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Böhmer F, Erber K, Ewringmann A, Klein R, Reese S, Böhmer C, Meyer-Lindenberg A, Walter B. Anti-Müllerian hormone concentrations in female rabbits and its relation to spay status, pseudopregnancy and ovarian follicle numbers. Reprod Domest Anim 2022; 57:1636-1643. [PMID: 36052807 DOI: 10.1111/rda.14240] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/22/2022] [Accepted: 08/31/2022] [Indexed: 11/28/2022]
Abstract
Anti-Müllerian hormone (AMH), known for its role during fetal sexual differentiation, is secreted by the Sertoli cells in males and the granulosa cells in females during postnatal life. As serum AMH concentrations correlate with follicle numbers, AMH is utilised as a marker of ovarian reserve in many species. In dogs and cats, AMH is used as a diagnostic tool to determine spay or neuter status. In the available literature, no research regarding serum AMH levels in rabbits has been published yet. The objectives of the present study were to 1) measure serum AMH concentrations in female rabbits and investigate the value of AMH as a diagnostic tool to differentiate between spayed and intact does, and 2) relate measured AMH levels to pseudopregnancy and ovarian follicle numbers. For AMH measurement, serum samples were obtained from sexually intact (n = 64) and spayed (n = 22) female rabbits. Spayed does were of various breeds; intact rabbits were Zika hybrid rabbits. In the intact does, AMH measurement was complemented by determination of progesterone levels, gynaecological examination, and histopathologic evaluation of the uterus and ovaries, including follicle counts. Serum AMH and progesterone concentrations were measured using a human-based chemiluminescence immunoassay (CLIA) and an enzyme-linked fluorescence assay (ELFA), respectively. Depending on progesterone levels, sexually intact does were classified into follicular (n = 52) or luteal phase (n = 12). Median serum AMH levels were 1.53 ng/ml (range 0.77 - 3.36 ng/ml) in intact and 0.06 ng/ml (range ≤ 0.01 - 0.23 ng/ml) in spayed does. AMH concentrations between the intact and spayed rabbits differed significantly and did not overlap (p < 0.001). Receiver operating characteristic (ROC) curve analysis yielded a sensitivity and specificity of 100% for a cut-off level of 0.50 ng/ml. Follicular or luteal phase had no significant influence on measured AMH levels (t = 0.061, df = 62, p = 0.951). While the number of secondary follicles correlated significantly with AMH concentrations (rs = 0.410, p = 0.001), the number of primary or antral follicles did not (rs = 0.241, p = 0.055 and rs = 0.137, p = 0.281, respectively). In conclusion, a single determination of serum AMH concentrations was adequate to distinguish spayed from intact female rabbits. Among sexually intact individuals, whether does were in follicular or luteal phase had no significant influence on measured serum AMH concentrations. The relationship between small growing follicles and AMH levels as described in other species could be partially confirmed, as secondary follicles correlated significantly with AMH.
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Affiliation(s)
- Florian Böhmer
- Faculty of Veterinary Medicine, Clinic of Small Animal Surgery and Reproduction at the Centre for Clinical Veterinary Medicine, Ludwig Maximilian University, Munich, Germany
| | - Katharina Erber
- Institute of Veterinary Pathology, Ludwig Maximilian University, Munich, Germany
| | - Anja Ewringmann
- Practice for small pets, Dr. Anja Ewringmann, Berlin, Germany
| | - Ruth Klein
- Laboklin GmbH & Co.KG, Bad Kissingen, Germany
| | - Sven Reese
- Institute of Veterinary Anatomy, Ludwig Maximilian University, Munich, Germany
| | - Christine Böhmer
- Zoological Institute, Zoology and Functional Morphology of Vertebrates, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Andrea Meyer-Lindenberg
- Faculty of Veterinary Medicine, Clinic of Small Animal Surgery and Reproduction at the Centre for Clinical Veterinary Medicine, Ludwig Maximilian University, Munich, Germany
| | - Beate Walter
- Faculty of Veterinary Medicine, Clinic of Small Animal Surgery and Reproduction at the Centre for Clinical Veterinary Medicine, Ludwig Maximilian University, Munich, Germany
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Gouvea TM, Cota E Souza LA, Lima AA. Correlation of serum anti-Mullerian hormone with hormonal and environmental parameters in Brazilian climacteric women. Sci Rep 2022; 12:12065. [PMID: 35835777 PMCID: PMC9283385 DOI: 10.1038/s41598-022-15429-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 06/23/2022] [Indexed: 11/09/2022] Open
Abstract
This study aimed to identify the correlation among anti-Mullerian Hormone serum levels and 25-OH-D, obesity, metabolic syndrome (MetS), and sexual hormones in climacteric women classified according to stages of reproductive aging (SRA). A cross-sectional study was conducted with a total of 177 Brazilian climacteric women between 40 and 64 years old. Concentrations of AMH were measured using the Access 2 Immunoassay System. A multiple linear regression analysis was used to identify the relationship among AMH, 25-OH-D, obesity, MetS, sexual hormones, sociodemographic and lifestyle factors. AMH levels decreased with increased age (B = - 0.059; p < 0.001), and reproductive aging (B = - 0.483; p < 0.001). Obesity indicators, lifestyle characters, 25-OH-D levels and MetS were not significantly associated with AMH serum concentration. Negative correlation was found for FSH (B = - 0.009; p < 0.001) and LH (B = - 0.006; p = 0.004); positive correlation for E2 (B = 0.001; p = 0.011), DHEAS (B = 0.003; p < 0.001) and SHBG (B = 0.003; p = 0.005). In the model adjusted for SRA, FSH levels (p < 0.001) and DHEAS (p = 0.014) were associated with AMH. Although, with the adjustment for age, only FSH remained with a significant association (p = 0.001). Of the other analytes, none was associated with AMH, regardless of the model fit. Our findings confirm that serum AMH level decreased with age and FSH levels, but there is no correlation between AMH with obesity, 25-OH-D, MetS or other sexual hormones in Brazilian climacteric women.
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Affiliation(s)
- Thiago Magalhães Gouvea
- Programa de Pós-Graduação em Ciências Farmacêuticas (CiPharma), Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, CEP 35400-000, Brazil.
| | - Laura Alves Cota E Souza
- Programa de Pós-Graduação em Ciências Farmacêuticas (CiPharma), Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, CEP 35400-000, Brazil
| | - Angélica Alves Lima
- Programa de Pós-Graduação em Ciências Farmacêuticas (CiPharma), Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, CEP 35400-000, Brazil.,Departamento de Análises Clínicas (DEACL), Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
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Clinical use of Anti-Müllerian Hormone to monitor resumption of ovarian activity following removal of a 4.7 mg deslorelin implant in queens. Vet Res Commun 2022; 46:917-924. [PMID: 35347540 DOI: 10.1007/s11259-022-09919-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/15/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The use of deslorelin implants to control reproduction in cats is increasing but because of its prolonged duration, cat breeders often request implant removal before the end of the treatment. Assaying Anti Mullerian Hormone (AMH) concentrations might be useful to predict time of resumption of ovarian activity in deslorelin-treated queens following implant removal. In queens a minimum of 3 weeks during increasing photoperiod after implant removal has been described for resumption of ovarian activity but no information about AMH concentrations were observed for determining ovarian activity. ANIMALS Sixteen queens in which deslorelin implants were surgically removed after 3, 6 or 9 months (n = 6, 4 and 6 queens, respectively) were used in this study. PROCEDURES A general and reproductive health check with a GnRH stimulation test were performed before the treatment. After implant removal queens were checked every 1-2 weeks with reproductive ultrasonography, a vaginal smear and blood collection to assay AMH concentrations. RESULTS AMH concentrations decreased significantly at the end of the treatment to ≤ 2.5 + 0.6 ng/ml (p ≤ 0.05) and reached a nadir at 1.9 ± 0.9 (p < 0.05) one-week post-removal. Following implant removal AMH concentrations started to rise reaching a value of 3.9 ± 0.7 ng/ml on the third week and were not different from pre-treatment levels on week 6 post-removal (5.8 ng/ml + 0.9, p ≥ 0.05). AMH values did not differ depending on duration of deslorelin treatment but were lower in adult queens (p < 0.05). CLINICAL RELEVANCE AMH assay can be a useful tool to follow resumption of feline ovarian function following a deslorelin treatment.
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Novak S, Yakobson B, Sorek S, Morgan L, Tal S, Nivy R, King R, Jaebker L, Eckery DC, Raz T. Short Term Safety, Immunogenicity, and Reproductive Effects of Combined Vaccination With Anti-GnRH (Gonacon) and Rabies Vaccines in Female Feral Cats. Front Vet Sci 2021; 8:650291. [PMID: 34041290 PMCID: PMC8141635 DOI: 10.3389/fvets.2021.650291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 04/07/2021] [Indexed: 11/29/2022] Open
Abstract
Overpopulation of free-roaming cats is a major problem leading to negative impacts on animal health and welfare, public nuisance, transmission of zoonotic diseases, and well-documented harm to wildlife. Surgical sterilization had failed to provide a practical solution to free-roaming cats' overpopulation under field conditions; therefore, efficient and safe non-surgical immunocontraception methods are aspired. Rabies is a deadly virus that may infect people and animals. However, the safety and efficacy of combined vaccination with anti-GnRH and rabies vaccines in feral cats, which often suffer from disrupted health conditions and experienced high stress level, has never been studied. Therefore, our objective was to examine the short-term safety and efficacy of anti-GnRH vaccine (Gonacon), in combination with rabies vaccine in female feral cats. Mature feral female cats were captured and divided into the following groups: (I) GonaconX1-Rabies: queens vaccinated with both Gonacon and rabies (n = 5); (II) GonaconX2-Rabies: queens vaccinated twice with Gonacon (3 weeks apart) and with Rabies (n = 4); (III) OVx-Rabies: queens ovariohysterectomized and vaccinated with rabies (n = 4); (IV) Intact-Rabies: queens vaccinated against rabies and remained intact (n = 3). Comprehensive veterinary examinations and blood tests were performed every 2 weeks for 14 weeks. Data were analyzed by Repeated-Measures-ANOVA or Fisher-Exact-Test. There were neither systemic nor local adverse reactions at the vaccination sites. Blood count (PCV, TS, RBC, HGB, HCT, WBC) and chemistry (Total protein, Total globulin, Albumin, Urea, Creatinine, Creatine kinase, Bilirubin, GGT, ALT, AST) analyses revealed no differences among groups. There were no differences in serum rabies antibodies titers among groups, and queens kept a protective titer (>0.5 IU/mL) starting at 2–4 weeks after vaccination. Anti-GnRH antibodies were detected in all Gonacon-vaccinated queens, excluding one queen (GonaconX2-Rabies group). Anti-müllerian hormone serum concentrations reduced significantly after ovariohysterectomy, as well as gradually following vaccination with Gonacon, but it remained high in intact queens. Evaluation of vaginal cytology and ovarian histology suggested that reproductive cyclicity was suppressed in Gonacon-vaccinated queens. Our results support the conclusion that in the short term, the combined vaccination with Gonacon and rabies is safe and effective in female feral cats. However, further long-term studies are warranted to test this immunologic regimen in feral cats.
