title: Circulating AMH reflects ovarian morphology by magnetic resonance imaging and 3D ultrasound in 121 healthy girls.
abstract: BACKGROUND
  In adult women, Anti-Müllerian hormone (AMH) is produced by small growing follicles, and circulating levels of AMH reflect the number of antral follicles as well as primordial follicles. Whether AMH reflects follicle numbers in healthy girls remains to be elucidated.
  
  
  OBJECTIVE
  This study aimed to evaluate whether serum levels of AMH reflects ovarian morphology in healthy girls.
  
  
  METHODS
  This was a population-based cohort study involving the general community.
  
  
  METHODS
  Included in the study were 121 healthy girls 9.8-14.7 years of age.
  
  
  METHODS
  Clinical examination, including pubertal breast stage (Tanner's classification B1-5), ovarian volume, as well as the number and size of antral follicles were assessed by two independent modalities: magnetic resonance imaging (MRI), Ellipsoid volume, follicles ≥2 mm; and Transabdominal ultrasound, Ellipsoid and 3D volume, follicles ≥1 mm. Circulating levels of AMH, inhibin B, estradiol, FSH, and LH were assessed by immunoassays; T and androstenedione were assessed by liquid chromatography-tandem mass spectrometry.
  
  
  RESULTS
  AMH reflected the number of small (MRI 2-3 mm) and medium (4-6 mm) follicles (Pearson's Rho [r] = 0.531 and r = 0.512, P < .001) but not large follicles (≥7 mm) (r = 0.109, P = .323). In multiple regression analysis, small and medium follicles (MRI ≤ 6 mm) remained the main contributors to circulating AMH (β, 0.501; P < .001) whereas the correlation between AMH and estradiol was negative (β, -0.318; P = .005). In early puberty (B1-B3), the number of AMH-producing follicles (2-6 mm) correlated positively with pubertal stages (r = 0.453, P = .001), whereas AMH levels were unaffected (-0.183, P = .118).
  
  
  CONCLUSIONS
  Similarly to adult women, small and medium antral follicles (≤6 mm) were the main contributors to circulating levels of AMH in girls.
authors.affiliation: Department of Growth and Reproduction (C.P.H., A.M., M.G.M., J.T., C.W.-V., A.J., K.M.M.), Department of Radiology, (E.F.), Department of Fetal Medicine and Ultrasound (V.B., K.S., L.N.J.), Rigshospitalet Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark; and Medical Research Council Centre for Reproductive Health (R.A.A.), University of Edinburgh, Edinburgh EH16 4TJ, United Kingdom.
authors.forename: Casper P
authors.initials: CP
authors.lastname: Hagen
authors.forename: Annette
authors.initials: A
authors.lastname: Mouritsen
authors.forename: Mikkel G
authors.initials: MG
authors.lastname: Mieritz
authors.forename: Jeanette
authors.initials: J
authors.lastname: Tinggaard
authors.forename: Christine
authors.initials: C
authors.lastname: Wohlfart-Veje
authors.forename: Eva
authors.initials: E
authors.lastname: Fallentin
authors.forename: Vibeke
authors.initials: V
authors.lastname: Brocks
authors.forename: Karin
authors.initials: K
authors.lastname: Sundberg
authors.forename: Lisa Neerup
authors.initials: LN
authors.lastname: Jensen
authors.forename: Richard A
authors.initials: RA
authors.lastname: Anderson
authors.forename: Anders
authors.initials: A
authors.lastname: Juul
authors.forename: Katharina M
authors.initials: KM
authors.lastname: Main
mesh_terms: D000293:Adolescent; D054304:Anti-Mullerian Hormone / Q000097:blood*; D002648:Child; D015331:Cohort Studies; D005260:Female; D006262:Health; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D009929:Organ Size; D006080:Ovarian Follicle / Q000033:anatomy & histology / Q000166:cytology / Q000000981:diagnostic imaging; D010053:Ovary / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D014463:Ultrasonography / Q000379:methods
chemical_list: D054304:Anti-Mullerian Hormone