title: Baseline AMH Level Associated With Ovulation Following Ovulation Induction in Women With Polycystic Ovary Syndrome.
abstract: Anti-Müllerian hormone (AMH) reduces aromatase activity and sensitivity of follicles to FSH stimulation. Therefore, elevated serum AMH may indicate a higher threshold for response to ovulation induction in women with polycystic ovary syndrome (PCOS).
  
  
  
  This study sought to determine the association between AMH levels and ovulatory response to treatment among the women enrolled into the Pregnancy in PCOS II (PPCOS II) trial.
  
  
  
  This was a secondary analysis of data from a randomized clinical trial in academic health centers throughout the United States Participants: A total of 748 women age 18-40 years, with PCOS and measured AMH levels at baseline, were included in this study.
  
  
  
  Couples were followed for up to five treatment cycles to determine ovulation (midluteal serum progesterone > 5 ng/mL) and the dose required to achieve ovulation.
  
  
  
  A lower mean AMH and AMH per follicle was observed among women who ovulated compared with women who never achieved ovulation during the study (geometric mean AMH, 5.54 vs 7.35 ng/mL; P = .0001; geometric mean AMH per follicle, 0.14 vs 0.18; P = .01) after adjustment for age, body mass index, T, and insulin level. As AMH levels increased, the dose of ovulation induction medication needed to achieve ovulation also increased. No associations were observed between antral follicle count and ovulation.
  
  
  
