Clinical significance of serum concentration of anti-Müllerian hormone in obese women with polycystic ovary syndrome

El-Halawaty, Samir; Rizk, Ahmed; Kamal, Manal; AboulHassan, Mona; Al-Sawah, Heba; Noah, Olfat; Al-Inany, Hesham

doi:10.1016/s1472-6483(10)60379-3

Cited by 41 publications

(30 citation statements)

References 20 publications

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“…Accordingly, LH was found to be a strong determinant of AMH in our study, and in four subgroups of patients with 'PCOS' (31). In clinical practice, 'PCOS' patients with LH levels O10 U/l show little or no response to clomiphene citrate stimulation, and AMH may predict the response to clomiphene citrate stimulation in these women (32). Androgen priming in a specific stimulation protocol increased the AMH concentration in follicular fluid (22), fitting in with the positive correlation between AMH and testosterone in this and earlier studies (17,31,33).…”

Section: Discussionsupporting

confidence: 52%

Anti-Müllerian hormone confirms the novel classification of female functional androgenization including polycystic ovary syndrome

Wetzka

Textor²,

Ochsner³

et al. 2011

European Journal of Endocrinology

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Objective: Functional androgenization (FA) can be divided into five groups corresponding to the predominant organ pathology as recently shown by our group: functional cutaneous androgenization (FCA, skin) and FA syndrome (FAS) I (ovary, lean individual), II (adrenal gland), III (ovary, fat tissue, pancreas, and hyperinsulinemia), and IV (residual FA dysfunctions). Group-specific clusters are based on primary variables such as LH, testosterone, DHEAS, sex hormone-binding globulin (SHBG), body mass index (BMI), glucose, insulin, and enlarged polyfollicular ovaries. Because anti-Mü llerian hormone (AMH) positively correlates with the antral follicle count, its relevance as an additional primary variable for classifying FA was investigated. Design: In this study, 178 patients with FA were consecutively enrolled and classified into the five FA groups as described earlier and 30 women with regular menstrual cycles served as control. Methods: Primary variables and serum AMH were analyzed in the early follicular phase. Results: FA patients showed significantly elevated AMH levels (11.1G6.7 ng/ml) versus control (3.0G2.0 ng/ml; P!.0001). AMH was significantly increased in groups FAS I (15.6G5.8 ng/ml) and FAS III (11.6G6.6 ng/ml) compared with groups FCA (7.0G3.8 ng/ml), FAS II (5.05G3.0 ng/ml), and FAS IV (6.9G4.6 ng/ml) and correlated positively (P!.0001) with LH (rZ0.538) and testosterone (rZ0.368). In regression and multivariate analyses, AMH was not dependent on SHBG, DHEAS, BMI, glucose, or insulin. In receiver operating characteristic analysis, 9.21 ng/ml AMH showed 90% specificity with 71.2% sensitivity for the diagnosis of the two ovarian FA groups, FAS I and III. Conclusion: AMH confirms the novel stratification system and constitutes a useful primary variable in the algorithm of FA classification.

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Section: Discussionsupporting

confidence: 52%

Anti-Müllerian hormone confirms the novel classification of female functional androgenization including polycystic ovary syndrome

Wetzka

Textor²,

Ochsner³

et al. 2011

European Journal of Endocrinology

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“…They reported circulating AMH concentrations to be negatively related to ovarian response to gonadotrophin. On the other hand, our findings meet with those of El-Halawaty et al [22], in that AMH concentrations were significantly more in responders when compared to non-responder. However, their findings included a subgroup of overweight PCOS women taking a higher doses of clomiphene citrate (150 mg/d).…”

Section: Resultssupporting

confidence: 91%

Prediction of Ovarian Response by Antimullerian Hormone in Women with Polycystic Ovarian Syndrome: A Randomized Prospective Study

