Role of anti-Müllerian hormone and testosterone in follicular growth: a cross-sectional study

Abstract

Background: Anti-Müllerian hormone (AMH) is now considered the best serum biomarker of ovarian reserve, while basal sex hormones are classic markers used for assessing ovarian reserve. The interaction between AMH and sex hormones are complicated and not sufficiently addressed. In this study, we took diminished ovarian reserve (DOR) and polycystic ovarian syndrome (PCOS) as two extremes of ovarian reserve (deficient and excessive respectively) to investigate the role of AMH and sex hormones in follicular growth. Methods: A retrospective cross-sectional survey was performed. The patients assessed AMH and basal sex hormones in the Second Hospital of Zhejiang University from April 2016 to March 2019 were involved in this study. Serum AMH and sex hormone concentrations were tested with electrochemiluminescence method. Stepwise linear regression and binary logistic regression was used to determine the predictors of AMH level and to explore the involved factors determining DOR and PCOS. Results: In the present study, we found that age and follicle-stimulating hormone (FSH) were main negative correlation factors, and luteinizing hormone (LH) and testosterone (T) were main positive factors of AMH. In DOR group, age, FSH and estradiol (E 2) increased and T decreased, while in PCOS group, LH and T increased. Binary logistic regression found that age, weight, FSH, E 2 , and T were the significant factors which independently predicted the likelihood of DOR, and that age, body mass index (BMI), AMH, LH, and T predicted the likelihood of PCOS. Conclusions: Our study demonstrated that age, FSH, and T were factors that most closely correlated with AMH level, and T was involved in both DOR and PCOS. Since DOR and PCOS are manifested with insufficient AMH and excessive AMH respectively, it is suggested that total testosterone correlated with AMH closely and plays an important role in follicular growth. More attention should be given to testosterone level during controlled ovarian hyperstimulation (COH) process.

The Relationship of Anti-Mullerian Hormone in Polycystic Ovary Syndrome Patients with Different Subgroups

“…HA had a weaker relationship in our results, which differed from some previous findings which reported a positive correlation between serum AMH and TT 20 , 21 and found that AMH levels were higher in PCOS when HA was present. 22 The AMH level in the HA+non-PCOM group (1161/1631) was higher than that in the healthy control group (7.6±4.23 vs 5.57±3.31 ng/mL) in our study.…”

The Relationship of Anti-Mullerian Hormone in Polycystic Ovary Syndrome Patients With Different Subgroups

“…Our study indicated that the increase of AMH is the result of HA and PCO together, consistent with previous studies [17]. The serum AMH in PCOM + non-HA group was higher in that in HA + non-PCOM group(9.57 ± 4.3 ng/ml vs 7.6 ± 4.23 ng/ml) showed that the AMH and PCOM had the strongest relationship which was determined by the intrinsic secretion characteristics of AMH, such as increased basal follicles or delayed disappearance of AMH expression, while HA has the weaker relationship which was different from some previous nding, it was reported that the positive correlation between serum AMH and total testosterone [18][19], AMH levels was higher in PCOS when HA was present [20]. In our study, the AMH level of HA + non-PCOM group (1161/1631) was higher to HC (7.6 ± 4.23 ng/ml vs 5.57 ± 3.31 ng/ml), which can be considered as the effect of HA on AMH simply without considering the false negative of the ultrasound result.…”

Improvement Effect of Metformin on Female and Male Reproduction in Endocrine Pathologies and Its Mechanisms

“…Excess levels of AMH lead to an impaired folliculogenesis, preventing the recruitment of primordial follicles into the pool of growing follicles and reducing the responsiveness of growing follicles to FSH [ 249 , 275 , 276 , 277 ]. The increased levels of AMH may be due to HA and hyperinsulinemia, which are characteristic features of PCOS and are closely interrelated [ 249 , 273 , 278 , 279 , 280 ], as well as to an increase in blood LH levels or the sensitivity of granulosa cells to LH, typical for PCOS patients [ 280 , 281 , 282 , 283 ]. In in vitro experiments using lutein granulosa cells obtained from oligo/anovulatory PCOS women, the LH increases the AMH production, while the expression of type II AMH receptors in these cells does not change significantly.…”