  These results suggest that high serum AMH is associated with a reduced response to ovulation induction among women with PCOS. Women with higher AMH levels may require higher doses of medication to achieve ovulation.
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research (S.L.M.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; Department of Obstetrics and Gynecology (R.S.L.), Pennsylvania State University, Hershey, Pennsylvania; Department of Obstetrics and Gynecology (M.P.D.), Augusta University, Augusta, Georgia; Department of Obstetrics and Gynecology (C.C.), University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology (A.Z.S.), University of North Carolina, Chapel Hill, North Carolina; Department of Obstetrics and Gynecology (R.A., N.S.), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Department of Obstetrics and Gynecology (G.M.C.), University of Michigan, Ann Arbor, Michigan; Department of Obstetrics and Gynecology (P.R.C.), University of Vermont, Burlington, Vermont; Department of Biostatistics (H.H., H.Z.), Yale University School of Public Health, New Haven, Connecticut; Fertility and Infertility Branch (E.E.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; and Department of Obstetrics, Gynecology and Reproductive Sciences (M.I.C.), University of California-San Francisco, San Francisco, California.
authors.forename: Sunni L
authors.initials: SL
authors.lastname: Mumford
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research (S.L.M.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; Department of Obstetrics and Gynecology (R.S.L.), Pennsylvania State University, Hershey, Pennsylvania; Department of Obstetrics and Gynecology (M.P.D.), Augusta University, Augusta, Georgia; Department of Obstetrics and Gynecology (C.C.), University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology (A.Z.S.), University of North Carolina, Chapel Hill, North Carolina; Department of Obstetrics and Gynecology (R.A., N.S.), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Department of Obstetrics and Gynecology (G.M.C.), University of Michigan, Ann Arbor, Michigan; Department of Obstetrics and Gynecology (P.R.C.), University of Vermont, Burlington, Vermont; Department of Biostatistics (H.H., H.Z.), Yale University School of Public Health, New Haven, Connecticut; Fertility and Infertility Branch (E.E.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; and Department of Obstetrics, Gynecology and Reproductive Sciences (M.I.C.), University of California-San Francisco, San Francisco, California.
authors.forename: Richard S
authors.initials: RS
authors.lastname: Legro
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research (S.L.M.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; Department of Obstetrics and Gynecology (R.S.L.), Pennsylvania State University, Hershey, Pennsylvania; Department of Obstetrics and Gynecology (M.P.D.), Augusta University, Augusta, Georgia; Department of Obstetrics and Gynecology (C.C.), University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology (A.Z.S.), University of North Carolina, Chapel Hill, North Carolina; Department of Obstetrics and Gynecology (R.A., N.S.), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Department of Obstetrics and Gynecology (G.M.C.), University of Michigan, Ann Arbor, Michigan; Department of Obstetrics and Gynecology (P.R.C.), University of Vermont, Burlington, Vermont; Department of Biostatistics (H.H., H.Z.), Yale University School of Public Health, New Haven, Connecticut; Fertility and Infertility Branch (E.E.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; and Department of Obstetrics, Gynecology and Reproductive Sciences (M.I.C.), University of California-San Francisco, San Francisco, California.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Diamond
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research (S.L.M.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; Department of Obstetrics and Gynecology (R.S.L.), Pennsylvania State University, Hershey, Pennsylvania; Department of Obstetrics and Gynecology (M.P.D.), Augusta University, Augusta, Georgia; Department of Obstetrics and Gynecology (C.C.), University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology (A.Z.S.), University of North Carolina, Chapel Hill, North Carolina; Department of Obstetrics and Gynecology (R.A., N.S.), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Department of Obstetrics and Gynecology (G.M.C.), University of Michigan, Ann Arbor, Michigan; Department of Obstetrics and Gynecology (P.R.C.), University of Vermont, Burlington, Vermont; Department of Biostatistics (H.H., H.Z.), Yale University School of Public Health, New Haven, Connecticut; Fertility and Infertility Branch (E.E.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; and Department of Obstetrics, Gynecology and Reproductive Sciences (M.I.C.), University of California-San Francisco, San Francisco, California.
authors.forename: Christos
authors.initials: C
authors.lastname: Coutifaris
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research (S.L.M.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; Department of Obstetrics and Gynecology (R.S.L.), Pennsylvania State University, Hershey, Pennsylvania; Department of Obstetrics and Gynecology (M.P.D.), Augusta University, Augusta, Georgia; Department of Obstetrics and Gynecology (C.C.), University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology (A.Z.S.), University of North Carolina, Chapel Hill, North Carolina; Department of Obstetrics and Gynecology (R.A., N.S.), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Department of Obstetrics and Gynecology (G.M.C.), University of Michigan, Ann Arbor, Michigan; Department of Obstetrics and Gynecology (P.R.C.), University of Vermont, Burlington, Vermont; Department of Biostatistics (H.H., H.Z.), Yale University School of Public Health, New Haven, Connecticut; Fertility and Infertility Branch (E.E.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; and Department of Obstetrics, Gynecology and Reproductive Sciences (M.I.C.), University of California-San Francisco, San Francisco, California.
