Mullerian Inhibiting Substance is an ovarian growth factor of emerging clinical significance.
OBJECTIVE
To examine Mullerian Inhibiting Substance (MIS) as an emerging diagnostic marker of ovarian function.


METHODS
Medline review of published studies pertaining to the role of MIS in assessing ovarian aging, predicting response to ovulation induction in preparation for in vitro fertilization, assessing risk of developing ovarian hyperstimulation (OHSS) before ovulation induction, and diagnosis of polycystic ovarian disease (PCOS).


RESULTS
The majority of published studies to date support a role for MIS as a marker of ovarian reserve. Specific cut-off values are dependent upon the particular assay used. Mullerian Inhibiting Substance may offer value in assessing risk of OHSS and diagnosis of PCOS.


CONCLUSIONS
Potential advantages of MIS compared with other conventional markers of ovarian reserve include: 1) MIS is the earliest marker to change with age; 2) it has the least intercycle variability; 3) it has the least intracycle variability; and 4) it may be informative if randomly obtained during the cycle. Widespread clinical use of MIS may await the availability of an international standard for MIS so that results using different assays may be reliably compared.
Seifer
David B
DB
Department of Obstetrics & Gynecology, Maimonides Medical Center, Brooklyn, New York 11228, USA. drseifer@genesisfertility.com
Maclaughlin
David T
DT
D054304:Anti-Mullerian Hormone; D005260:Female; D006023:Glycoproteins / Q000502:physiology*; D006106:Granulosa Cell Tumor / Q000175:diagnosis; D006801:Humans; D008597:Menstrual Cycle; D016471:Ovarian Hyperstimulation Syndrome / Q000503:physiopathology; D010051:Ovarian Neoplasms / Q000175:diagnosis; D010053:Ovary / Q000254:growth & development*; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000503:physiopathology; D013735:Testicular Hormones / Q000502:physiology*
D006023:Glycoproteins; D013735:Testicular Hormones; D054304:Anti-Mullerian Hormone