Increased anti-Müllerian hormone and decreased FSH levels in follicular fluid obtained in women with polycystic ovaries at the time of follicle puncture for in vitro fertilization.
OBJECTIVE
To confirm the increased levels of anti-Müllerian hormone (AMH) in preovulatory follicles from patients with polycystic ovary syndrome (PCOS) and to study the role of other hormones involved in folliculogenesis in this increased secretion.


METHODS
Prospective study.


METHODS
University hospital in France.


METHODS
Twenty-two patients with PCOS and 20 controls undergoing IVF.


METHODS
On the day of oocyte retrieval, follicular fluid (FF) from one small follicle (8-13 mm) (SF) and one large follicle (16-23 mm) (LF) was collected in each patient.


METHODS
Per-follicle AMH, FSH, estradiol, androstenedione, hCG, and progesterone levels, and pregnancy rate.


RESULTS
In FF from both SF and LF of PCOS patients, AMH level was significantly increased, and FSH level was significantly decreased when compared with controls. Both hormone levels were negatively and significantly related in controls but not in PCOS. The AMH levels from SF and LF were significantly lower in patients who began a pregnancy.


CONCLUSIONS
Our findings suggest that the granulosa cells from polycystic ovaries continue to produce elevated levels of AMH, possibly because of impaired access of FSH to follicles. Such an excess in FF AMH may have harmful consequences on oocyte quality and final maturation through unknown mechanisms.
Department of Endocrine Gynaecology and Reproductive Medicine, Hôpital Jeanne de Flandre, CHRU and Université de Lille II, Lille, France.
Virginie
V
Desforges-Bullet
Cécile
C
Gallo
Catherine
C
Lefebvre
Pascal
P
Pigny
Didier
D
Dewailly
Sophie
S
Catteau-Jonard
D000328:Adult; D054304:Anti-Mullerian Hormone / Q000009:adverse effects / Q000096:biosynthesis*; D015415:Biomarkers / Q000378:metabolism; D002454:Cell Differentiation / Q000502:physiology; D015536:Down-Regulation / Q000502:physiology; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005640:Follicle Stimulating Hormone / Q000032:analysis / Q000378:metabolism*; D015571:Follicular Fluid / Q000378:metabolism*; D006107:Granulosa Cells / Q000378:metabolism / Q000473:pathology; D006801:Humans; D009865:Oocytes / Q000473:pathology; D006080:Ovarian Follicle / Q000378:metabolism*; D011085:Polycystic Ovary Syndrome / Q000175:diagnosis / Q000378:metabolism*; D011247:Pregnancy; D011446:Prospective Studies; D013997:Time Factors; D055815:Young Adult
D015415:Biomarkers; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone