrinologie et maladies de la Reproduction, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, 78, rue du Général Leclerc, Le Kremlin-Bicêtre F-94275, France
| | - Gabriela Berdan
- Department of Pathology,” Burghele” Hospital, Bucharest, Romania
| | - Issam Abd-Alsamad
- Service d’Anatomo-Pathologie, Centre Hospitalier Intercommunal de Creteil, Creteil F-94276, France
| | - Marc Lombès
- Faculté de Médecine Paris-Sud, Univ Paris-Sud, UMR-S693, Le Kremlin-Bicêtre F-94276, France
- Inserm, U693, Le Kremlin-Bicêtre F-94276, France
- Service d’Endocrinologie et maladies de la Reproduction, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, 78, rue du Général Leclerc, Le Kremlin-Bicêtre F-94275, France
| | - Jacques Young
- Faculté de Médecine Paris-Sud, Univ Paris-Sud, UMR-S693, Le Kremlin-Bicêtre F-94276, France
- Inserm, U693, Le Kremlin-Bicêtre F-94276, France
- Service d’Endocrinologie et maladies de la Reproduction, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, 78, rue du Général Leclerc, Le Kremlin-Bicêtre F-94275, France
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50
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Ortega-Hrepich C, Polyzos NP, Anckaert E, Guzman L, Tournaye H, Smitz J, De Vos M. The effect of ovarian puncture on the endocrine profile of PCOS patients who undergo IVM. Reprod Biol Endocrinol 2014; 12:18. [PMID: 24564914 PMCID: PMC3936928 DOI: 10.1186/1477-7827-12-18] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Accepted: 02/01/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To examine whether ovarian puncture for immature oocyte retrieval and in-vitro maturation (IVM) has an effect on the endocrine profile of patients with polycystic ovary syndrome (PCOS). METHODS Twenty-two consecutive patients with PCOS undergoing IVM treatment were included. Serum anti-Müllerian hormone (AMH), sex hormone-binding globulin (SHBG), total testosterone (TT) and luteinized hormone (LH) levels were analyzed at the start of the cycle, on the day of immature oocyte retrieval (OR) and at fixed intervals thereafter, for up to three months after OR. RESULTS Five days after OR circulating AMH, TT, calculated free testosterone (FTc), and LH levels were significantly reduced and circulating SHBG was significantly increased. Two weeks after OR, TT, FTc and LH remained reduced, whereas circulating AMH and SHBG levels recovered to pre-puncture values. Three months after OR, all circulating hormone levels had recovered to baseline values. CONCLUSION Ovarian puncture for the retrieval of immature oocytes and IVM in patients with PCOS has a significant impact on the ovarian endocrine profile, but this impact is brief and transient.
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Affiliation(s)
| | - Nikolaos P Polyzos
- Centre for Reproductive Medicine, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Ellen Anckaert
- Laboratory of Clinical Chemistry and Radioimmunology, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Luis Guzman
- Laboratory of Clinical Chemistry and Radioimmunology, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Herman Tournaye
- Centre for Reproductive Medicine, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Johan Smitz
- Laboratory of Clinical Chemistry and Radioimmunology, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Michel De Vos
- Centre for Reproductive Medicine, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
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