Per-follicle measurements indicate that anti-müllerian hormone secretion is modulated by the extent of follicular development and luteinization and may reflect qualitatively the ovarian follicular status.
OBJECTIVE
To investigate the possible influence of follicular maturation and luteinization on anti-müllerian hormone (AMH) secretion and the relationship between per-follicle AMH levels, ovarian follicular status, and responsiveness to controlled ovarian hyperstimulation (COH).


METHODS
Prospective study.


METHODS
University hospital in France.


METHODS
Thirty seven in vitro fertilization/embryo transfer candidates undergoing COH.


METHODS
On the day of oocyte retrieval, serum samples and follicular fluids from two small (8-12 mm in diameter) and two large (16-20 mm in diameter) follicles were collected for AMH, E2, and progesterone (P4) measurements.


METHODS
Per-follicle AMH levels.


RESULTS
Small follicles secreted AMH levels that were approximately three times as high as large follicles. Follicular fluid AMH and P4 levels were negatively correlated to each other both in small and large follicles. Per-follicle AMH levels in both follicular classes were positively correlated with antral follicle count on cycle day 3 before COH and with growing follicle (> or =12 mm) count and oocytes retrieved, but negatively correlated with FSH requirement.


CONCLUSIONS
Both final follicular maturation and luteinization interfere with granulosa cell AMH production. The relationship between intrafollicular AMH content, the surrounding follicular status, and ovarian response to COH indicates that peripheral AMH levels reflect not only follicle count but also per-follicle AMH production.
Fanchin
Renato
R
Department of Obstetrics and Gynecology and Reproductive Medicine, Clamart, France. renato.fanchin@abc.ap-hop-paris.fr
Louafi
Nabil
N
Méndez Lozano
Daniel H
DH
Frydman
Nelly
N
Frydman
René
R
Taieb
Joëlle
J
D000328:Adult; D054304:Anti-Mullerian Hormone; D005260:Female; D005640:Follicle Stimulating Hormone / Q000378:metabolism; D006023:Glycoproteins / Q000378:metabolism*; D006801:Humans; D034461:Luteinization / Q000378:metabolism*; D006080:Ovarian Follicle / Q000254:growth & development* / Q000378:metabolism*; D011446:Prospective Studies; D013735:Testicular Hormones / Q000378:metabolism*
D006023:Glycoproteins; D013735:Testicular Hormones; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone