Serum anti-Müllerian hormone levels are negatively related to Follicular Output RaTe (FORT) in normo-cycling women undergoing controlled ovarian hyperstimulation

BACKGROUND Since in rodents anti-Müllerian hormone (AMH) has been shown to inhibit antral follicle responsiveness to FSH, we aimed at verifying whether a relationship exists between serum AMH levels and antral follicle responsiveness to exogenous FSH in normo-cycling women. METHODS Serum AMH, estrad...

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Bibliographic Details
Published in:Human reproduction (Oxford) 2011-03, Vol.26 (3), p.671-677
Main Authors: Genro, V.K., Grynberg, M., Scheffer, J.B., Roux, I., Frydman, R., Fanchin, R.
Format: Article
Language:English
Subjects:
Adult
Algorithms
Anti-Mullerian Hormone - blood
Anti-Mullerian Hormone - physiology
Biological and medical sciences
Embryo Transfer
Female
Fertilization in Vitro
Follicle Stimulating Hormone - blood
Follicle Stimulating Hormone - pharmacology
Follicle Stimulating Hormone - therapeutic use
Gynecology. Andrology. Obstetrics
Humans
Infertility - blood
Infertility - therapy
Medical sciences
Oocyte Retrieval
Oogenesis - drug effects
Ovarian Follicle - cytology
Ovarian Follicle - diagnostic imaging
Ovarian Follicle - drug effects
Ovulation Induction
Recombinant Proteins - pharmacology
Recombinant Proteins - therapeutic use
Ultrasonography
Young Adult
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Summary:BACKGROUND Since in rodents anti-Müllerian hormone (AMH) has been shown to inhibit antral follicle responsiveness to FSH, we aimed at verifying whether a relationship exists between serum AMH levels and antral follicle responsiveness to exogenous FSH in normo-cycling women. METHODS Serum AMH, estradiol (E2) and FSH levels were prospectively measured on cycle day 3 in patients undergoing controlled ovarian hyperstimulation (COH) with a time-release GnRH agonist and standardized FSH doses. In 162 patients, follicles were counted after pituitary suppression and before FSH administration (baseline; small antral follicles; 3–8 mm), and on the day of hCG (dhCG; pre-ovulatory follicles; 16–22 mm). Antral follicle responsiveness to FSH was estimated by the Follicular Output RaTe (FORT), determined by the ratio pre-ovulatory follicle count on dhCG × 100/small antral follicle count at baseline. RESULTS Serum AMH levels were positively correlated with the number of small antral follicles at baseline (r = 0.59; P < 0.0001) and pre-ovulatory follicles on dhCG (r = 0.17; P < 0.04). Overall, FORT was 47.5 ± 1.4% and failed to be influenced by the woman's age, BMI or basal E2 and FSH level. Conversely, multiple regression analysis showed that FORT was negatively correlated with AMH levels (r = −0.30; P < 0.001), irrespective of duration of COH and total FSH dose. CONCLUSIONS The percentage of follicles that effectively respond to FSH by reaching pre-ovulatory maturation is negatively and independently related to serum AMH levels. Although the mechanisms underlying this finding remain unclear, it is in keeping with the hypothesis that AMH inhibits follicle sensitivity to FSH.
ISSN:0268-1161
1460-2350
DOI:10.1093/humrep/deq361