Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus University Medical Centre, Rotterdam, The Netherlands.
J Clin Endocrinol Metab. 2020 May 1;105(5). doi: 10.1210/clinem/dgaa116.
Different phenotypical features of women with hypothalamic hypogonadism (HH), also known as World Health Organization-1 anovulation, including ovarian morphology, have been scarcely described in large cohorts. Some studies have reported increased levels of anti-Müllerian hormone (AMH) in women with HH.
To assess whether women with HH, compared with healthy controls, have increased serum levels of AMH and what proportion of these women erroneously meet the Rotterdam Criteria for Polycystic Ovarian Syndrome (PCOS).
DESIGN, SETTING AND PARTICIPANTS: Retrospective cohort study in a Dutch academic medical center including 83 women with neither anovulation nor menstrual cycle disorders (healthy controls), 159 women with HH and 3640 women with PCOS. Age matching was used between the HH and PCOS group (1:2 ratio) to create a second group consisting of 318 age-matched women with PCOS.
None.
AMH levels and ovarian morphology.
Median AMH serum levels for the HH group were 3.8 (<0.1-19.8), compared with 7.5 (<0.1-81.0) in the PCOS group and 1.9 (<0.1-21.5) in the control group (P < 0.001). In the HH group, 58 (36%) erroneously met the Rotterdam Criteria for PCOS (meeting 2 of 3 criteria).
AMH levels are increased in women with HH. We hypothesize that this increase, although there was no increase in follicle count, may be explained by the presence of a relatively large pool of antral follicles smaller than 2 mm in diameter, that are undetectable by transvaginal ultrasound. This study highlights the importance of measuring gonadotropins and estradiol before diagnosing a patient with PCOS.
下丘脑性性腺功能减退症（HH），也被称为世界卫生组织-1 排卵障碍，其女性患者的表型特征，包括卵巢形态，在大型队列研究中鲜有描述。一些研究报告称，HH 女性的抗苗勒管激素（AMH）水平升高。
评估与健康对照组相比，HH 女性的血清 AMH 水平是否升高，以及这些女性中错误符合多囊卵巢综合征（PCOS） Rotterdam 标准的比例。
设计、地点和参与者：这是荷兰学术医疗中心的一项回顾性队列研究，纳入了 83 名既无排卵障碍也无月经周期紊乱的女性（健康对照组）、159 名 HH 女性和 3640 名 PCOS 女性。为了创建由 318 名年龄匹配的 PCOS 女性组成的第二组，HH 和 PCOS 组之间使用年龄匹配（1:2 比例）。
无。
AMH 水平和卵巢形态。
HH 组的 AMH 血清中位水平为 3.8（<0.1-19.8），与 PCOS 组的 7.5（<0.1-81.0）和对照组的 1.9（<0.1-21.5）相比均降低（P<0.001）。在 HH 组中，有 58 名（36%）女性错误地符合 PCOS Rotterdam 标准（符合 3 项标准中的 2 项）。
HH 女性的 AMH 水平升高。我们假设，这种增加虽然卵泡计数没有增加，但可能是由于直径小于 2mm 的窦前卵泡数量相对较大，这些卵泡无法通过阴道超声检测到。本研究强调了在诊断 PCOS 患者之前测量促性腺激素和雌二醇的重要性。
