Biologic markers of ovarian reserve and reproductive aging: application in a cohort study of HIV infection in women.
OBJECTIVE
To compare Müllerian inhibiting substance (MIS) levels in serum obtained during the early follicular phase to those obtained randomly during the menstrual cycle. To determine whether HIV infection influences early follicular MIS levels, an early marker of ovarian aging.


METHODS
A cross-sectional study.


METHODS
Women's Interagency HIV Study, a multicenter prospective study.


METHODS
Serum samples obtained from 263 (187 HIV infected and 76 uninfected) participants of the Women's Interagency HIV Study who reported menstrual bleeding during the preceding 6 months and who were not taking exogenous hormones.


METHODS
Early follicular (cycle days 2-5) MIS samples were compared with serum samples that had been obtained without regard to menstrual cycle phase. Comparison samples were obtained within 6 weeks before or within 3 to 6 months after the early follicular samples. Early follicular FSH, E(2), inhibin B, and MIS levels were also compared between the HIV infected and uninfected women.


METHODS
Correlation between early follicular MIS and prior and subsequent samples. Comparison of serum markers of ovarian reserve between HIV positive and negative women.


RESULTS
The MIS values from early follicular and other random cycle phases were highly correlated with each other (r > 0.93). In multivariate analysis, increased age and FSH level and lower inhibin B levels were associated with lower MIS level; MIS values did not vary by HIV serostatus.


CONCLUSIONS
Without regard to cycle phase, MIS was similar during early follicular phase and highly correlated with early follicular FSH and inhibin B in women with and without HIV. Measurement of serum MIS offers a simplified method of determining ovarian reserve using specimens obtained without menstrual phase timing. Furthermore, using biologic measures of reproductive aging, we found no evidence that HIV infection influences ovarian aging.
Seifer
David B
DB
Maimonides Medical Center, Department of Obstetrics & Gynecology, Brooklyn, New York, USA. drseifer@genesisfertility.com
Golub
Elizabeth T
ET
Lambert-Messerlian
Geralyn
G
Springer
Gayle
G
Holman
Susan
S
Moxley
Michael
M
Cejtin
Helen
H
Nathwani
Niyati
N
Anastos
Kathryn
K
Minkoff
Howard
H
Greenblatt
Ruth M
RM
D000328:Adult; D000375:Aging / Q000097:blood / Q000502:physiology*; D054304:Anti-Mullerian Hormone / Q000032:analysis / Q000097:blood*; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005498:Follicular Phase / Q000097:blood; D005500:Follow-Up Studies; D015658:HIV Infections / Q000097:blood / Q000503:physiopathology*; D015497:HIV-1; D006801:Humans; D010053:Ovary / Q000502:physiology*; D011446:Prospective Studies; D012098:Reproduction / Q000502:physiology*
D015415:Biomarkers; D054304:Anti-Mullerian Hormone