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Affiliation(s)
- Shiri Novak
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agricultural, Food, and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Boris Yakobson
- Kimron Veterinary Institute, Ministry of Agriculture, Rishon Lezion, Israel
| | - Shir Sorek
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agricultural, Food, and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Liat Morgan
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agricultural, Food, and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Smadar Tal
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agricultural, Food, and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Ran Nivy
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agricultural, Food, and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Roni King
- Israel Nature and Parks Authority, Jerusalem, Israel
| | - Lauren Jaebker
- National Wildlife Research Center, United States Department of Agriculture Animal and Plant Health Inspection Service Wildlife Services, Fort Collins, CO, United States
| | - Douglas C Eckery
- National Wildlife Research Center, United States Department of Agriculture Animal and Plant Health Inspection Service Wildlife Services, Fort Collins, CO, United States
| | - Tal Raz
- Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agricultural, Food, and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
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First Case Report of Maternal Mosaic Tetrasomy 9p Incidentally Detected on Non-Invasive Prenatal Testing. Genes (Basel) 2021; 12:genes12030370. [PMID: 33807602 PMCID: PMC7998520 DOI: 10.3390/genes12030370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/23/2021] [Accepted: 03/01/2021] [Indexed: 01/09/2023] Open
Abstract
Tetrasomy 9p (ORPHA:3390) is a rare syndrome, hallmarked by growth retardation; psychomotor delay; mild to moderate intellectual disability; and a spectrum of skeletal, cardiac, renal and urogenital defects. Here we present a Chinese female with good past health who conceived her pregnancy naturally. Non-invasive prenatal testing (NIPT) showed multiple chromosomal aberrations were consistently detected in two sampling times, which included elevation in DNA from chromosome 9p. Amniocentesis was performed and sent for chromosomal microarray, which was normal. Maternal karyotype revealed that mos 47,XX,+dic(9;9)(q21.1;q21.1)(24)/46,XX(9) presents mosaic tetrasomy for the short arm of chromosome 9p and is related to the NIPT results showing elevation in DNA from chromosome 9p. The pregnancy was uneventful, and the patient was delivered at term. Maternal samples were obtained at two different time points after delivery showed the same multiple chromosomal aberrations detected during pregnancy. This is a first report on an unusual case of mosaic isodicentric tetrasomy 9p in a healthy adult with normal intellect. With widespread adoption of NIPT for screening fetal aneuploidy and genome-wide copy number changes, a rise in incidental detection of maternal rare genetic syndrome will bring challenges in our current approach to genetic counselling and prenatal diagnosis.
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Scheffer JB, Carvalho RFD, Aguiar APDS, Machado IJM, Franca JB, Lozano DM, Fanchin R. Which ovarian reserve marker relates to embryo quality on day 3 and blastocyst; age, AFC, AMH? JBRA Assist Reprod 2021; 25:109-114. [PMID: 32960526 PMCID: PMC7863095 DOI: 10.5935/1518-0557.20200060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Objective: The aim of the present prospective study was to evaluate which ovarian reserve marker would be more reliable as the quality of the A + B embryos (day 3 and blastocyst). Methods: We ran a prospective study with 124 infertile women, aged 24-48 years, from 2017 to 2018. The patients were divided into 3 groups according to age and the subgroups were compared for AMH, AFC, number of A+B embryos. New division of the 3 groups was performed based on the AMH, and the subgroups were compared for age, AFC and number of A+B embryos. Finally, we divided the patients into 3 groups, based on the AFC, and we compared the subgroups for age, AMH and number of A+B embryos. P<0.05 was considered statistically significant. Results: When the 124 patients were divided according to age, we found a significant fall in an A+B embryo quality (day3; blastocyst) after 35 years (p<0.038; p<0.035), and more severely after 37 years (p<0.032; p<0.027). When the 124 patients were divided according to AMH, there was a significant fall in A+B embryo quality (day 3; blastocyst), with AMH<1ng/ml (p<0.023; p<0.021). When the 124 patients were divided according to AFC, there was a significant fall in A+B embryo quality (day 3; blastocyst) with AFC<7 (p<0.025; p<0.023). These markers had significant associations with embryo quality (p<0.005). Conclusion: Age, AFC and AMH have significant associations with A +B embryo quality on day 3 and blastocyst.
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Affiliation(s)
| | | | | | | | | | - Daniel Mendez Lozano
- School of Medicine, Tecnologico de Monterrey and Center for Reproductive Medicine CREASIS, San Pedro Monterrey, Mexico
| | - Renato Fanchin
- Professeur des Universites - Praticien Hospitalier en Medecine de la Reproduction, France; Hopital Foch, France
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Transitioning to the menopausal transition: a scoping review of research on the late reproductive stage in reproductive aging. ACTA ACUST UNITED AC 2021; 28:447-466. [PMID: 33470754 DOI: 10.1097/gme.0000000000001707] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
IMPORTANCE AND OBJECTIVE In 2001 Staging Reproductive Aging Workshop conferees described the late reproductive stage (LRS) of reproductive aging as preceding the onset of the menopausal transition, yet there has been little attention to this aspect of reproductive aging. The aim of this scoping review was to examine scientific publications characterizing the LRS to map what is known about this stage with particular focus on reproductive endocrine patterns, menstrual cycle changes, and symptoms. METHODS The initial search strategy included PubMed and CINAHL searches for the phrase LRS and "human." Given a low yield of research articles, a second stage used "late reproductive age" (LRA) as a search term. These strategies yielded 9 and 26 research articles, respectively. Publications meeting inclusion criteria (data-based research studies, focus on LRS or LRA and hormonal patterns, menstrual characteristics, and symptoms) published in English were reviewed by coinvestigators. Excluded studies were related to specific diseases, such as cardiovascular disease, and treatment studies. Data were summarized using qualitative methods. To ensure adequate coverage of published research we expanded our review to a third phase in which we identified longitudinal studies of the menopausal transition. DISCUSSION AND CONCLUSIONS Studies of the LRS focused on: symptoms (anxiety and mood symptoms, bladder symptoms, urinary incontinence, urinary frequency, and nocturia) and associated factors, such as endocrine levels and gene polymorphisms; symptom clusters women experienced during the LRS; cognitive function testing results; changing patterns of physiology such as cytokines and chemokines, lipids, hormone patterns/levels; and association of lifestyle factors such as smoking with hormone levels and symptoms. The LRA search yielded a preponderance of studies of reproductive hormones (such as anti-Mullerian hormone) and menstrual cycle patterns. Remaining studies focused on symptoms, gene variants, health-related behaviors and approaches to classifying menstrual cycles. Longitudinal studies revealed reports of symptoms as well as attempts to classify the progression from the reproductive years to the menopausal transition. Study of the LRS has not been systematic and the limited number and scope of completed studies have yet to contribute a clear and complete picture of the LRS. In some, LRS provided a comparison stage against which to evaluate menopausal transition hormonal and cycle patterns and symptoms. Harmonizing the results of studies of the LRS and LRA is essential to understand more completely women's experiences of the LRS and to allow clinicians to provide better support for women during this time. The LRS also represents an ideal inflection point to promote lifestyle choices that could alter the trajectories of chronic diseases that arise in the fifth, sixth, and seventh decades of women's lives.
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Place NJ, Cheraskin JL, Hansen BS. Evaluation of combined assessments of serum anti-Müllerian hormone and progesterone concentrations for the diagnosis of ovarian remnant syndrome in dogs. J Am Vet Med Assoc 2020; 254:1067-1072. [PMID: 30986154 DOI: 10.2460/javma.254.9.1067] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the usefulness of combined assessments of serum anti-Müllerian hormone (AMH) and progesterone (P4) concentrations for diagnosis of ovarian remnant syndrome (ORS) in dogs. DESIGN Prospective case series. ANIMALS 602 bitches that had previously undergone ovariohysterectomy or ovariectomy without hysterectomy and that were being evaluated for ORS. PROCEDURES Serum AMH and P4 concentrations were measured in a single serum sample obtained from each of the 602 dogs; results were classified as positive, negative, or inconclusive. Following AMH testing, submitting veterinarians were offered reimbursement for shipping and histologic evaluation of any tissue removed during treatment of dogs for which serum samples had been assessed. RESULTS Tissue samples were provided from 53 of 55 dogs that underwent surgical abdominal exploration. Of 48 dogs with histologically confirmed ORS, 25 were positive for both AMH and P4 and 23 were positive for AMH or P4 or test results were inconclusive. No dogs with histologically confirmed ORS were negative for both AMH and P4. Tissue samples that included no ovarian tissue were obtained from 5 dogs that were positive for both AMH and P4. In 2 dogs that were negative for both AMH and P4, no ovarian remnant was identified and no tissue was removed at the time of exploratory surgery. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that combined determination of AMH and P4 concentrations in a single serum sample can be an effective diagnostic test for spayed dogs suspected to have ORS. Histologic analysis of excised tissues to assess the completeness of surgical treatment in dogs with ORS is warranted.