authors.forename: Anne Z
authors.initials: AZ
authors.lastname: Steiner
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research (S.L.M.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; Department of Obstetrics and Gynecology (R.S.L.), Pennsylvania State University, Hershey, Pennsylvania; Department of Obstetrics and Gynecology (M.P.D.), Augusta University, Augusta, Georgia; Department of Obstetrics and Gynecology (C.C.), University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology (A.Z.S.), University of North Carolina, Chapel Hill, North Carolina; Department of Obstetrics and Gynecology (R.A., N.S.), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Department of Obstetrics and Gynecology (G.M.C.), University of Michigan, Ann Arbor, Michigan; Department of Obstetrics and Gynecology (P.R.C.), University of Vermont, Burlington, Vermont; Department of Biostatistics (H.H., H.Z.), Yale University School of Public Health, New Haven, Connecticut; Fertility and Infertility Branch (E.E.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; and Department of Obstetrics, Gynecology and Reproductive Sciences (M.I.C.), University of California-San Francisco, San Francisco, California.
authors.forename: William D
authors.initials: WD
authors.lastname: Schlaff
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research (S.L.M.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; Department of Obstetrics and Gynecology (R.S.L.), Pennsylvania State University, Hershey, Pennsylvania; Department of Obstetrics and Gynecology (M.P.D.), Augusta University, Augusta, Georgia; Department of Obstetrics and Gynecology (C.C.), University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology (A.Z.S.), University of North Carolina, Chapel Hill, North Carolina; Department of Obstetrics and Gynecology (R.A., N.S.), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Department of Obstetrics and Gynecology (G.M.C.), University of Michigan, Ann Arbor, Michigan; Department of Obstetrics and Gynecology (P.R.C.), University of Vermont, Burlington, Vermont; Department of Biostatistics (H.H., H.Z.), Yale University School of Public Health, New Haven, Connecticut; Fertility and Infertility Branch (E.E.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; and Department of Obstetrics, Gynecology and Reproductive Sciences (M.I.C.), University of California-San Francisco, San Francisco, California.
authors.forename: Ruben
authors.initials: R
authors.lastname: Alvero
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research (S.L.M.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; Department of Obstetrics and Gynecology (R.S.L.), Pennsylvania State University, Hershey, Pennsylvania; Department of Obstetrics and Gynecology (M.P.D.), Augusta University, Augusta, Georgia; Department of Obstetrics and Gynecology (C.C.), University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology (A.Z.S.), University of North Carolina, Chapel Hill, North Carolina; Department of Obstetrics and Gynecology (R.A., N.S.), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Department of Obstetrics and Gynecology (G.M.C.), University of Michigan, Ann Arbor, Michigan; Department of Obstetrics and Gynecology (P.R.C.), University of Vermont, Burlington, Vermont; Department of Biostatistics (H.H., H.Z.), Yale University School of Public Health, New Haven, Connecticut; Fertility and Infertility Branch (E.E.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; and Department of Obstetrics, Gynecology and Reproductive Sciences (M.I.C.), University of California-San Francisco, San Francisco, California.
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Christman
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research (S.L.M.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; Department of Obstetrics and Gynecology (R.S.L.), Pennsylvania State University, Hershey, Pennsylvania; Department of Obstetrics and Gynecology (M.P.D.), Augusta University, Augusta, Georgia; Department of Obstetrics and Gynecology (C.C.), University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology (A.Z.S.), University of North Carolina, Chapel Hill, North Carolina; Department of Obstetrics and Gynecology (R.A., N.S.), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Department of Obstetrics and Gynecology (G.M.C.), University of Michigan, Ann Arbor, Michigan; Department of Obstetrics and Gynecology (P.R.C.), University of Vermont, Burlington, Vermont; Department of Biostatistics (H.H., H.Z.), Yale University School of Public Health, New Haven, Connecticut; Fertility and Infertility Branch (E.E.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; and Department of Obstetrics, Gynecology and Reproductive Sciences (M.I.C.), University of California-San Francisco, San Francisco, California.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Casson
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research (S.L.M.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; Department of Obstetrics and Gynecology (R.S.L.), Pennsylvania State University, Hershey, Pennsylvania; Department of Obstetrics and Gynecology (M.P.D.), Augusta University, Augusta, Georgia; Department of Obstetrics and Gynecology (C.C.), University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology (A.Z.S.), University of North Carolina, Chapel Hill, North Carolina; Department of Obstetrics and Gynecology (R.A., N.S.), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Department of Obstetrics and Gynecology (G.M.C.), University of Michigan, Ann Arbor, Michigan; Department of Obstetrics and Gynecology (P.R.C.), University of Vermont, Burlington, Vermont; Department of Biostatistics (H.H., H.Z.), Yale University School of Public Health, New Haven, Connecticut; Fertility and Infertility Branch (E.E.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; and Department of Obstetrics, Gynecology and Reproductive Sciences (M.I.C.), University of California-San Francisco, San Francisco, California.
