Increased intrafollicular androgen levels affect human granulosa cell secretion of anti-Müllerian hormone and inhibin-B.
OBJECTIVE
To evaluate whether the follicular fluid concentrations of anti-müllerian hormone (AMH), inhibin-B, and P become affected by androgen priming before controlled ovarian hyperstimulation and IVF/intracytoplasmic sperm injection (ICSI) treatment, extending our previous study.


METHODS
Prospective nonrandomized clinical study.


METHODS
University hospital.


METHODS
Patients (N = 45) undergoing IVF/ICSI treatment received androgen priming before controlled ovarian hyperstimulation.


METHODS
All patients received cetrorelix, 3 mg SC, on cycle day 2 and 5. Group I (n = 15) received no other pretreatment. Group II (n = 15) received 2.5 mg once daily of letrozole from cycle day 2 through 8. Group III (n = 15) received letrozole as group II plus 1,250 IU hCG on cycle day 2.


METHODS
Follicular fluid concentrations of AMH, inhibin-B, and steroids.


RESULTS
Follicular fluid concentrations of AMH were significantly higher in group III than in groups I and II (2.6 +/- 0.3 vs. 1.6 +/- 0.2 and 1.5 +/- 0.4 ng/mL. Concentrations of inhibin-B were significantly lower in group II and III as compared with group I (27 +/- 4, 27 +/- 3 versus 46 +/- 6 ng/mL, respectively). Follicular fluid P concentrations remained similar in all groups.


CONCLUSIONS
Granulosa cell production of AMH was significantly augmented and inhibin-B production was significantly reduced by a highly specific pharmacologically induced increase in the intrafollicular androgen levels, suggesting a dual action of androgen on follicular growth and development.
Andersen
Claus Yding
CY
Laboratory of Reproductive Biology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. yding@rh.dk
Lossl
Kristine
K
D000728:Androgens / Q000378:metabolism*; D000738:Androsterone / Q000378:metabolism; D054304:Anti-Mullerian Hormone / Q000378:metabolism*; D010064:Embryo Implantation; D004624:Embryo Transfer; D004958:Estradiol / Q000378:metabolism; D005260:Female; D005307:Fertilization in Vitro; D015571:Follicular Fluid / Q000737:chemistry; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives / Q000627:therapeutic use; D006107:Granulosa Cells / Q000378:metabolism*; D006727:Hormone Antagonists / Q000627:therapeutic use; D006801:Humans; D007265:Inhibins / Q000378:metabolism*; D006080:Ovarian Follicle / Q000502:physiology*; D010062:Ovulation Induction; D011374:Progesterone / Q000378:metabolism; D011446:Prospective Studies; D020554:Sperm Injections, Intracytoplasmic; D013739:Testosterone / Q000378:metabolism
D000728:Androgens; D006727:Hormone Antagonists; C422364:inhibin B; D007987:Gonadotropin-Releasing Hormone; D013739:Testosterone; D011374:Progesterone; D004958:Estradiol; D007265:Inhibins; D054304:Anti-Mullerian Hormone; D000738:Androsterone; C062876:cetrorelix