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Melado L, Arnanz A, Bayram A, Elkhatib I, De Munck N, Navarro AT, Coughlan C, Lawrenz B, Fatemi HM. Anti-Müllerian hormone is an independent marker for oocyte survival after vitrification. Reprod Biomed Online 2020; 41:119-127. [PMID: 32499103 DOI: 10.1016/j.rbmo.2020.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/26/2020] [Accepted: 03/23/2020] [Indexed: 01/04/2023]
Abstract
RESEARCH QUESTION This study explored the relationship between anti-Müllerian hormone (AMH) and oocyte survival after vitrification. The association between AMH and blastocyst formation after oocyte vitrification was also assessed. DESIGN A retrospective observational analysis was performed in a private IVF centre. A total of 4507 metaphase-II warmed oocytes were included from 450 couples, predominantly of Arab ethnicity. Between August 2015 and August 2018, couples underwent 484 intracytoplasmic sperm injection (ICSI) treatments using vitrified-warmed oocytes. RESULTS Patients' median age ± SD was 36.2 ± 6.1 years, AMH concentration 2.6 ± 3.4 ng/ml and body mass index (BMI) 26.5 ± 4.6 kg/m2. The oocyte survival rate after vitrification was 87.37 ± 20.42%. AMH concentration showed a significant correlation (Kendall's tau 0.087, P = 0.0079) with oocyte survival rate independent of oocyte yield. Correlation was significant (odds ratio 1.041, 95% confidence interval 1.007-1.077, P = 0.018) when a multivariant model was applied that included AMH, age and BMI. The receiver operating characteristic curve showed an AMH cut-off value of 1.09 ng/ml that could obtain at least a 70% survival rate, with an area under the curve of 0.669. Regarding embryo development in ICSI cycles including fresh and warmed oocytes for the same patient, blastocyst formation rate was higher in fresh compared with warmed oocytes (P < 0.001). In this subgroup no significant correlation was seen between fertilization or blastocyst rate and AMH concentration. CONCLUSIONS AMH concentration showed a significant correlation with oocyte survival. Blastocyst formation was significantly lower after oocyte vitrification, but no correlation was found with AMH. Clinicians should carefully evaluate oocyte vitrification for patients with AMH below 1.09 ng/ml and consider embryo accumulation for these patients in preference to oocyte accumulation.
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Affiliation(s)
- Laura Melado
- IVF Department, IVI Middle-East Fertility Clinic, Abu Dhabi, UAE; IVF Department, IVI Middle-East Fertility Clinic, Dubai, UAE.
| | - Ana Arnanz
- IVF Department, IVI Middle-East Fertility Clinic, Abu Dhabi, UAE
| | - Asina Bayram
- IVF Department, IVI Middle-East Fertility Clinic, Abu Dhabi, UAE
| | - Ibrahim Elkhatib
- IVF Department, IVI Middle-East Fertility Clinic, Abu Dhabi, UAE
| | - Neelke De Munck
- IVF Department, IVI Middle-East Fertility Clinic, Abu Dhabi, UAE
| | | | - Carol Coughlan
- IVF Department, IVI Middle-East Fertility Clinic, Dubai, UAE
| | - Barbara Lawrenz
- IVF Department, IVI Middle-East Fertility Clinic, Abu Dhabi, UAE; Women's University Hospital Tuebingen, Tuebingen, Germany
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Gowkielewicz M, Lipka A, Piotrowska A, Szadurska-Noga M, Nowakowski JJ, Dzięgiel P, Majewski MK, Jozwik M, Majewska M. Anti-Müllerian Hormone Expression in Endometrial Cancer Tissue. Int J Mol Sci 2019; 20:ijms20061325. [PMID: 30884769 PMCID: PMC6471522 DOI: 10.3390/ijms20061325] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 03/11/2019] [Accepted: 03/12/2019] [Indexed: 12/29/2022] Open
Abstract
Anti-Müllerian hormone (AMH) is a commonly known factor secreted by Sertoli cells, responsible for regression of the Müllerian ducts in male fetuses. AMH has also other functions in humans. In vivo and in vitro studies have shown that AMH inhibits cell cycle and induces apoptosis in cancers with AMH receptors. The aim of the study was to assess whether the tissue of pre-cancerous states of endometrium (PCS) and various histopathologic types of endometrial cancer (EC) exhibit the presence of AMH. We aimed to investigate whether the potential presence of the protein concerns menopausal women or those regularly menstruating, and whether is related to cancers with a good or a bad prognosis, as well as what other factors may influence AMH expression. The undertaken analysis was carried out on tissues retrieved from 232 women who underwent surgical treatment for PCS and EC. Tissues were prepared for immunohistochemical assessment with the use of a tissue microarrays method. AMH expression was confirmed in 23 patients with well differentiated endometrioid adenocarcinoma (G1), moderately differentiated endometrioid adenocarcinoma (G2), clear cell carcinoma (CCA) and nonatypical hyperplasia. AMH was not found in EC tissues in regularly menstruating women. An appropriately long mean period of breastfeeding in line with a prolonged period of hormonal activity had a positive effect on AMH expression. Our results may suggest that AMH is a factor which protects the organism against cancer, and should be further investigated as a potential prognosis marker and a therapeutic agent.
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Affiliation(s)
- Marek Gowkielewicz
- Department of Gynecology and Obstetrics, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-045 Olsztyn, Poland.
| | - Aleksandra Lipka
- Department of Gynecology and Obstetrics, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-045 Olsztyn, Poland.
| | - Aleksandra Piotrowska
- Division of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, 50-368 Wroclaw, Poland.
| | - Marta Szadurska-Noga
- Department of Pathomorphology, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-561 Olsztyn, Poland.
| | - Jacek J Nowakowski
- Department of Ecology & Environmental Protection, University of Warmia and Mazury in Olsztyn, 10⁻727 Olsztyn, Poland.
| | - Piotr Dzięgiel
- Division of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, 50-368 Wroclaw, Poland.
- Department of Physiotherapy, Wroclaw University School of Physical Education, 51-612 Wroclaw, Poland.
| | - Mariusz Krzysztof Majewski
- Department of Human Physiology, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-082 Olsztyn, Poland.
| | - Marcin Jozwik
- Department of Gynecology and Obstetrics, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-045 Olsztyn, Poland.
| | - Marta Majewska
- Department of Human Physiology, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-082 Olsztyn, Poland.
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Barbotin AL, Peigné M, Malone SA, Giacobini P. Emerging Roles of Anti-Müllerian Hormone in Hypothalamic-Pituitary Function. Neuroendocrinology 2019; 109:218-229. [PMID: 31280262 PMCID: PMC6878735 DOI: 10.1159/000500689] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 05/01/2019] [Indexed: 12/29/2022]
Abstract
Since its initial discovery in the 1940s, research into the physiological actions of anti-Müllerian hormone (AMH), from its eponymous role in male developmental biology to its routine clinical use in female reproductive health, has undergone a paradigm shifting change. With several exciting studies recently reporting hitherto unforeseen AMH actions at all levels in the hypogonadal-pituitary-gonadal axis, the importance of this hormone for both hypothalamic and pituitary reproductive control is finding increasing support and significance. In this review, we will briefly summarize what is known about the traditional roles and biology of AMH and how this could be integrated with new findings of AMH actions at the level of the hypothalamic-pituitary axis. We also synthesize the important findings from these new studies and discuss their potential impact and significance to our understanding of one of the most common reproductive disorders currently affecting women, polycystic ovary syndrome.
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Affiliation(s)
- Anne-Laure Barbotin
- Université de Lille, Inserm, CHU Lille, UMR-S 1172, Laboratoire du Développement et Plasticité du Cerveau Neuroendocrine, Centre de Recherche Jean-Pierre Aubert, Lille, France
- Institut de Biologie de la Reproduction-Spermiologie-CECOS, CHU de Lille, Lille, France
| | - Maëliss Peigné
- Université de Lille, Inserm, CHU Lille, UMR-S 1172, Laboratoire du Développement et Plasticité du Cerveau Neuroendocrine, Centre de Recherche Jean-Pierre Aubert, Lille, France
- AP-HP, Unité de Médecine de la Reproduction, Service de Gynécologie-Obstétrique, Hôpital Bichat-Claude Bernard, Paris, France
| | - Samuel Andrew Malone
- Université de Lille, Inserm, CHU Lille, UMR-S 1172, Laboratoire du Développement et Plasticité du Cerveau Neuroendocrine, Centre de Recherche Jean-Pierre Aubert, Lille, France
| | - Paolo Giacobini
- Université de Lille, Inserm, CHU Lille, UMR-S 1172, Laboratoire du Développement et Plasticité du Cerveau Neuroendocrine, Centre de Recherche Jean-Pierre Aubert, Lille, France,
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Hawkins Bressler L, Steiner A. Anti-Müllerian hormone as a predictor of reproductive potential. Curr Opin Endocrinol Diabetes Obes 2018; 25:385-390. [PMID: 30299431 DOI: 10.1097/med.0000000000000440] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Anti-Müllerian hormone (AMH), a marker of ovarian reserve, declines over a woman's reproductive lifespan. AMH is highly correlated with a woman's age and number of primordial ovarian follicles, and has been shown to predict time to menopause in women in their 40s. For these reasons, it was assumed that AMH levels could predict a woman's reproductive potential or serve as a 'fertility test'. Recently, studies have sought to determine the association between AMH and fertility. RECENT FINDINGS Although a small, prospective, time-to-pregnancy study of 98 women suggested that an AMH level less than 0.7 ng/ml was associated with lower day-specific probabilities of conception, the follow-up, larger cohort did not identify an association with AMH and fecundability. Women with AMH values less than 0.7 ng/ml had similar pregnancy rates after 12 cycles of attempting to conceive as women with normal AMH values after adjusting for age. Four additional studies, including a secondary analysis of the NICHD EAGER trial including over 1200 women confirmed these findings. SUMMARY Although AMH is a marker of ovarian reserve, existing literature does not support the use of AMH as a marker of reproductive potential in the general population.
