Serum anti-Mullerian hormone levels during controlled ovarian hyperstimulation in women with polycystic ovaries with and without hyperandrogenism.
BACKGROUND
Anti-Mullerian hormone (AMH) is expressed in pre- and small-antral follicles. High serum levels are found in women with polycystic ovaries (PCO), accordant with their increased content of small follicles. To evaluate the relationship between AMH, folliculogenesis and hyperandrogenism, we compared serum AMH levels between women with PCO with and without hyperandrogenism and normal controls during controlled ovarian hyperstimulation (COH).


METHODS
Nineteen women with PCO and hyperandrogenism (group A), 10 women with PCO but no hyperandrogenism (group B) and 23 ovulatory women with normal ovarian morphology (group C, controls) underwent COH with the long protocol. Serum levels of AMH, estradiol, androstenedione and follicular tracking were determined before gonadotropins treatment (day 0) and every 2-4 days up to the day of HCG administration.


RESULTS
AMH levels declined gradually throughout COH in the three groups, but remained higher in groups A and B compared with the controls. Significantly higher levels were found in group A compared with group B, despite comparable numbers of small follicles. Multiple regression analysis revealed that both the number of small follicles and serum androgens were correlated to AMH.


CONCLUSIONS
Women with PCO have higher serum AMH levels during COH than controls. Hyperandrogenism is associated with an additional increase in AMH. It is conceivable that hyperandrogenism may reflect more severe disruption of folliculogenesis in women with PCO or may affect AMH secretion.
Eldar-Geva
Talia
T
IVF Unit, Department of Obstetrics and Gynecology, Shaare-Zedek Medical Center, Ben Gurion University of Negev, Jerusalem, Israel. gevat@szmc.org.il
Margalioth
Ehud J
EJ
Gal
Michael
M
Ben-Chetrit
Avraham
A
Algur
Nurit
N
Zylber-Haran
Edit
E
Brooks
Baruch
B
Huerta
Michael
M
Spitz
Irving M
IM
D000328:Adult; D054304:Anti-Mullerian Hormone; D005260:Female; D005307:Fertilization in Vitro; D006023:Glycoproteins / Q000097:blood*; D006801:Humans; D017588:Hyperandrogenism / Q000097:blood* / Q000150:complications*; D007246:Infertility / Q000097:blood / Q000209:etiology / Q000628:therapy; D008297:Male; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000150:complications*; D011446:Prospective Studies; D013735:Testicular Hormones / Q000097:blood*
D006023:Glycoproteins; D013735:Testicular Hormones; D054304:Anti-Mullerian Hormone