Elsaid¹

2016

J Gynecol Res Obstet

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033Anti-Müllerian hormone (AMH) is proved as an outstanding contributors to this disorder [4,5].AMH is synthesized specifically by granulose cells of developing ovarian preantral and small antral follicles. Circulating AMH levels in women with PCOS are 2-to 3-fold more compared to ovulatory women with normal ovaries [6,7], which denotes to the 2-to 3-fold rise in the count of small follicles detected in PCOS. The excessive AMH has been hypothesized to decrease follicle sensitivity to FSH induction and oestradiol production, so hindering follicle selection, resulting in follicular maturation arrest at the small antral phase with the failure to reach maturity.Gonadotropin induction is widely utilized for ovulation stimulation in clomiphene citrate resistant PCOS women [8]. Human menopausal gonadotropin (hMG) is prepared by extraction from postmenopausal women urine. Commercial preparations contain 75 units of FSH and 75 units LH (Pergonal, Serono and Humegon, Organon) [9]. The utilization of urofollitropin, a purified FSH free of LH activity, looks to be an advisable therapy, since there is a proof that pure FSH may significantly decrease persistently high LH levels, favorably change the intraovarian hormonal environment, and IntroductionPolycystic ovary syndrome (PCOS) is the most frequent endocrine abnormality in women of reproductive age, with a prevalence of nearly 5-10 %. PCOS is the main reason of an ovulatory infertility [1]. The recent reports demonstrate that ovarian dysfunction results from ovarian follicle disorders in PCOS women are 2-folds [2,3]. First, early follicular development is excessive, so women with PCOS are characterized by an increase number of developing small antral follicles (2-to 3-folds that of normal ovaries). Secondly, the selection of the dominant follicle from the excessive pool of selectable follicles does not occur. This second disorder in the process of folliculogenesis is named the follicular arrest (FA) and explains the ovulatory dysfunction of PCOS. Although the FA has not clearly explained, Research AbstractObjective: To assess the effect of high level of circulating antimullerian hormone on the outcome of gonadotrophin ovulation induction in women with polycystic ovarian syndrome. Patients and Methods:This was a prospective study performed at Ain Shams University Maternity Hospital, over a 3-year period, between Jan 2013 and Jan 2016, and included 300 women who were presented at the infertility clinic and scheduled for having gonadotrophin ovulation induction. Participant ages ranged from 18 to 35 years, the patients were divided into two equal groups; group I (N=150) included women with PCOS having antimullerian hormone < 7.7 mg/dl and group II (N=150) which included women with PCOS with antimullerian hormone ≥ 7.7 mg/dl. The two groups underwent gonadotrophin stimulation of the ovary, serum AMH concentrations were measured on cycle day 3 before the commencement of gonadotrophins ovarian induction. Ovarian response and the biochemical and clinical pregnancy rates were a...

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“…The data are rather scarce; however, in one study, the response to clomiphene citrate in obese patients with PCOS was again dependent on initial AMH concentration (El-Halawaty et al 2007). Unfortunately, AMH response during treatment was not measured in this study.…”

Section: Amh and Response To Treatment In Pcosmentioning

confidence: 76%

Anti-Müllerian hormone and polycystic ovary syndrome: a mountain too high?

Pellatt¹,

Rice²,

Mason³

2010

Reproduction

190

112

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Anti-Mü llerian hormone (AMH) was initially thought to be produced solely by the foetal male during sexual differentiation to promote regression of the Mü llerian ducts. Over the last decade, however, a new and interesting role has emerged for AMH in the ovary. In human ovaries, AMH is produced by granulosa cells from 36 weeks of gestation until menopause, with the highest expression being in small antral follicles. AMH production gradually declines as follicles grow; once follicles reach a size at which they are dominant, it has largely disappeared. Its removal from these larger follicles appears to be an important requirement for dominant follicle selection and progression to ovulation as AMH has an inhibitory role in the ovary, reducing both primordial follicle initiation and follicle sensitivity to FSH by inhibition of aromatase. It is for this reason that AMH is a focus of interest in polycystic ovary syndrome (PCOS). Serum levels are doubled, and granulosa cell production is greatly increased. Interestingly, there appear to be two groups of women with PCOS who can be distinguished by their AMH level: one group consists of those who have high levels which do not reduce with treatment and who respond less well to induction of ovulation, and a second group consists of those in whom the level is less elevated and reduces on treatment and who seem to respond rather better. Understanding the reason for the raised AMH in PCOS may give clues as to the mechanism of anovulation. To conclude, AMH appears to have a major inhibitory role during folliculogenesis, which may contribute to anovulation in PCOS.

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Clinical significance of serum concentration of anti-Müllerian hormone in obese women with polycystic ovary syndrome

Cited by 41 publications

References 20 publications

Anti-Müllerian hormone confirms the novel classification of female functional androgenization including polycystic ovary syndrome

Anti-Müllerian hormone confirms the novel classification of female functional androgenization including polycystic ovary syndrome

Prediction of Ovarian Response by Antimullerian Hormone in Women with Polycystic Ovarian Syndrome: A Randomized Prospective Study

Anti-Müllerian hormone and polycystic ovary syndrome: a mountain too high?

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