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Affiliation(s)
- Leah Hawkins Bressler
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill
| | - Anne Steiner
- Department of Obstetrics & Gynecology, Duke University, Durham, NC, USA
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Scheffer JAB, Scheffer B, Scheffer R, Florencio F, Grynberg M, Lozano DM. Are age and anti-Müllerian hormone good predictors of ovarian reserve and response in women undergoing IVF? JBRA Assist Reprod 2018; 22:215-220. [PMID: 29949322 PMCID: PMC6106624 DOI: 10.5935/1518-0557.20180043] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective Ovarian reserve evaluation has been the focus of substantial clinical
research for several years. This study aimed to examine the associations
between markers of ovarian reserve and ovarian response. Methods This prospective study included 132 infertile women aged 24-48 years
undergoing routine exploration during unstimulated cycles prior to the start
of assisted reproductive technology (ART) treatments at our center from July
2015 to January 2017. Descriptive parameters and patient characteristics
were reported as mean (SD) or median (range) values depending on the data
distribution pattern. Student’s t-test was performed for continuous
variables; the Wilcoxon and Pearson’s test were used for data not following
a normal distribution; and Fisher’s test was used for categorical variables.
p<0.05 was considered statistically significant. Results At the time of the study, the patients had a mean age of 35.7±3.84
years. On day 3 of the cycle, the mean anti-Müllerian hormone (AMH)
serum level was 2.84±1.57 ng/mL and the patients had 14.68±4.2
antral follicles (AFC). A significant correlation was observed between AMH
and age (r=-0.34 p<.01), follicle stimulating hormone
(FSH) serum levels (r=-0.32, p<.01), AFC (r=0.81,
p<.00001), total dose of medication during ovarian
stimulation (r=-0.28, p<.0003), and ongoing pregnancy
rate (p<.05). Age was significantly correlated with FSH
(r=0.46, p<.01), AFC (r=-0.34,
p<.00001), total dose of medication during ovarian
stimulation (r=0.43, p<.0003), and ongoing pregnancy
rate (p<.04). Conclusion Serum AMH and age are independent predictors of ovarian reserve and ovarian
stimulation outcome in infertile women. Age and serum AMH level may be used
to advise subfertile couples of their pregnancy prospects.
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Affiliation(s)
| | - Bruno Scheffer
- IBRRA - Brazilian Institute of Assisted Reproduction, Belo Horizonte, Brazil
| | - Rafaela Scheffer
- IBRRA - Brazilian Institute of Assisted Reproduction, Belo Horizonte, Brazil
| | - Fabio Florencio
- IBRRA - Brazilian Institute of Assisted Reproduction, Belo Horizonte, Brazil
| | - Michael Grynberg
- Department of Reproductive Medicine, Hôpital Jean Verdier (AP-HP), University Paris XIII, and INSERM, Paris, France
| | - Daniel Mendez Lozano
- School of Medicine, Tecnologico de Monterrey and Center for Reproductive Medicine CREASIS, San Pedro Monterrey, Mexico
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Shahrokhi SZ, Kazerouni F, Ghaffari F. Anti-Müllerian Hormone: genetic and environmental effects. Clin Chim Acta 2018; 476:123-129. [DOI: 10.1016/j.cca.2017.11.027] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 11/20/2017] [Accepted: 11/22/2017] [Indexed: 02/08/2023]
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Gat I, AlKudmani B, Wong K, Zohni K, Weizman NF, Librach C, Sharma P. Significant correlation between anti-müllerian hormone and embryo euploidy in a subpopulation of infertile patients. Reprod Biomed Online 2017; 35:602-608. [PMID: 28826601 DOI: 10.1016/j.rbmo.2017.06.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 06/24/2017] [Accepted: 06/27/2017] [Indexed: 11/30/2022]
Abstract
Anti-Müllerian hormone (AMH) is a standard marker of ovarian reserve. Correlation between AMH and egg euploidy is controversial. We evaluated the association between AMH and blastocyst euploidy rate examined by pre-implantation genetic screening (PGS). This retrospective study was conducted at the CReATe Fertility Centre. We included single IVF cycles of 216 infertile couples, which resulted in 911 blastocysts subjected to array comparative genomic hybridization and evaluated IVF outcome after embryo transfer. The average age and median AMH of female patients were 37.2 (SD = 3.8) and 20 pmol/l, respectively, and the average euploidy rate was 38.3%. Using multivariate regression controlling for age, antral follicle count, body mass index and parity, there was a significant association between serum AMH and proportion of euploid embryos (P = 0.02), due to the dominant ≤36 age group in which significant correlation between AMH and euploidy rate (P = 0.02) was demonstrated. Clinical outcome was similar, including biochemical, clinical and ongoing pregnancy rates as well as pregnancy loss. This study shows a correlation between AMH and aneuploidy rate, specifically among infertile patients younger than 37 years old. Study limitations are discussed.
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Affiliation(s)
- Itai Gat
- CReATe Fertility Centre, Toronto, Ontario, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada; Department of Gynecology, Women's College Hospital, Toronto, Ontario, Canada; Pinchas Borenstein Talpiot Medical Leadership Program, Sheba Medical Centre, Tel Hashomer, Israel; Sackler Medical School, Tel Aviv University, Tel Aviv, Israel.
| | - Basheer AlKudmani
- CReATe Fertility Centre, Toronto, Ontario, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada; Department of Gynecology, Women's College Hospital, Toronto, Ontario, Canada
| | - Karen Wong
- CReATe Fertility Centre, Toronto, Ontario, Canada
| | - Khaled Zohni
- CReATe Fertility Centre, Toronto, Ontario, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada; Department of Gynecology, Women's College Hospital, Toronto, Ontario, Canada
| | - Noga Fuchs Weizman
- CReATe Fertility Centre, Toronto, Ontario, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada; Department of Gynecology, Women's College Hospital, Toronto, Ontario, Canada
| | - Clifford Librach
- CReATe Fertility Centre, Toronto, Ontario, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada; Department of Gynecology, Women's College Hospital, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Prati Sharma
- CReATe Fertility Centre, Toronto, Ontario, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada; Department of Gynecology, Women's College Hospital, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Abstract
OBJECTIVE To evaluate the association of hysterectomy on ovarian function by comparing antimüllerian hormone, a marker of ovarian reserve, before and after hysterectomy. METHODS The Prospective Research on Ovarian Function study prospectively followed 1) premenopausal women undergoing ovary-sparing hysterectomy for benign indications, and 2) a referent cohort with similar age distributions and intact reproductive organs; they reported that women undergoing hysterectomy became menopausal 1.9 years earlier than referents. In a planned secondary analysis, baseline antimüllerian hormone levels and the absolute change and percentage change in antimüllerian hormone levels between baseline and 1-year follow-up were compared between groups. RESULTS Baseline median antimüllerian hormone levels were similar between the hysterectomy group (n=148) and the referent group (n=172). After 1 year, patients undergoing hysterectomy had a significantly greater median percentage decrease (-40.7% compared with -20.9%; P<.001), had a higher proportion with undetectable antimüllerian hormone (12.8% compared with 4.7%; P=.02), and had on average 0.77 times the antimüllerian hormone level (P=.001) compared with referents. These differences were attenuated among white women but remained significant among black women. Comparisons of women stratified by low or high ovarian reserve at baseline or among propensity score-matched cohorts showed similar findings; however, the absolute median change in antimüllerian hormone levels was similar between groups (-0.3 compared with -0.2; P=.31). CONCLUSION Women undergoing hysterectomy had similar antimüllerian hormone levels at baseline and experienced a greater percentage decrease in levels after 1 year compared with referents, suggesting that hysterectomy may lead to ovarian damage that is unrelated to baseline ovarian reserve.
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Silva JBD, Panaino TR, Tamm MA, Lira P, Arêas PCF, Mancebo ACA, Souza MMD, Antunes RA, Souza MDCBD. Prediction of metaphase II oocytes according to different serum Anti-Müllerian hormone (AMH) levels in antagonist ICSI cycles. JBRA Assist Reprod 2016; 20:222-226. [PMID: 28050957 PMCID: PMC5265621 DOI: 10.5935/1518-0557.20160043] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objective This paper aims to assess a qualitative aspect of ovarian response in terms
of metaphase II oocytes according to different serum Anti-Müllerian
hormone levels in antagonist ICSI cycles. A prediction index might
contribute to the individualization of care. Methods This observational study looked into 287 antagonist ICSI cycles carried out
with patients treated in a single center between January of 2012 and January
of 2016. Serum AMH and subgroup analyses were performed based on five AMH
ranges (≤ 0.3 ng/mL;> 0.3 and ≤ 0.7 ng/mL; > 0.7 and
≤ 1.0 ng/mL; > 1.0 and < 3.0 ng/mL; ≥ 3.0 ng/mL). The
variables analyzed included patient age; serum FSH and antral follicle count
at the start of the cycle; number of stimulation days and number follicles
≥ 15 mm on hCG day; number of oocytes retrieved and number of
metaphase II oocytes. Results AMH is a better predictor of ovarian response to controlled ovarian
stimulation than AFC or serum FSH, while age is an independent marker. AMH
levels ≤0.70 (patients with poor prognosis) were observed in 140
patients (48.7%). Patients within this AMH level range accounted for 92% of
the 24 failed cycles (cancelled cycles, no oocytes or immature oocytes
retrieved). Conclusion AMH predicts the quality of ovarian response to stimulation, regardless of
patient age. Women with AMH levels ≥1.0 and ≤3.0 ng/mL are
probably normal responders with good prognosis. Clinical application relies
on the examination of the data from each individual center and on the
establishment of correlations between AMH levels and ovarian response in the
form of metaphase II oocytes.
