Increased anti-Müllerian hormone and decreased FSH levels in follicular fluid obtained in women with polycystic ovaries at the time of follicle puncture for in vitro fertilization.
ABSTRACT To confirm the increased levels of anti-Müllerian hormone (AMH) in preovulatory follicles from patients with polycystic ovary syndrome (PCOS) and to study the role of other hormones involved in folliculogenesis in this increased secretion.
University hospital in France.
Twenty-two patients with PCOS and 20 controls undergoing IVF.
On the day of oocyte retrieval, follicular fluid (FF) from one small follicle (8-13 mm) (SF) and one large follicle (16-23 mm) (LF) was collected in each patient.
Per-follicle AMH, FSH, estradiol, androstenedione, hCG, and progesterone levels, and pregnancy rate.
In FF from both SF and LF of PCOS patients, AMH level was significantly increased, and FSH level was significantly decreased when compared with controls. Both hormone levels were negatively and significantly related in controls but not in PCOS. The AMH levels from SF and LF were significantly lower in patients who began a pregnancy.
Our findings suggest that the granulosa cells from polycystic ovaries continue to produce elevated levels of AMH, possibly because of impaired access of FSH to follicles. Such an excess in FF AMH may have harmful consequences on oocyte quality and final maturation through unknown mechanisms.
Article: Relationship between anti-mullerian hormone and assisted reproductive technique outcome in patients with polycystic ovary syndrome[show abstract] [hide abstract]
ABSTRACT: Background: Anti-mullerian hormone (AMH) levels may represent the ovarian follicular pool and could be a useful marker of ovarian reserve. The clinical application of AMH measurement has been proposed in the prediction of quantitative and qualitative aspects in assisted reproductive technologies.Objective: This study aimed to assess the relationship between the serum levels of AMH and results of assisted reproductive technique (ART) outcome in polycystic ovary syndrome (PCOS) patients versus control group.Materials and Methods: This cohort study was conducted on 61 (PCOS) patients and 28 patients without PCOS (controls) candidates for assisted reproductive technique. Serum levels of AMH were measured on the 3rd day of menstrual cycle and all the patients underwent controlled ovarian hyper stimulation and ART. The relationship between AMH serum level with retrieved oocytes, mature oocytes and pregnancy rate were assessed. Results: There was significant correlation between the AMH level with number of total retrieved oocytes and mature oocytes in patients with PCOS and controls (p=0.001). In PCOS and control groups AMH level in pregnant patients was higher, but it was not statistically significant (p=0.65, p=0.46, respectively). The major outcome of the study (pregnancy) did not differ significantly between two groups.Conclusion: This study revealed that AMH level was higher in pregnant patients undergoing ART; but AMH may not be an accurate predictor for pregnancy in PCOS patients.Iranian Journal of Reproductive Medicine. 01/2010;
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ABSTRACT: Anti-Müllerian hormone (AMH) is a glycoprotein produced in the granulosa cells of the ovary. It is involved in the regulation of follicular growth and development. AMH serum and follicular fluid concentration is increased in women with polycystic ovary syndrome (PCOS), which correlates with the extent of ovarian dysfunction and clinical manifestation of the syndrome. It is unclear whether the higher AMH levels in PCOS are due to the higher number of preantral follicles or result from a specific disorder in the synthesis of AMH causing follicular arrest in PCOS. AMH determination has high specificity and sensitivity as a diagnostic marker for PCOS. The AMH level can also be used to predict the effect of treatment in PCOS women, the higher values implying more difficulties in the therapeutic management of the disease.Folia medica 53(1):5-10.