Gorkem Umit, Kucukler Ferit Kerim, Togrul Cihan, Gungor Tayfun
Department of Obstetrics and Gynaecology, Hitit University Faculty of Medicine, Corum, Turkey.
Department of Endocrinology, Hitit University Faculty of Medicine, Corum, Turkey.
Aust N Z J Obstet Gynaecol. 2017 Aug;57(4):464-468. doi: 10.1111/ajo.12625. Epub 2017 Apr 17.
Several conflicting studies with results on the biological variability of serum anti-Müllerian hormone (AMH) levels have been reported. Most of the studies have not focused on whether the level of AMH fluctuations shows variability by a baseline ovarian follicular reserve.
To reveal whether intracyclic variation in AMH levels occurs among women with adequate, high and diminished ovarian reserve patterns.
In this prospective cross-sectional study, 171 infertile women between the ages of 18 and 42 years were recruited. All participants were divided into three types of ovarian reserve patterns (adequate, high and diminished). Serum samples were tested for levels of follicular AMH (F-AMH), luteal AMH (L-AMH), estradiol (E2), and follicle stimulating hormone (FSH) and progesterone.
The median age of the 171 participating women was 28 (18-42) years. The three ovarian reserve groups had similar body mass index (BMI) and E2 (P = 0.797 and P = 0.135, respectively). The serum AMH levels of all women and the three ovarian reserve groups in the follicular phase were higher compared to those in the luteal phase (P < 0.001). There were strong positive correlations between follicular and luteal AMH levels in adequate, high and diminished reserve groups (Spearman r = 0.864, P < 0.001 vs r = 0.899, P < 0.001 vs r = 0.863, P < 0.001, respectively).
Serum AMH levels were higher during the follicular phase than the luteal phase in women with adequate, high and diminished ovarian patterns. Since the highest AMH levels are demonstrated during the follicular phase, the optimal time to measure AMH concentration might be during the follicular phase.
有几项相互矛盾的研究报告了血清抗苗勒管激素(AMH)水平的生物学变异性结果。大多数研究并未关注AMH波动水平是否因基线卵巢卵泡储备而显示出变异性。
揭示卵巢储备模式充足、高和降低的女性中AMH水平的周期内变化是否发生。
在这项前瞻性横断面研究中,招募了171名年龄在18至42岁之间的不孕女性。所有参与者被分为三种卵巢储备模式(充足、高和降低)。检测血清样本中的卵泡期AMH(F-AMH)、黄体期AMH(L-AMH)、雌二醇(E2)、卵泡刺激素(FSH)和孕酮水平。
171名参与女性的中位年龄为28(18 - 42)岁。三个卵巢储备组的体重指数(BMI)和E2相似(分别为P = 0.797和P = 0.135)。与黄体期相比,所有女性以及三个卵巢储备组在卵泡期的血清AMH水平更高(P < 0.001)。在储备充足、高和降低组中,卵泡期和黄体期AMH水平之间存在强正相关(Spearman相关系数分别为r = 0.864,P < 0.001;r = 0.899,P < 0.001;r = 0.863,P < 0.001)。
卵巢模式充足、高和降低的女性中,卵泡期血清AMH水平高于黄体期。由于卵泡期AMH水平最高,测量AMH浓度的最佳时间可能是在卵泡期。