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Affiliation(s)
| | | | - Maria A Tamm
- Fertipraxis Reproduction Center, Rio de Janeiro, RJ, Brazil
| | - Paloma Lira
- Fertipraxis Reproduction Center, Rio de Janeiro, RJ, Brazil
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Holst BS. Diagnostic possibilities from a serum sample-Clinical value of new methods within small animal reproduction, with focus on anti-Müllerian hormone. Reprod Domest Anim 2016; 52 Suppl 2:303-309. [DOI: 10.1111/rda.12856] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- BS Holst
- Department of Clinical Sciences; Swedish University of Agricultural Sciences; Uppsala Sweden
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Ovario-protective effects of genistein against cyclophosphamide toxicity in rats: Role of anti-müllerian hormone and oestradiol. Eur J Pharmacol 2016; 789:163-171. [DOI: 10.1016/j.ejphar.2016.07.026] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 07/14/2016] [Accepted: 07/15/2016] [Indexed: 01/25/2023]
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Maternal antimullerian hormone as a predictor of fetal aneuploidy occurring in an early pregnancy loss. Obstet Gynecol Sci 2015; 58:494-500. [PMID: 26623414 PMCID: PMC4663228 DOI: 10.5468/ogs.2015.58.6.494] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Revised: 07/03/2015] [Accepted: 07/23/2015] [Indexed: 11/30/2022] Open
Abstract
Objective The purpose of the study was to examine the relationship between the parameter representing ovarian reserve and the fetal aneuploidy in early spontaneous miscarriage. Methods A multicenter retrospective cohort study was performed in patients who were diagnosed with early pregnancy loss (≤13 gestational weeks) and examined for fetal karyotype at the CHA Gangnam Medical Center, CHA Bundang Medical Center, and CHA Gumi Medical Center between January 2011 and December 2012. Karyotyping was performed by the Genetic Laboratory of the Fertility Center of CHA Gangnam Medical Center. Medical records were reviewed for demographics, karyotype analysis and hormonal assay of ovarian reserve including antimullerian hormone (AMH) and follicle stimulating hormone. Statistical analysis was performed using SPSS software. Results A total 462 patients were included in this study. The mean age of the patients was 35.31±4.12 years and the mean AMH level was 3.88±3.50 ng/mL (n=195). Two hundred eleven conceptuses (45.7%) of patients showed the euploid and 251 (54.3%) showed the aneuploid. There are significant differences in maternal age, AMH and gestational age between fetal euploid and aneuploid groups (34.46±4.35 vs. 36.04±3.78 years, P<0.001; 4.60±3.86 vs. 3.43±3.18 ng/mL, P=0.022; 7.67±1.54 vs. 8.27±1.46 weeks, P<0.001, respectively). Multivariate analysis revealed that low AMH level and early gestational age were maternal age-independent markers for fetal aneuploid (P<0.001 and P=0.045, respectively). Conclusion Low maternal AMH level might be a predicting marker for fetal aneuploid in early pregnancy loss.
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McLennan IS, Pankhurst MW. Anti-Müllerian hormone is a gonadal cytokine with two circulating forms and cryptic actions. J Endocrinol 2015; 226:R45-57. [PMID: 26163524 DOI: 10.1530/joe-15-0206] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2015] [Indexed: 12/23/2022]
Abstract
Anti-Müllerian hormone (AMH) is a multi-faceted gonadal cytokine. It is present in all vertebrates with its original function in phylogeny being as a regulator of germ cells in both sexes, and as a prime inducer of the male phenotype. Its ancient functions appear to be broadly conserved in mammals, but with this being obscured by its overt role in triggering the regression of the Müllerian ducts in male embryos. Sertoli and ovarian follicular cells primarily release AMH as a prohormone (proAMH), which forms a stable complex (AMHN,C) after cleavage by subtilisin/kexin-type proprotein convertases or serine proteinases. Circulating AMH is a mixture of proAMH and AMHN,C, suggesting that proAMH is activated within the gonads and putatively by its endocrine target-cells. The gonadal expression of the cleavage enzymes is subject to complex regulation, and the preliminary data suggest that this influences the relative proportions of proAMH and AMHN,C in the circulation. AMH shares an intracellular pathway with the bone morphogenetic protein (BMP) and growth differentiation factor (GDF) ligands. AMH is male specific during the initial stage of development, and theoretically should produce male biases throughout the body by adding a male-specific amplification of BMP/GDF signalling. Consistent with this, some of the male biases in neuron number and the non-sexual behaviours of mice are dependent on AMH. After puberty, circulating levels of AMH are similar in men and women. Putatively, the function of AMH in adulthood maybe to add a gonadal influence to BMP/GDF-regulated homeostasis.
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Affiliation(s)
- Ian S McLennan
- Department of AnatomyUniversity of Otago, PO Box 913, Dunedin 9054, New Zealand
| | - Michael W Pankhurst
- Department of AnatomyUniversity of Otago, PO Box 913, Dunedin 9054, New Zealand
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AMH: An ovarian reserve biomarker in assisted reproduction. Clin Chim Acta 2014; 437:175-82. [DOI: 10.1016/j.cca.2014.07.029] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 07/18/2014] [Accepted: 07/23/2014] [Indexed: 11/22/2022]
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Scherzer R, Bacchetti P, Messerlian G, Goderre J, Maki PM, Seifer DB, Anastos K, Karim R, Greenblatt RM. Impact of CD4+ lymphocytes and HIV infection on Anti-Müllerian Hormone levels in a large cohort of HIV-infected and HIV-uninfected women. Am J Reprod Immunol 2014; 73:273-84. [PMID: 25339186 DOI: 10.1111/aji.12332] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 09/23/2014] [Indexed: 12/21/2022] Open
Abstract
PROBLEM Effects of HIV infection on ovarian function and aging are unclear. METHOD OF STUDY Anti-Müllerian Hormone (AMH) levels were analyzed in 2621 HIV-infected and 941 uninfected participants using left-censored longitudinal models. RESULTS Age-adjusted AMH levels were 16% lower in women with undetectable viraemia and 26% lower in detectable viraemia, relative to uninfected women. Current CD4 count associated with higher AMH in both HIV-infected and HIV-uninfected women. After controlling for current and nadir CD4, AMH was ~15% higher in HIV-infected relative to uninfected women, regardless of HIV viraemia. Gravidity, amenorrhea, and nadir total lymphocyte counts associated with higher AMH; hormonal contraceptive use and past weight loss associated with lower AMH. CONCLUSIONS CD4 + lymphocyte counts were associated with AMH in both HIV-infected and uninfected women. After adjustment for CD4 counts and age, HIV infection was associated with higher AMH. CD4 T cells and cellular activation may influence ovarian granulosa cell function.
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Affiliation(s)
- Rebecca Scherzer
- Department of Medicine, San Francisco School of Medicine, University of California, San Francisco, CA, USA; San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
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Wang MH, Chen CH, Wang CW, Hsu MI, Tzeng CR. A higher anti-Müllerian hormone level is associated with an increased chance of pregnancy in patients undergoing controlled ovarian stimulation and intrauterine insemination. J OBSTET GYNAECOL 2014; 35:64-8. [PMID: 25010731 DOI: 10.3109/01443615.2014.935718] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Anti-Müllerian hormone (AMH) level has been found to be a useful marker of ovarian reserve, and a predictor of poor and hyper-responses in patients undergoing controlled ovarian stimulation (COS). The study aimed to determine the association of serum AMH level with achieving pregnancy in patients undergoing COS with intrauterine insemination. The cross-sectional study investigated 204 patients who underwent COS with intrauterine insemination at the Obstetrics and Gynecology Department of Taipei Medical University Hospital, from January 2011 to March 2012. The medical records of these patients were reviewed, and serum AMH levels were evaluated for association with successful clinical pregnancy. The AMH level in the patients who achieved clinical pregnancy was significantly higher than in patients who did not (median 2.7 vs 2.0 ng/ml, p = 0.005). Controlling for factors affecting infertility, AMH level had a significant independent influence on outcome; a higher AMH level was associated with a decreased risk of a non-pregnant outcome (odds ratio, OR = 0.895, p = 0.026). In patients undergoing COS and intrauterine insemination, a low AMH level is associated with a decreased chance of a clinical pregnancy, and this association remains irrespective of the presence or absence of endometriosis.
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Affiliation(s)
- M-H Wang
- Department of Obstetrics and Gynecology, China Medical University Hospital , Taichung , Taiwan
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Birdir C, Fryze J, Vasiliadis H, Nicolaides KH, Poon LC. Maternal serum anti-Müllerian hormone at 11-13 weeks' gestation in the prediction of preeclampsia. J Matern Fetal Neonatal Med 2014; 28:865-8. [PMID: 24953352 DOI: 10.3109/14767058.2014.937418] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate the potential value of maternal serum anti-Müllerian hormone (AMH) at 11-13 weeks' gestation in the prediction of preeclampsia (PE). METHODS The serum concentration of AMH was measured at 11-13 weeks' gestation in cases of PE (n = 50) and normotensive controls (n = 150). Backward stepwise multiple regression analysis was used to determine which of the factors amongst the maternal characteristics and gestation were significant predictors of the serum AMH in the control group and from the regression model the value in each case and control was expressed as a multiple of the expected median (MoM). RESULTS In normotensive pregnancies, the maternal serum concentration of AMH is higher in Afro-Caribbean than in Caucasian women and in smokers than in non-smokers. In the PE group, the median serum concentration of AMH was significantly higher than in the controls (2.140 ng/L, IQR 1.968-2.273 versus 2.062 ng/L, IQR 1.938-2.181; p = 0.025), but the median MoM value of AMH was not significantly different between the PE group and the controls (1.040, IQR 0.941-1.081 versus 0.995, IQR 0.939-1.065, p = 0.147). CONCLUSIONS Maternal serum AMH is not an effective early predictor for PE.
