title: The dynamics of serum anti-Mullerian-hormone levels during controlled ovarian hyperstimulation with GnRH-antagonist short protocol in polycystic ovary syndrome and low responders.
abstract: OBJECTIVE
  To determine whether the decrease in AMH levels during ovarian hyperstimulation for IVF occurs in patients with polycystic ovary syndrome (PCOS) and patients with low ovarian reserve (LOR), as in normal cycling women.
  
  
  METHODS
  A cohort of 22 infertile patients treated in a single tertiary center with a GnRH-antagonist short protocol for IVF were prospectively included and divided into three groups: PCOS with hyperandrogenism (n=7), LOR (n=8) and control (n=7). Serum AMH levels were measured before and during FSH treatment, on the day of HCG administration, at the mid-luteal phase, and 14 days after embryo transfer. The three groups were compared using an ANOVA model in the case of continuous data and with Fisher's exact test when the data were discrete.
  
  
  RESULTS
  In the PCOS group, AMH levels increased at the beginning of the stimulation, but later decreased, until the mid-luteal stage. In the other two groups, AMH levels decreased throughout ovarian stimulation until the mid-luteal stage. In all groups, AMH levels returned to baseline levels two weeks after HCG administration, regardless of treatment outcome (pregnancy or not).
  
  
  CONCLUSIONS
  AMH levels decline during controlled ovarian hyperstimulation with a GnRH-antagonist short protocol in women with low and normal ovarian reserves. In contrast, in women with PCOS, an increase in AMH levels precedes this decline. These findings may support the hypothesis that androgens may play a role in AMH regulation in women.
authors.affiliation: Reproductive Endocrinology and Genetics Unit, IVF Unit, Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University School of Medicine, P.O.B. 3235, Jerusalem 91031, Israel. Electronic address: amirw@szmc.org.il.
authors.forename: Amir
authors.initials: A
authors.lastname: Weintraub
authors.affiliation: Reproductive Endocrinology and Genetics Unit, IVF Unit, Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University School of Medicine, P.O.B. 3235, Jerusalem 91031, Israel.
authors.forename: Ehud J
authors.initials: EJ
authors.lastname: Margalioth
authors.affiliation: Reproductive Endocrinology and Genetics Unit, IVF Unit, Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University School of Medicine, P.O.B. 3235, Jerusalem 91031, Israel.
authors.forename: Avraham Ben
authors.initials: AB
authors.lastname: Chetrit
authors.affiliation: Reproductive Endocrinology and Genetics Unit, IVF Unit, Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University School of Medicine, P.O.B. 3235, Jerusalem 91031, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Gal
authors.affiliation: Reproductive Endocrinology and Genetics Unit, IVF Unit, Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University School of Medicine, P.O.B. 3235, Jerusalem 91031, Israel.
authors.forename: Doron
authors.initials: D
authors.lastname: Goldberg
authors.affiliation: Endocrine Laboratories, Shaare Zedek Medical Center, P.O.B. 3235, Jerusalem 91031, Israel.
authors.forename: Sara
authors.initials: S
authors.lastname: Alerhand
authors.affiliation: Reproductive Endocrinology and Genetics Unit, IVF Unit, Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University School of Medicine, P.O.B. 3235, Jerusalem 91031, Israel.
authors.forename: Talia
authors.initials: T
authors.lastname: Eldar-Geva
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood* / Q000378:metabolism; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000037:antagonists & inhibitors; D006801:Humans; D017588:Hyperandrogenism; D007247:Infertility, Female / Q000628:therapy*; D008183:Luteal Phase; D006080:Ovarian Follicle; D065851:Ovarian Reserve; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000097:blood*
chemical_list: D007987:Gonadotropin-Releasing Hormone; D054304:Anti-Mullerian Hormone; C062876:cetrorelix
keywords: Anti-Mullerian hormone; Controlled ovarian hyperstimulation; GnRH-antagonist protocol; Low ovarian reserve; Polycystic ovary syndrome