title: AMH as Predictor of Premature Ovarian Insufficiency: A Longitudinal Study of 120 Turner Syndrome Patients.
abstract: BACKGROUND
  The majority of Turner syndrome (TS) patients suffer from accelerated loss of primordial follicles. Low circulating levels of anti-Müllerian hormone (AMH) may predict the lack of spontaneous puberty in prepubertal girls and imminent premature ovarian insufficiency (POI) in TS women with preserved ovarian function.
  
  
  OBJECTIVE
  To evaluate the association between circulating AMH and ovarian status in TS patients.
  
  
  METHODS
  Longitudinal observational cohort study.
  
  
  METHODS
  Tertiary referral center for pediatric and gynecologic endocrinology.
  
  
  METHODS
  A total of 120 TS patients, aged 0 to 48 years.
  
  
  METHODS
  Longitudinal measurements of AMH, FSH, LH, estradiol, and inhibin B according to age, karyotype (45,X; 45,X/46,XX mosaicism; miscellaneous karyotypes), and ovarian status (group 0, prepubertal; group 1, never ovarian function; group 2, ongoing ovarian function; and group 3, loss of ovarian function).
  
  
  RESULTS
  Ovarian status was highly associated with the TS karyotype: spontaneous puberty—45,X (three of 44 patients), 45,X/46,XX (15 of 17), miscellaneous (17 of 42); and POI—45,X (three of three), 45,X/46,XX (one of 15), and miscellaneous (eight of 17). AMH was associated with ovarian status (eg, group 1, <2 pmol/L; vs group 2, 19 pmol/L; P < .001). AMH < 4 pmol/L (corresponding to <-2 SD) predicted absent puberty in prepubertal girls and POI in adolescent and adult patients.
  
  
  CONCLUSIONS
  The majority of women with mosaic karyotype 45,X/46,XX had ongoing ovarian function in early adulthood. AMH < -2 SD predicted failure to enter puberty in young TS girls and imminent POI in adolescent and adult TS patients.
authors.affiliation: Department of Gynecology/Fertility Clinic (S.Aa.L., A.T.P.), and Department of Clinical Genetics (L.A.), Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark; Medical Research Council Centre for Reproductive Health (R.A.A.), University of Edinburgh, Edinburgh EH8 9YL, United Kingdom; and Department of Growth and Reproduction and EDMaRC (K.M.M., A.J., C.P.H.), and The Paed-Gyn Endo Transition Clinic (K.M.M., A.J., C.P.H., A.T.P.) at Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark.
authors.forename: Stine Aa
authors.initials: SA
authors.lastname: Lunding
authors.affiliation: Department of Gynecology/Fertility Clinic (S.Aa.L., A.T.P.), and Department of Clinical Genetics (L.A.), Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark; Medical Research Council Centre for Reproductive Health (R.A.A.), University of Edinburgh, Edinburgh EH8 9YL, United Kingdom; and Department of Growth and Reproduction and EDMaRC (K.M.M., A.J., C.P.H.), and The Paed-Gyn Endo Transition Clinic (K.M.M., A.J., C.P.H., A.T.P.) at Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark.
authors.forename: Lise
authors.initials: L
authors.lastname: Aksglaede
authors.affiliation: Department of Gynecology/Fertility Clinic (S.Aa.L., A.T.P.), and Department of Clinical Genetics (L.A.), Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark; Medical Research Council Centre for Reproductive Health (R.A.A.), University of Edinburgh, Edinburgh EH8 9YL, United Kingdom; and Department of Growth and Reproduction and EDMaRC (K.M.M., A.J., C.P.H.), and The Paed-Gyn Endo Transition Clinic (K.M.M., A.J., C.P.H., A.T.P.) at Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Anderson
authors.affiliation: Department of Gynecology/Fertility Clinic (S.Aa.L., A.T.P.), and Department of Clinical Genetics (L.A.), Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark; Medical Research Council Centre for Reproductive Health (R.A.A.), University of Edinburgh, Edinburgh EH8 9YL, United Kingdom; and Department of Growth and Reproduction and EDMaRC (K.M.M., A.J., C.P.H.), and The Paed-Gyn Endo Transition Clinic (K.M.M., A.J., C.P.H., A.T.P.) at Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark.
authors.forename: Katharina M
authors.initials: KM
authors.lastname: Main
authors.affiliation: Department of Gynecology/Fertility Clinic (S.Aa.L., A.T.P.), and Department of Clinical Genetics (L.A.), Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark; Medical Research Council Centre for Reproductive Health (R.A.A.), University of Edinburgh, Edinburgh EH8 9YL, United Kingdom; and Department of Growth and Reproduction and EDMaRC (K.M.M., A.J., C.P.H.), and The Paed-Gyn Endo Transition Clinic (K.M.M., A.J., C.P.H., A.T.P.) at Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Juul
authors.affiliation: Department of Gynecology/Fertility Clinic (S.Aa.L., A.T.P.), and Department of Clinical Genetics (L.A.), Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark; Medical Research Council Centre for Reproductive Health (R.A.A.), University of Edinburgh, Edinburgh EH8 9YL, United Kingdom; and Department of Growth and Reproduction and EDMaRC (K.M.M., A.J., C.P.H.), and The Paed-Gyn Endo Transition Clinic (K.M.M., A.J., C.P.H., A.T.P.) at Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark.
authors.forename: Casper P
authors.initials: CP
authors.lastname: Hagen
authors.affiliation: Department of Gynecology/Fertility Clinic (S.Aa.L., A.T.P.), and Department of Clinical Genetics (L.A.), Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark; Medical Research Council Centre for Reproductive Health (R.A.A.), University of Edinburgh, Edinburgh EH8 9YL, United Kingdom; and Department of Growth and Reproduction and EDMaRC (K.M.M., A.J., C.P.H.), and The Paed-Gyn Endo Transition Clinic (K.M.M., A.J., C.P.H., A.T.P.) at Rigshospitalet, University of Copenhagen, DK-2100 Copenhagen, Denmark.
authors.forename: Anette T
authors.initials: AT
authors.lastname: Pedersen
mesh_terms: D000293:Adolescent; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008875:Middle Aged; D016649:Primary Ovarian Insufficiency / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D011379:Prognosis; D014424:Turner Syndrome / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D054304:Anti-Mullerian Hormone