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Affiliation(s)
- Cahit Birdir
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital , London , UK and
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Peigné M, Decanter C. Serum AMH level as a marker of acute and long-term effects of chemotherapy on the ovarian follicular content: a systematic review. Reprod Biol Endocrinol 2014; 12:26. [PMID: 24666685 PMCID: PMC3987687 DOI: 10.1186/1477-7827-12-26] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 03/06/2014] [Indexed: 11/10/2022] Open
Abstract
Anti-Müllerian hormone (AMH) is a very sensitive indicator of the ovarian follicular content. Chemotherapeutic agents are notoriously ovariotoxic in that they damage follicles. The aim of this systematic review was to investigate the interest of serum AMH variations in determining the acute and long-term effects of chemotherapy on the ovarian reserve. According to the PRISMA guidelines, searches were conducted on PubMed for all English language articles until December 2013. Fifteen articles that focused on dynamic variations of AMH levels before and after chemotherapy were selected. Cancer patients have significantly lower AMH after chemotherapy than age-matched controls. Longitudinal studies of AMH variations before, during and after chemotherapy provide information about the degree of follicle loss for each patient according to different chemotherapy regimens. Different patterns of AMH levels during the ovarian recovery phase make it possible to discriminate between high and low gonadotoxic chemotherapy protocols. In addition, pretreatment AMH levels are shown to predict the long-term ovarian function after the end of treatment. These results may help to better understand the ovarian toxicity mechanisms of chemotherapy and to predict the degree of the ovarian follicle loss. Therefore, it can be useful for fertility preservation strategies, fertility counseling and future family planning.
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Affiliation(s)
- Maëliss Peigné
- Department of Endocrine Gynaecology and Reproductive Medicine, Hôpital Jeanne de Flandre, CHRU, Lille 59037, France
| | - Christine Decanter
- Department of Endocrine Gynaecology and Reproductive Medicine, Hôpital Jeanne de Flandre, CHRU, Lille 59037, France
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Messinis IE, Messini CI, Dafopoulos K. Novel aspects of the endocrinology of the menstrual cycle. Reprod Biomed Online 2014; 28:714-22. [PMID: 24745832 DOI: 10.1016/j.rbmo.2014.02.003] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2013] [Revised: 12/04/2013] [Accepted: 02/04/2014] [Indexed: 01/03/2023]
Abstract
Ovarian control of gonadotrophin secretion is normally achieved via the feedback mechanisms mediated by oestradiol and progesterone. Evidence has been provided that nonsteroidal substances, such as inhibin A and B, participate in the negative feedback control of FSH secretion. Another nonsteroidal ovarian substance is gonadotrophin surge-attenuating factor (GnSAF), the activity of which is particularly evident in women undergoing ovulation induction. Accumulating evidence has suggested that GnSAF plays a physiological role during the menstrual cycle. In particular, this factor antagonizes the sensitizing effect of oestradiol on the pituitary response to gonadotrophin-releasing hormone during the follicular phase of the cycle. A hypothesis has been developed that, in the late follicular phase, the activity of GnSAF is reduced and this facilitates the sensitizing effect of oestradiol on the pituitary, thus enforcing the massive discharge of gonadotrophins at the midcycle LH surge. The interaction of oestradiol, progesterone and GnSAF on the hypothalamic-pituitary system provides a novel approach to explain the mechanisms which control LH secretion during the normal menstrual cycle. The ovarian control of gonadotrophin secretion during the normal menstrual cycle is achieved via negative and positive feedback mechanisms. The steroids oestradiol and progesterone are the main regulators; however, nonsteroidal substances, such as inhibin A and inhibn B, also participate. Accumulating evidence has demonstrated that another nonsteroidal ovarian substance, gonadotrophin surge-attenuating factor (GnSAF), plays a key role in the control of LH secretion during the follicular phase and at midcycle, providing thus a novel aspect in the ovarian control of gonadotrophin secretion during the human menstrual cycle. The ovarian control of gonadotrophin secretion during the normal menstrual cycle is achieved via negative and positive feedback mechanisms. The steroids oestradiol and progesterone are the main regulators; however, nonsteroidal substances, such as inhibin A and inhibn B, also participate. Accumulating evidence has demonstrated that another nonsteroidal ovarian substance, gonadotrophin surge-attenuating factor (GnSAF), plays a key role in the control of LH secretion during the follicular phase and at midcycle, providing thus a novel aspect in the ovarian control of gonadotrophin secretion during the human menstrual cycle.
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Affiliation(s)
- Ioannis E Messinis
- Department of Obstetrics and Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
| | - Christina I Messini
- Department of Obstetrics and Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Konstantinos Dafopoulos
- Department of Obstetrics and Gynaecology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
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Anti-Müllerian hormone (AMH): a reliable biomarker of oocyte quality in IVF. J Assist Reprod Genet 2014; 31:493-8. [PMID: 24573377 DOI: 10.1007/s10815-014-0193-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 02/07/2014] [Indexed: 10/25/2022] Open
Abstract
PURPOSE To evaluate the impact of serum AMH levels on stimulated IVF implantation and clinical pregnancy rates. METHODS • DESIGN Retrospective study with multivariate analysis. • SETTING Clinique ovo (Montreal University affiliated Center). • PATIENT(S) Six hundred and thirty seven patients undergoing a stimulated IVF protocol were included. Only non-polycystic ovary patients at their first IVF attempt were considered for the analysis. • INTERVENTION(S) None. • MAIN OUTCOME MEASURES(S) Implantation and ongoing pregnancy rates. RESULT(S) Cycle outcomes were analysed according to AMH percentiles based on the AMH normogram per patient's age of our infertile population. Multivariate analyses were done to adjust for potential confounding factors such as age, total exogenous FSH dosage and number of eggs retrieved. Compared to the reference population, a significant lower mean implantation rate (0.26 vs 0.45) was observed in patients under 35 years of age with AMH < 1 ng/ml. Women with AMH < 25th percentile had less chances of having an embryo transferred, lower chances of having an ongoing pregnancy per started IVF cycle and a lower embryo freezing rate compared to the reference population. CONCLUSION(S) Patients with AMH < 0.47 ng/ml should be advised before starting a stimulated IVF cycle of the poorer prognosis compared to our reference population independently of their age, total exogenous FSH dosage and number of eggs retrieved. Therefore, AMH could enable a more individualized number of embryo transfer policy based on oocyte quality.
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Impact of tubal ligation on ovarian reserve as measured by anti-Müllerian hormone levels: a prospective cohort study. Contraception 2013; 88:700-5. [PMID: 24120250 DOI: 10.1016/j.contraception.2012.09.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Revised: 09/03/2012] [Accepted: 09/18/2012] [Indexed: 11/23/2022]
Abstract
BACKGROUND Tubal ligation (TL) is considered a very efficient contraceptive method. However, some patients complain of a variety of postoperative symptoms. The objective of this study was to investigate whether ovarian reserve may change after tubal ligation. STUDY DESIGN This was a prospective cohort study of 80 fertile women who underwent TL. Ovarian reserve was evaluated by measuring pre- and postoperative (1 year after surgery) serum anti-Müllerian hormone (AMH) levels and transvaginal antral follicular count (AFC). Potential confounding factors were age, body mass index (BMI), smoking, surgical technique and prior contraceptive methods. The Wilcoxon test was used to compare pre- and postoperative (12 months) AMH and AFC, and simple and multiple linear regression were used to evaluate confounding factors. RESULTS Fifty-two patients completed the study protocol. The median AMH level was 1.43 ng/mL (interquartile range 0.63-2.62) preoperatively and 1.30 ng/mL (interquartile range 0.53-2.85) after 12 months (p=.23). The mean AFC was 8.0 (interquartile range 5.0-14.0) and 11.0 (interquartile range 7.0-15.0) before and after TL, respectively (p=.12). These differences were not statistically significant. Use of a hormonal contraceptive method prior to TL was significantly associated with a postoperative increase in AMH. CONCLUSIONS This study suggests that ovarian reserve is not altered by TL.
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Finch A, Valentini A, Greenblatt E, Lynch HT, Ghadirian P, Armel S, Neuhausen SL, Kim-Sing C, Tung N, Karlan B, Foulkes WD, Sun P, Narod S. Frequency of premature menopause in women who carry a BRCA1 or BRCA2 mutation. Fertil Steril 2013; 99:1724-8. [PMID: 23414920 DOI: 10.1016/j.fertnstert.2013.01.109] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 01/14/2013] [Accepted: 01/15/2013] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To evaluate the impact of carrying a BRCA1 or BRCA2 mutation on the probability of experiencing premature natural menopause. DESIGN Observational study. SETTING Patients in an academic research environment. PATIENT(S) Women who carry a BRCA1 or BRCA2 mutation (case subjects) and women who do not carry a mutation (control subjects). INTERVENTION(S) Survey about reproductive history administered on study entry and every 2 years thereafter. MAIN OUTCOME MEASURE(S) The impact of carrying a BRCA mutation on age at menopause and other factors, including parity, age at first birth, age at last birth, and self-reported fertility. RESULT(S) A total of 908 matched pairs were identified. The mean age at natural menopause was 48.8 years for BRCA1 carriers, 49.2 years for BRCA2 carriers, and 50.3 years for control subjects. Women who carried a BRCA mutation had parity similar to noncarriers and were as likely as noncarriers to have a child after age 35 years. Similar proportions reported a history of fertility problems (12.5% vs. 13.7%) and use of fertility medication (6.0% vs. 7.0%). CONCLUSION(S) Women who carry a BRCA mutation experience menopause earlier, on average, than women who do not have a mutation, but the difference is small and does not appear to affect fertility.
