title: Anti-Mullerian hormone, inhibin B, and antral follicle count in young women with ovarian failure.
abstract: BACKGROUND
  Ovarian dysfunction is classically categorized on the basis of cycle history, FSH, and estradiol levels. Novel ovarian markers may provide a more direct insight into follicular quantity in hypergonadotropic women.
  
  
  OBJECTIVE
  The objective of the study was to investigate the distribution of novel ovarian markers in young hypergonadotropic women as compared with normogonadotropic regularly menstruating women.
  
  
  METHODS
  This was a nationwide prospective cohort study.
  
  
  METHODS
  The study was conducted at 10 hospitals in The Netherlands.
  
  
  METHODS
  Women below age 40 yr with regular menses and normal FSH (controls; n = 83), regular menstrual cycles and elevated FSH [incipient ovarian failure (IOF); n = 68]; oligomenorrhea and elevated FSH [referred to as transitional ovarian failure (TOF); n = 79]; or at least 4 months amenorrhea together with FSH levels exceeding 40 IU/liter [premature ovarian failure (POF); n = 112].
  
  
  METHODS
  Serum levels of anti-Müllerian hormone (AMH), inhibin B, and antral follicle count (AFC) was measured.
  
  
  RESULTS
  All POF patients showed AMH levels below the fifth percentile (p(5)) of normoovulatory women. Normal AMH levels (>p(5)) could be identified in 75% of IOF, 33% of TOF patients, and 98% of controls. AFC and AMH levels changed with increasing age (P < 0.0001), whereas inhibin B did not (P = 0.26). AMH levels were significantly different between TOF and IOF over the entire age range, whereas AFC became similar for TOF and IOF at higher ages.
  
  
  CONCLUSIONS
  Compared with inhibin B and AFC, AMH was more consistently correlated with the clinical degree of follicle pool depletion in young women presenting with elevated FSH levels. AMH may provide a more accurate assessment of the follicle pool in young hypergonadotropic patients, especially in the clinically challenging subgroups of patients with elevated FSH and regular menses (i.e. IOF) and in hypergonadotropic women with cycle disturbances not fulfilling the POF diagnostic criteria (i.e. TOF).
authors.affiliation: Department of Reproductive Medicine and Gynecology, University Medical Centre, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. knauff@gmail.com
authors.forename: Erik A H
authors.initials: EA
authors.lastname: Knauff
authors.forename: Marinus J C
authors.initials: MJ
authors.lastname: Eijkemans
authors.forename: Cornelius B
authors.initials: CB
authors.lastname: Lambalk
authors.forename: Marianne J
authors.initials: MJ
authors.lastname: ten Kate-Booij
authors.forename: Annemieke
authors.initials: A
authors.lastname: Hoek
authors.forename: Catharina C M
authors.initials: CC
authors.lastname: Beerendonk
authors.forename: Joop S E
authors.initials: JS
authors.lastname: Laven
authors.forename: Angelique J
authors.initials: AJ
authors.lastname: Goverde
authors.forename: Frank J M
authors.initials: FJ
authors.lastname: Broekmans
authors.forename: Axel P N
authors.initials: AP
authors.lastname: Themmen
authors.forename: Frank H
authors.initials: FH
authors.lastname: de Jong
authors.forename: Bart C J M
authors.initials: BC
authors.lastname: Fauser
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007265:Inhibins / Q000097:blood*; D006080:Ovarian Follicle / Q000473:pathology*; D016649:Primary Ovarian Insufficiency / Q000097:blood* / Q000473:pathology; D011446:Prospective Studies
chemical_list: C422364:inhibin B; D007265:Inhibins; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone