Serum levels of anti-Müllerian hormone as a marker of ovarian function in 926 healthy females from birth to adulthood and in 172 Turner syndrome patients.
BACKGROUND
In adult women, anti-Müllerian hormone (AMH) is related to the ovarian follicle pool. Little is known about AMH in girls.


OBJECTIVE
The objective of the study was to provide a reference range for AMH in girls and adolescents and to evaluate AMH as a marker of ovarian function.


METHODS
The study was conducted at a tertiary referral center for pediatric endocrinology.


METHODS
We measured AMH in 926 healthy females (longitudinal values during infancy) as well as in 172 Turner syndrome (TS) patients according to age, karyotype (A: 45,X; B: miscellaneous karyotypes; C: 45,X/46,XX), and ovarian function (1: absent puberty; 2: cessation of ovarian function; 3: ongoing ovarian function).


RESULTS
AMH was undetectable in 54% (38 of 71) of cord blood samples (<2; <2-15 pmol/liter) (median; 2.5th to 97.5th percentile) and increased in all (37 of 37) infants from birth to 3 months (15; 4.5-29.5 pmol/liter). From 8 to 25 yr, AMH levels were stable (19.9; 4.7-60.1 pmol/liter), with the lower level of the reference range clearly above the detection limit. AMH levels were associated with TS-karyotype groups (median A vs. B: <2 vs. 3 pmol/liter, P = 0.044; B vs. C: 3 vs. 16 pmol/liter, P < 0.001) as well as with ovarian function (absent puberty vs. cessation of ovarian function: <2 vs. 6 pmol/liter, P = 0.004; cessation of ovarian function vs. ongoing ovarian function: 6 vs. 14 pmol/liter, P = 0.001). As a screening test of premature ovarian failure in TS, the sensitivity and specificity of AMH less than 8 pmol/liter was 96 and 86%, respectively.


CONCLUSIONS
AMH seems to be a promising marker of ovarian function in healthy girls and TS patients.
Hagen
Casper P
CP
Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. casper.hagen@rh.regionh.dk
Aksglaede
Lise
L
Sørensen
Kaspar
K
Main
Katharina M
KM
Boas
Malene
M
Cleemann
Line
L
Holm
Kirsten
K
Gravholt
Claus H
CH
Andersson
Anna-Maria
AM
Pedersen
Anette T
AT
Petersen
Jørgen Holm
JH
Linneberg
Allan
A
Kjaergaard
Susanne
S
Juul
Anders
A
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002648:Child; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007265:Inhibins / Q000097:blood; D008875:Middle Aged; D010053:Ovary / Q000502:physiology*; D012372:ROC Curve; D012016:Reference Values; D018709:Statistics, Nonparametric; D014424:Turner Syndrome / Q000097:blood* / Q000503:physiopathology
D015415:Biomarkers; C422364:inhibin B; D007265:Inhibins; D054304:Anti-Mullerian Hormone