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Affiliation(s)
- Amy Finch
- Familial Breast Cancer Research, Women's College Research Institute Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
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Nelson SM. Biomarkers of ovarian response: current and future applications. Fertil Steril 2013; 99:963-9. [PMID: 23312225 DOI: 10.1016/j.fertnstert.2012.11.051] [Citation(s) in RCA: 155] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 11/13/2012] [Accepted: 11/26/2012] [Indexed: 01/31/2023]
Abstract
With our increasing appreciation that simply maximizing oocyte yield for all patients is no longer an appropriate stimulation strategy and that age alone cannot accurately predict ovarian response, there has been an explosion in the literature regarding the utility of biomarkers to predict and individualize treatment strategies. Antral follicle count (AFC) and antimüllerian hormone (AMH) have begun to dominate the clinical scene, and although frequently pitted against each other as alternatives, both may contribute and indeed be synergistic. Their underlying technologies are continuing to develop rapidly and overcome the standardization issues that have limited their development to date. In the context of in vitro fertilization (IVF), their linear relationship with oocyte yield and thereby extremes of ovarian response has led to improved pretreatment patient counseling, individualization of stimulation strategies, increased cost effectiveness, and enhanced safety. This review highlights that although biomarkers of ovarian response started in the IVF clinic, their future extends well beyond the boundaries of assisted reproduction. The automation of AMH and its introduction into the routine repertoire of clinical biochemistry has tremendous potential. A future where primary care physicians, endocrinologists, and oncologists can rapidly assess ovarian dysfunction and the ovarian reserve more accurately than with the current standard of follicle-stimulating hormone (FSH) is an exciting possibility. For women, the ability to know the duration of their own reproductive life span will be empowering and allow them to redefine the meaning of family planning.
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Affiliation(s)
- Scott M Nelson
- School of Medicine, University of Glasgow, Glasgow, United Kingdom.
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Patrelli TS, Gizzo S, Sianesi N, Levati L, Pezzuto A, Ferrari B, Bacchi Modena A. Anti-Müllerian hormone serum values and ovarian reserve: can it predict a decrease in fertility after ovarian stimulation by ART cycles? PLoS One 2012; 7:e44571. [PMID: 22984527 PMCID: PMC3439394 DOI: 10.1371/journal.pone.0044571] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 08/09/2012] [Indexed: 11/21/2022] Open
Abstract
Background A variety of indicators of potentially successful ovarian stimulation cycles are available, including biomarkers such as anti-Mullerian hormone. The aim of our study was to confirm the usefulness of serum anti-Mullerian hormone assay in predicting ovarian response and reproductive outcome in women eligible for ART cycles. Materials Forty-six women undergoing ART cycles at the Centre for Reproductive Medicine in Parma were recruited from March-to-June 2010. Inclusion criteria: age<42 years; body-mass-index = 20–25; regular menstrual cycles; basal serum FSH concentration <12 IU/L and basal serum estradiol concentration <70 pg/mL. The couples included in our study reported a variety of primary infertility causes. All women underwent FSH stimulation and pituitary suppression (GnRH-agonist/GnRH-antagonist protocols). Women were considered poor-responders if thay had ≤3 oocytes; normal-responders 4–9 oocytes and high-responders ≥10 oocytes. Serum samples for the AMH assays were obtained on the first and last days of stimulation. A P value ≤0.05 was considered statistically significant. Result FSH levels increased significantly when AMH levels decreased. The total dose of r-FSH administered to induce ovulation was not correlated to AMH. The number of follicles on the hCG, serum estradiol levels on the hCG-day, and the number of retrieved oocytes were significantly correlated to AMH. The number of fertilized oocytes was significantly correlated to the AMH levels. No significant correlation was found between obtained embryos or transferred embryos and AMH. Basal serum AMH levels were significantly higher than those measured on the hCG-day, which appeared significantly reduced. There was a significant correlation between AMH in normal responders and AMH in both high and poor responders. Conclusions Our data confirm the clinical usefulness of AMH in ART-cycles to customize treatment protocols and suggest the necessity of verifying an eventual permanent decrease in AMH levels after IVF.
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Affiliation(s)
- Tito Silvio Patrelli
- Department of Gynecology, Obstetrics and Neonatology, University of Parma, Parma, Italy.
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Normal serum anti-Müllerian hormone levels in the general female population and the relationship with reproductive history. Eur J Obstet Gynecol Reprod Biol 2012; 163:180-4. [DOI: 10.1016/j.ejogrb.2012.04.013] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Revised: 04/05/2012] [Accepted: 04/17/2012] [Indexed: 11/18/2022]
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Farzadi L, Nouri M, Ghojazadeh M, Mohiti M, Aghadavod E. Evaluation of ovarian reserve after laparoscopic surgery in patients with polycystic ovary syndrome. BIOIMPACTS : BI 2012; 2:167-70. [PMID: 23678455 DOI: 10.5681/bi.2012.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 06/19/2012] [Accepted: 06/21/2012] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Ovarian reserve depends on the size and quality of oocytes stored in ovary. Aging and some diseases reduce ovarian reserve, leading to decreased reproductive performance. Laparoscopic surgery is used to treat infertility in women with PCOS. The purpose of this study was measurement of ovarian reserve in patients with PCOS before and after laparoscopic surgery. METHODS In this study thirty infertile patients with PCOS that had not responded to initial treatment with drug were selected. We assessed the serum levels of anti-mullerian hormone, testosterone, luteinizing hormone (LH), and the number of antral follicles before laparoscopic surgery and 1 week, 3 and 6 months after the surgery. RESULTS The average amount of anti-mullerian hormone serum levels was 8.4±4.7 before laparoscopic surgery and 7.5±4.5, 7±4.5, and 7.7±4.4 ng/ml one week, 3 and 6 months after surgery, respectively. Serum levels of LH was 13.6±6.7 and 12.7±11.1 IU /ml (P=0.87) before surgery and 6 months after laparoscopy, respectively. Mean serum testosterone levels were 0.9±0.8, 0.8±0.9 ng/ml (P=0.86) before and after surgery. Annual reproductive rate was 26.7 percent in this population. CONCLUSION Laparoscopic ovarian puncture didn't change anti-mullerian hormone serum, testosterone and LH in women with PCOS and hence has no adverse effects on the ovarian reserve.
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Affiliation(s)
- Laya Farzadi
- Women Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Place NJ, Hansen BS, Cheraskin JL, Cudney SE, Flanders JA, Newmark AD, Barry B, Scarlett JM. Measurement of serum anti-Müllerian hormone concentration in female dogs and cats before and after ovariohysterectomy. J Vet Diagn Invest 2012; 23:524-7. [PMID: 21908283 DOI: 10.1177/1040638711403428] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Anti-Müllerian hormone (AMH), or Müllerian inhibitory substance, is a hormone that is best known for its production by fetal testes in mammals and as the inhibitor of Müllerian (paramesonephric) duct development in males. However, following the development of the Müllerian ducts into the oviduct, uterus, and upper vagina in female mammals, the ovaries produce AMH, which can be found in measureable amounts within the peripheral circulation, especially in adults. The ovaries appear to be the sole source of AMH in the circulation; therefore, it may be a useful marker in clinically relevant situations when an assessment of the presence or absence of ovaries or ovarian remnants in dogs and cats is important. To that end, a commercially available, human-based assay was evaluated for the measurement of AMH in dogs and cats. A preliminary assessment involved a single test on a set of serum samples from dogs that were submitted to a diagnostic endocrinology laboratory for other tests. Favorable preliminary results led to a more formal assessment of the assay using serum samples from dogs and cats with the presence or absence of the ovaries known by surgical confirmation. Overall, a single measurement of serum AMH concentration was highly effective at distinguishing ovariohysterectomized from intact adult animals. In addition, the assay also accurately identified several cases of ovarian remnant syndrome.
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Affiliation(s)
- Ned J Place
- Schurman Hall-S1-088, Department of Population Medicine & Diagnostic Sciences, Cornell University, Ithaca, NY 14853, USA.
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Sills ES, Collins GS, Brady AC, Walsh DJ, Marron KD, Peck AC, Walsh APH, Salem RD. Bivariate analysis of basal serum anti-Müllerian hormone measurements and human blastocyst development after IVF. Reprod Biol Endocrinol 2011; 9:153. [PMID: 22136508 PMCID: PMC3241207 DOI: 10.1186/1477-7827-9-153] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Accepted: 12/02/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To report on relationships among baseline serum anti-Müllerian hormone (AMH) measurements, blastocyst development and other selected embryology parameters observed in non-donor oocyte IVF cycles. METHODS Pre-treatment AMH was measured in patients undergoing IVF (n = 79) and retrospectively correlated to in vitro embryo development noted during culture. RESULTS Mean (+/- SD) age for study patients in this study group was 36.3 ± 4.0 (range = 28-45) yrs, and mean (+/- SD) terminal serum estradiol during IVF was 5929 +/- 4056 pmol/l. A moderate positive correlation (0.49; 95% CI 0.31 to 0.65) was noted between basal serum AMH and number of MII oocytes retrieved. Similarly, a moderate positive correlation (0.44) was observed between serum AMH and number of early cleavage-stage embryos (95% CI 0.24 to 0.61), suggesting a relationship between serum AMH and embryo development in IVF. Of note, serum AMH levels at baseline were significantly different for patients who did and did not undergo blastocyst transfer (15.6 vs. 10.9 pmol/l; p = 0.029). CONCLUSIONS While serum AMH has found increasing application as a predictor of ovarian reserve for patients prior to IVF, its roles to estimate in vitro embryo morphology and potential to advance to blastocyst stage have not been extensively investigated. These data suggest that baseline serum AMH determinations can help forecast blastocyst developmental during IVF. Serum AMH measured before treatment may assist patients, clinicians and embryologists as scheduling of embryo transfer is outlined. Additional studies are needed to confirm these correlations and to better define the role of baseline serum AMH level in the prediction of blastocyst formation.
