Ovarian Antral Follicle Subclasses and Anti-Müllerian Hormone During Normal Reproductive Aging

Bentzen, Jens; Forman, Julie Lyng; Johannsen, Trine Holm; Pinborg, Anja; Larsen, Elisabeth; Andersen, Anders Nyboe

doi:10.1210/jc.2012-1829

Cited by 117 publications

(85 citation statements)

References 37 publications

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“…Similar levels of androgens and indexes of insulin sensitivity were observed in healthy girls with and without PCOM [181]. Nevertheless, persistence of enlarged ovaries and menstrual irregularities may foretell the future development of PCOS [176, 182, 183]. …”

Section: B Diagnosismentioning

confidence: 84%

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An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence

Ibáñez¹,

et al. 2017

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This paper represents an international collaboration of paediatric endocrine and other societies (listed in the Appendix) under the International Consortium of Paediatric Endocrinology (ICPE) aiming to improve worldwide care of adolescent girls with polycystic ovary syndrome (PCOS)¹. The manuscript examines pathophysiology and guidelines for the diagnosis and management of PCOS during adolescence. The complex pathophysiology of PCOS involves the interaction of genetic and epigenetic changes, primary ovarian abnormalities, neuroendocrine alterations, and endocrine and metabolic modifiers such as anti-Müllerian hormone, hyperinsulinemia, insulin resistance, adiposity, and adiponectin levels. Appropriate diagnosis of adolescent PCOS should include adequate and careful evaluation of symptoms, such as hirsutism, severe acne, and menstrual irregularities 2 years beyond menarche, and elevated androgen levels. Polycystic ovarian morphology on ultrasound without hyperandrogenism or menstrual irregularities should not be used to diagnose adolescent PCOS. Hyperinsulinemia, insulin resistance, and obesity may be present in adolescents with PCOS, but are not considered to be diagnostic criteria. Treatment of adolescent PCOS should include lifestyle intervention, local therapies, and medications. Insulin sensitizers like metformin and oral contraceptive pills provide short-term benefits on PCOS symptoms. There are limited data on anti-androgens and combined therapies showing additive/synergistic actions for adolescents. Reproductive aspects and transition should be taken into account when managing adolescents.

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Section: B Diagnosismentioning

confidence: 84%

“…[175]. Follicle size also changes with age, and the greatest number of small follicles is observed during adolescence and young adulthood, with a significant decrease in follicle count with age [176]. …”

Section: B Diagnosismentioning

confidence: 99%

An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence

Ibáñez¹,

et al. 2017

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“…The slow changes in AMH levels suggest that it regulates the long-term processes, across the lifespan. Correlation studies suggest that the size of the developing follicle pool is the primary determinant of AMH concentrations in women (Fanchin et al 2003, Hansen et al 2011, Bentzen et al 2013. In essence, the AMH-responsive cells (outside of early developing follicles) are being regulated by the size of the developing follicle pool.…”

Section: Anti-müllerian Hormone Expression In the Ovarymentioning

confidence: 99%

A putative role for anti-Müllerian hormone (AMH) in optimising ovarian reserve expenditure

Pankhurst

2017

Journal of Endocrinology

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The mammalian ovary has a finite supply of oocytes, which are contained within primordial follicles where they are arrested in a dormant state. The number of primordial follicles in the ovary at puberty is highly variable between females of the same species. Females that enter puberty with a small ovarian reserve are at risk of a shorter reproductive lifespan, as their ovarian reserve is expected to be depleted faster. One of the roles of anti-Müllerian hormone (AMH) is to inhibit primordial follicle activation, which slows the rate at which the ovarian reserve is depleted. A simple interpretation is that the function of AMH is to conserve ovarian reserve. However, the females with the lowest ovarian reserve and the greatest risk of early reserve depletion have the lowest levels of AMH. In contrast, AMH apparently strongly inhibits primordial follicle activation in females with ample ovarian reserve, for reasons that remain unexplained. The rate of primordial follicle activation determines the size of the developing follicle pool, which in turn, determines how many oocytes are available to be selected for ovulation. This review discusses the evidence that AMH regulates the size of the developing follicle pool by altering the rate of primordial follicle activation in a context-dependent manner. The expression patterns of AMH across life are also consistent with changing requirements for primordial follicle activation in the ageing ovary. A potential role of AMH in the fertility of ageing females is proposed herein.

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“…11 Throughout early reproductive life, the number of growing follicles is highly correlated with the size of the resting pool. Between the ages of 30 and 35, however, the percentage of growing follicles increases [12][13][14] and the trajectory of follicle loss is accelerated until the pool of resting follicles is reduced to between 100 and 1000, when there is cessation of reproductive cycles. 15 Age-related changes in oocyte quality parallel the decrease in follicle number, with reported decreases in fertilization and conception rates and higher rates of pregnancy loss.…”

Section: Ovarian Aging In Womenmentioning

confidence: 99%

Endocrinology of the Menopause

Hall

2015

Endocrinology and Metabolism Clinics of North America

138

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In women, age-related changes in ovarian function begin in the mid-30s with decreased fertility and compensatory hormonal changes in the hypothalamus-pituitary-gonadal axis that maintain follicle development and estrogen secretion in the face of a waning pool of ovarian follicles. The menopause transition is characterized by marked variability in follicle development, ovulation, bleeding patterns, and symptoms of hyper- and hypoestrogenism. The menopause, which is clinically defined by the last menstrual period, is followed by the consistent absence of ovarian secretion of estradiol.

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Ovarian Antral Follicle Subclasses and Anti-Müllerian Hormone During Normal Reproductive Aging

Cited by 117 publications

References 37 publications

An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence

An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence

A putative role for anti-Müllerian hormone (AMH) in optimising ovarian reserve expenditure

Endocrinology of the Menopause

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