Fertility preservation in pediatric and adolescent girls
Joseph S. Sanfilippo, Eduardo Lara-Torre, Veronica Gomez-Lobo in Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition, 2019
Anti-müllerian hormone (AMH) is produced by the granulosa cells of preantral and antral follicles, which are thought to reflect overall follicular reserve, and is thus another marker of ovarian reserve. Assessing AMH levels is often more practical than FSH/estradiol, as there is minimal fluctuation both within and between cycles, and levels are not as dramatically affected by hormonal treatment, such as birth control pills. AMH rises irregularly during the teen years and peaks in the early 20s, which means serum AMH levels can be difficult to interpret in adolescents.12 Moreover, AMH levels are often suppressed during chemotherapy,13 so they are of little utility in patients actively undergoing treatment. Finally, the antral follicles (2–10 mm) can also be assessed directly by ultrasound measurement, but normal ranges have not been established in adolescence.
Egg and embryo donation
David K. Gardner, Ariel Weissman, Colin M. Howles, Zeev Shoham in Textbook of Assisted Reproductive Techniques, 2017
Anti-Mullerian hormone (AMH) is produced in the granulosa cells from preantral and small antral follicles and serum levels are measurable and reflective of ovarian reserve. Higher levels of AMH are associated with greater numbers of retrieved oocytes in women undergoing IVF, while low levels appear to be reliable markers for diminished ovarian reserve (27). Thus, AMH testing may identify women at risk for either extreme (hypoor hyper-) in ovarian responsiveness. Other tests are extant to assess ovarian reserve, but are more cumbersome than day-3 serum FSH and estradiol. The clomiphene challenge test measures serum FSH, luteinizing hormone (LH), and estradiol at baseline and again after five days (days 5–9) of 100 mg clomiphene citrate (28). Serum FSH values >15 mIU/mL post-clomiphene are predictive of IVF failure. Day-2 or -3 serum inhibin B may also define ovarian reserve (29), but the commercially available assay is currently far more complex and time consuming than assays for FSH, estradiol, and AMH and not readily available.
Polycystic ovary syndrome
David M. Luesley, Mark D. Kilby in Obstetrics & Gynaecology, 2016
Polycystic ovaries are commonly detected by pelvic ultrasound, with estimates of the prevalence in the general population being in the order of 20–33 percent.6 The morphology of the polycystic ovary was also defined in the ESHRE/ASRM consensus as an ovary with 12 or more follicles measuring 2–9 mm in diameter and/or increased ovarian volume (>10 cm3).7 With improvements in the resolution of ultrasound technology it has more recently been suggested that the threshold number of follicles to define a polycystic ovary should be increased and that the biochemical marker of anti-Mullerian hormone may be even more precise than ultrasound, although a figure has not been universally accepted.
Premature ovarian insufficiency: a toolkit for the primary care physician
Published in Climacteric, 2021
I. Lambrinoudaki, S. A. Paschou, M. A. Lumsden, S. Faubion, E. Makrakis, S. Kalantaridou, N. Panay
Anti-Müllerian hormone (AMH) is produced by developing antral follicles in the ovaries. There are several different assays and therefore interpretation of results can be difficult, but currently the ultra-sensitive assays are thought to be the most reliable measure of impaired ovarian reserve. However, the test is not widely available in primary care and can be difficult to access in secondary care. As such, it is not recommended as a routine part of the diagnostic work up. However, it can be used where there is diagnostic uncertainty, in which case the woman may need to be referred to a specialty center to have this done6. Women undergoing chemo- or radiotherapy for malignancy can also be monitored with AMH tests if a certain degree of recovery of ovarian function is expected9.
The effects of the anti-Müllerian hormone on folliculogenesis in rats: light and electron microscopic evaluation
Published in Ultrastructural Pathology, 2021
Anti-Müllerian hormone (AMH), a member of transforming growth factor-beta (TGF-β) superfamily, has an inhibitory effect on the initial follicle recruitment.4 Anti-Müllerian hormone is produced by granulosa cells of growing preantral and small antral follicles as a dimeric glycoprotein.5 While the highest expression of AMH is observed in granulosa cells of preantral and small antral follicles, its expression decreases in late antral follicles.4,6 Studies have confirmed that AMH is not expressed in primordial and atretic follicles.7 Anti-Müllerian hormone modulates two regulatory steps of folliculogenesis: It inhibits activation of primordial follicles and decreases the sensitivity of large preantral and small antral follicles to FSH.7 Durlinger et al. reported that ovaries of AMH null prepubertal and adult female mice contain more preantral and small antral follicles, in addition, the ovaries will show a relatively early depletion of primordial follicles.4 Furthermore, greater AMH serum concentrations were detected in women with polycystic ovarian syndrome (PCOS) compared to healthy women; thus, the AMH serum concentration as a diagnostic criterion has been used clinically.8 AMH is used to monitor ovarian follicle reserve during the premenopausal period and for the women in assisted reproductive technology centers.9,10
Frozen blastocyst transfer improves the chance of live birth in women with endometrioma
Published in Gynecological Endocrinology, 2020
Mehmet Resit Asoglu, Cem Celik, Mustafa Bahceci
A total of 315 patients fulfilled the inclusion criteria, with 180 in frozen-BT group and 135 in fresh-BT group. The means of age, BMI, and duration of infertility in the study population were 33.2 ± 3.8 years, 22.8 ± 3.5 kg/m2, and 3.1 ± 2 years, respectively. The mean number of previous attempts was 0.8 ± 1.3. The mean anti-Mullerian hormone level was 1.77 ± 1.26 ng/mL. Of the study population, 8.3% (n = 26) had secondary infertility, 11.7% (n = 37) had concomitant tubal factor and 15.2% (n = 48) had concomitant male factor. The average size of the largest endometrioma was 27 ± 11 mm. The mean number of endometrioma was 1.4 ± 0.7. Endometrioma was bilateral in 29.2% (n = 92) of the patients. The study groups did not differ in terms of these variables (Table 1).
Related Knowledge Centers
- Activin & Inhibin
- Chromosome 12
- Chromosome 19
- Folliculogenesis
- Transforming Growth Factor Beta
- Glycoprotein
- Hormone
- Activin & Inhibin
- Gene
- Receptor
- Sox9