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Affiliation(s)
- E Scott Sills
- Division of Reproductive Endocrinology, Pacific Reproductive Center; Irvine, California, USA
- Division of Reproductive Endocrinology, The Sims Institute/Department of Obstetrics & Gynaecology, School of Medicine, Royal College of Surgeons in Ireland; Dublin, Ireland
| | - Gary S Collins
- Centre for Statistics in Medicine, Wolfson College Annexe, University of Oxford; Oxford, UK
| | - Adam C Brady
- Department of Medicine, University of Massachusetts School of Medicine; Worcester, Massachusetts, USA
| | - David J Walsh
- Division of Reproductive Endocrinology, The Sims Institute/Department of Obstetrics & Gynaecology, School of Medicine, Royal College of Surgeons in Ireland; Dublin, Ireland
| | - Kevin D Marron
- Division of Reproductive Endocrinology, The Sims Institute/Department of Obstetrics & Gynaecology, School of Medicine, Royal College of Surgeons in Ireland; Dublin, Ireland
| | - Alison C Peck
- Division of Reproductive Endocrinology, Pacific Reproductive Center; Irvine, California, USA
| | - Anthony PH Walsh
- Division of Reproductive Endocrinology, The Sims Institute/Department of Obstetrics & Gynaecology, School of Medicine, Royal College of Surgeons in Ireland; Dublin, Ireland
| | - Rifaat D Salem
- Division of Reproductive Endocrinology, Pacific Reproductive Center; Irvine, California, USA
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Tolikas A, Tsakos E, Gerou S, Prapas Y, Loufopoulos A. Anti-Mullerian hormone (AMH) levels in serum and follicular fluid as predictors of ovarian response in stimulated (IVF and ICSI) cycles. HUM FERTIL 2011; 14:246-53. [DOI: 10.3109/14647273.2011.608464] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Massé V, Ferrari P, Boucoiran I, Delotte J, Isnard V, Bongain A. Normal serum concentrations of anti-Mullerian hormone in a population of fertile women in their first trimester of pregnancy. Hum Reprod 2011; 26:3431-6. [PMID: 21972255 DOI: 10.1093/humrep/der320] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Anti-Müllerian hormone (AMH) levels are used to evaluate the ovarian reserve. AMH serum concentrations have recently been studied among women attending fertility centers, and among women with regular menstrual cycles but normative values have not been established among fertile women: the objective of this study was to establish those values. METHODS This prospective cross-sectional study included 340 healthy fertile women attending a single centre, aged between 15 and 50 years. The women were all in the first trimester of pregnancy, had no serious medical history and attended the abortion service of the University Hospital of Nice, France. Serum AMH was measured using a second-generation AMH enzyme-linked immunosorbent assay. RESULTS Median AMH concentration was 2.42 ng/ml (25-75 percentiles 1.19-4.12). The relationship between AMH concentration and age was best fitted by a polynomial function. Serum AMH values rose until age 29 years and then showed a significant decline (R(2)= 0.289, P < 0.001). Normative values for serum AMH were established in different age groups between 15 and 50 years. CONCLUSIONS We established the normative values for serum AMH in a population of French fertile women in their first trimester of pregnancy.
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Affiliation(s)
- V Massé
- Department of Obstetrics, Gynaecology and Reproductive Medicine, Archet II Hospital, University of Nice-Sophia-Antipolis, 151 Rte St Antoine de Ginestiere, 06202 Nice Cedex 3, France.
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Nelson S, La Marca A. The journey from the old to the new AMH assay: how to avoid getting lost in the values. Reprod Biomed Online 2011; 23:411-20. [DOI: 10.1016/j.rbmo.2011.06.011] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 05/05/2011] [Accepted: 06/21/2011] [Indexed: 11/16/2022]
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Kelsey TW, Anderson RA, Wright P, Nelson SM, Wallace WHB. Data-driven assessment of the human ovarian reserve. Mol Hum Reprod 2011; 18:79-87. [PMID: 21933846 DOI: 10.1093/molehr/gar059] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Human ovarian physiology is still poorly understood, with the factors and mechanisms that control initiation of follicular recruitment and loss remaining particularly unclear. Conventional hypothesis-led studies provide new data, results and insights, but datasets from individual studies are often small, allowing only limited interpretation. Great power is afforded by the aggregation of data from multiple studies into single datasets. In this paper, we describe how modern computational analysis of these datasets provides important new insights into ovarian function and has generated hypotheses that are testable in the laboratory. Specifically, we can hypothesize that age is the most important factor for variations in individual ovarian non-growing follicle (NGF) populations, that anti-Müllerian hormone (AMH) levels generally rise and fall in childhood years before peaking in the mid-twenties, and that there are strong correlations between AMH levels and both NGF populations and rates of recruitment towards maturation, for age ranges before and after peak AMH levels.
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Affiliation(s)
- T W Kelsey
- School of Computer Science, University of St Andrews, St Andrews KY16 9SX, UK.
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Li HWR, Anderson RA, Yeung WSB, Ho PC, Ng EHY. Evaluation of serum antimullerian hormone and inhibin B concentrations in the differential diagnosis of secondary oligoamenorrhea. Fertil Steril 2011; 96:774-9. [DOI: 10.1016/j.fertnstert.2011.06.016] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2010] [Revised: 06/04/2011] [Accepted: 06/06/2011] [Indexed: 11/27/2022]
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Green JA, Graves G. Is there a place for AMH testing in Canada? JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2011; 33:628-632. [PMID: 21846454 DOI: 10.1016/s1701-2163(16)34913-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Anti-müllerian hormone (AMH) is a glycoprotein traditionally known for its role in male sexual differentiation. More recently, AMH has been studied for its role in ovarian folliculogenesis and as a potential marker of ovarian reserve. A number of studies have suggested that measurement of serum AMH is a superior test of ovarian reserve because it is highly associated with the number of antral follicles, has little cycle variability, and declines throughout the reproductive lifespan. There is also evidence supporting the ability of AMH levels to predict age of menopause. Other studies have shown that measurement of serum AMH can predict responsiveness to ovarian follicular stimulation and the risk for ovarian hyperstimulation syndrome in women undergoing in vitro fertilization. Given the variety of potential applications and favourable test characteristics, it is reasonable to ask whether there is a place for providing universal AMH testing in Canada.
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Affiliation(s)
- Jordan A Green
- Department of Medicine, Dalhousie University, Halifax NS
| | - Gillian Graves
- Department of Obstetrics and Gynaecology, IWK Health Centre, Dalhousie University, Halifax NS
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Loh JS, Maheshwari A. Anti-Mullerian hormone--is it a crystal ball for predicting ovarian ageing? Hum Reprod 2011; 26:2925-32. [DOI: 10.1093/humrep/der271] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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A validated model of serum anti-müllerian hormone from conception to menopause. PLoS One 2011; 6:e22024. [PMID: 21789206 PMCID: PMC3137624 DOI: 10.1371/journal.pone.0022024] [Citation(s) in RCA: 294] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Accepted: 06/12/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Anti-Müllerian hormone (AMH) is a product of growing ovarian follicles. The concentration of AMH in blood may also reflect the non-growing follicle (NGF) population, i.e. the ovarian reserve, and be of value in predicting reproductive lifespan. A full description of AMH production up to the menopause has not been previously reported. METHODOLOGY/PRINCIPAL FINDINGS By searching the published literature for AMH concentrations in healthy pre-menopausal females, and using our own data (combined n = 3,260) we have generated and robustly validated the first model of AMH concentration from conception to menopause. This model shows that 34% of the variation in AMH is due to age alone. We have shown that AMH peaks at age 24.5 years, followed by a decline to the menopause. We have also shown that there is a neonatal peak and a potential pre-pubertal peak. Our model allows us to generate normative data at all ages. CONCLUSIONS/SIGNIFICANCE These data highlight key inflection points in ovarian follicle dynamics. This first validated model of circulating AMH in healthy females describes a transition period in early adulthood, after which AMH reflects the progressive loss of the NGF pool. The existence of a neonatal increase in gonadal activity is confirmed for females. An improved understanding of the relationship between circulating AMH and age will lead to more accurate assessment of ovarian reserve for the individual woman.
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Antimüllerian hormone as a predictor of controlled ovarian hyperstimulation outcome: comparison of two commercial immunoassay kits. Fertil Steril 2011; 95:2602-4. [DOI: 10.1016/j.fertnstert.2011.01.126] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2010] [Revised: 01/16/2011] [Accepted: 01/18/2011] [Indexed: 11/18/2022]
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49
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Almog B, Shehata F, Suissa S, Holzer H, Shalom-Paz E, La Marca A, Muttukrishna S, Blazar A, Hackett R, Nelson SM, Cunha-Filho JS, Eldar-Geva T, Margalioth EJ, Raine-Fenning N, Jayaprakasan K, McIlveen M, Wunder D, Freour T, Nardo LG, Balasch J, Peñarrubia J, Smeenk J, Gnoth C, Godehardt E, Lee TH, Lee MS, Levin I, Gamzu R, Tulandi T. Age-related normograms of serum antimüllerian hormone levels in a population of infertile women: a multicenter study. Fertil Steril 2011; 95:2359-63, 2363.e1. [DOI: 10.1016/j.fertnstert.2011.02.057] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Revised: 02/11/2011] [Accepted: 02/25/2011] [Indexed: 10/18/2022]
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50
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The role of anti-Mullerian hormone in assisted reproductive medicine. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2011. [DOI: 10.1016/j.mefs.2010.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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