Prince Henry’s Institute, Monash Medical Centre, Clayton, Victoria, Australia.
Menopause. 2011 May;18(5):521-4. doi: 10.1097/gme.0b013e3181f8d9e0.
The aim of this study was to assess the pattern of serum antimüllerian hormone (AMH) across the normal ovulatory menstrual cycle in women in late reproductive age when ovarian follicle reserve and, hence, serum AMH levels are reduced.
Serum AMH levels were determined by enzyme-linked immunosorbent assay across the ovulatory menstrual cycle from women in mid (n = 18) and late (n = 43) reproductive life, including the menopausal transition.
: No intracycle variation in AMH level was observed in women in mid reproductive life nor in 33% (n = 14) of women with normal ovulatory cycles in late reproductive age. In the remaining cycles, a significant 2-fold decrease (P < 0.01) in AMH in 11 cycles and a significant 4.2-fold increase (P < 0.01) in 10 cycles were observed between the follicular and luteal phases. In a further eight ovulatory cycles, AMH was below the level of assay detection. As ovarian follicle reserve decreases with age and AMH levels are reduced, separate patterns of AMH are detected in the follicular and luteal phases of ovulatory menstrual cycles, presumably reflecting the intermittent pattern of the emergence of follicles close to menopause.
It is concluded that when AMH levels are substantially reduced, as in late reproductive age, they become less reliable as markers of ovarian reserve because of the changing patterns observed in some cycles.
本研究旨在评估在卵巢卵泡储备减少（即血清抗苗勒管激素[AMH]水平降低）的晚生育期女性正常排卵月经周期中 AMH 的变化模式。
采用酶联免疫吸附试验法测定中生育期（n=18）和晚生育期（n=43）女性的排卵月经周期中 AMH 水平，包括围绝经期。
中生育期女性的 AMH 水平在周期内无变化，33%（n=14）的晚生育期正常排卵周期女性的 AMH 水平也无变化。在其余周期中，11 个周期的 AMH 水平显著降低（P＜0.01），2 倍；10 个周期的 AMH 水平显著升高（P＜0.01），4.2 倍。另外 8 个排卵周期的 AMH 水平低于检测水平。随着卵巢卵泡储备随年龄减少，AMH 水平降低，在排卵月经周期的卵泡期和黄体期检测到 AMH 呈不同的模式，可能反映了接近绝经期时卵泡间歇性出现的模式。
当 AMH 水平明显降低，如在晚生育期，由于部分周期观察到的变化模式，其作为卵巢储备标志物的可靠性降低。