authors.forename: Hao
authors.initials: H
authors.lastname: Huang
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research (S.L.M.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; Department of Obstetrics and Gynecology (R.S.L.), Pennsylvania State University, Hershey, Pennsylvania; Department of Obstetrics and Gynecology (M.P.D.), Augusta University, Augusta, Georgia; Department of Obstetrics and Gynecology (C.C.), University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology (A.Z.S.), University of North Carolina, Chapel Hill, North Carolina; Department of Obstetrics and Gynecology (R.A., N.S.), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Department of Obstetrics and Gynecology (G.M.C.), University of Michigan, Ann Arbor, Michigan; Department of Obstetrics and Gynecology (P.R.C.), University of Vermont, Burlington, Vermont; Department of Biostatistics (H.H., H.Z.), Yale University School of Public Health, New Haven, Connecticut; Fertility and Infertility Branch (E.E.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; and Department of Obstetrics, Gynecology and Reproductive Sciences (M.I.C.), University of California-San Francisco, San Francisco, California.
authors.forename: Nanette
authors.initials: N
authors.lastname: Santoro
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research (S.L.M.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; Department of Obstetrics and Gynecology (R.S.L.), Pennsylvania State University, Hershey, Pennsylvania; Department of Obstetrics and Gynecology (M.P.D.), Augusta University, Augusta, Georgia; Department of Obstetrics and Gynecology (C.C.), University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology (A.Z.S.), University of North Carolina, Chapel Hill, North Carolina; Department of Obstetrics and Gynecology (R.A., N.S.), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Department of Obstetrics and Gynecology (G.M.C.), University of Michigan, Ann Arbor, Michigan; Department of Obstetrics and Gynecology (P.R.C.), University of Vermont, Burlington, Vermont; Department of Biostatistics (H.H., H.Z.), Yale University School of Public Health, New Haven, Connecticut; Fertility and Infertility Branch (E.E.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; and Department of Obstetrics, Gynecology and Reproductive Sciences (M.I.C.), University of California-San Francisco, San Francisco, California.
authors.forename: Esther
authors.initials: E
authors.lastname: Eisenberg
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research (S.L.M.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; Department of Obstetrics and Gynecology (R.S.L.), Pennsylvania State University, Hershey, Pennsylvania; Department of Obstetrics and Gynecology (M.P.D.), Augusta University, Augusta, Georgia; Department of Obstetrics and Gynecology (C.C.), University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology (A.Z.S.), University of North Carolina, Chapel Hill, North Carolina; Department of Obstetrics and Gynecology (R.A., N.S.), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Department of Obstetrics and Gynecology (G.M.C.), University of Michigan, Ann Arbor, Michigan; Department of Obstetrics and Gynecology (P.R.C.), University of Vermont, Burlington, Vermont; Department of Biostatistics (H.H., H.Z.), Yale University School of Public Health, New Haven, Connecticut; Fertility and Infertility Branch (E.E.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; and Department of Obstetrics, Gynecology and Reproductive Sciences (M.I.C.), University of California-San Francisco, San Francisco, California.
authors.forename: Heping
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research (S.L.M.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; Department of Obstetrics and Gynecology (R.S.L.), Pennsylvania State University, Hershey, Pennsylvania; Department of Obstetrics and Gynecology (M.P.D.), Augusta University, Augusta, Georgia; Department of Obstetrics and Gynecology (C.C.), University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology (A.Z.S.), University of North Carolina, Chapel Hill, North Carolina; Department of Obstetrics and Gynecology (R.A., N.S.), University of Colorado Anschutz Medical Campus, Aurora, Colorado; Department of Obstetrics and Gynecology (G.M.C.), University of Michigan, Ann Arbor, Michigan; Department of Obstetrics and Gynecology (P.R.C.), University of Vermont, Burlington, Vermont; Department of Biostatistics (H.H., H.Z.), Yale University School of Public Health, New Haven, Connecticut; Fertility and Infertility Branch (E.E.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland; and Department of Obstetrics, Gynecology and Reproductive Sciences (M.I.C.), University of California-San Francisco, San Francisco, California.
authors.forename: Marcelle I
authors.initials: MI
authors.lastname: Cedars
mesh_terms: D000293:Adolescent; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015415:Biomarkers / Q000097:blood*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006080:Ovarian Follicle / Q000378:metabolism*; D010060:Ovulation / Q000502:physiology*; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000503:physiopathology*; D011247:Pregnancy; D011379:Prognosis; D055815:Young Adult
chemical_list: D015415:Biomarkers; D054304:Anti-Mullerian Hormone