title: Ovarian antral follicle subclasses and anti-mullerian hormone during normal reproductive aging.
abstract: BACKGROUND
  The interindividual variation in the age-related decline of ovarian follicles is wide. Hence, it is important to identify reliable, sensitive, and specific markers to assess the ovarian reserve of the individual woman.
  
  
  OBJECTIVE
  The aim of this study was to characterize the relation between age and ovarian reserve parameters in a population of healthy women with regular menstrual cycle.
  
  
  METHODS
  We conducted a prospective, population-based, cross-sectional study.
  
  
  METHODS
  A total of 366 health care workers aged 21-41 years employed at a University Hospital were included.
  
  
  METHODS
  There were no interventions.
  
  
  METHODS
  Serum anti-Müllerian hormone (AMH) concentration, antral follicle count (AFC), antral follicle size categories (small: 2-4 mm; intermediate: 5-7 mm; and large: 8-10 mm), and ovarian volume were measured.
  
  
  RESULTS
  Serum AMH level declined by 5.6% per year (95% confidence interval 3.7-7.4%, P < .001), AFC (2-10 mm) declined by 4.4% per year (3.2-5.7%, P < .001), and ovarian volume declined by 1.1% per year (0.2-2.0, P = .002), respectively. The mean proportion of small follicles decreased with age (P = .04), the proportion of intermediate follicles displayed no significant change with age (P = .58), and the mean proportion of large follicles increased with age (P < .001). The prevalence of large follicles increased with decreasing serum AMH concentration [odds ratio 1.04 per 1 pmol/L (1.02-1.06), P < .001, area under the curve 0.66], and with decreasing total AFC [odds ratio 1.04 per follicle (1.02-1.05), P < .001, area under the curve 0.62].
  
  
  CONCLUSIONS
  Chronological age was inversely related to serum AMH concentration, total AFC, and ovarian volume. Subclasses of AFC sized 2-4 and 5-7 mm decreased with increasing age, whereas AFC sized 8-10 mm increased with increasing age. Within AFC, a shift toward larger follicles with increasing age was observed. The occurrence of large follicles was more strongly related to biological age in terms of AMH and AFC than chronological age.
authors: The Fertility Clinic, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. janne.gasseholm.bentzen@rh.regionh.dk
authors: J G
authors: JG
authors: Bentzen
authors: J L
authors: JL
authors: Forman
authors: T H
authors: TH
authors: Johannsen
authors: A
authors: A
authors: Pinborg
authors: E C
authors: EC
authors: Larsen
authors: A Nyboe
authors: AN
authors: Andersen
mesh_terms: D000328:Adult; D017677:Age Distribution; D000375:Aging / Q000097:blood / Q000502:physiology*; D000465:Algorithms; D054304:Anti-Mullerian Hormone / Q000097:blood*; D002452:Cell Count; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008597:Menstrual Cycle / Q000097:blood / Q000502:physiology; D009929:Organ Size; D006080:Ovarian Follicle / Q000166:cytology* / Q000000981:diagnostic imaging; D010053:Ovary / Q000033:anatomy & histology / Q000166:cytology* / Q000000981:diagnostic imaging; D012098:Reproduction / Q000502:physiology*; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D054304:Anti-Mullerian Hormone