Serum Anti-Mullerian Hormone Levels in Turkish Girls Aged 18 and Younger for Ovarian Reserve Determination

Overview

Journal J Turk Ger Gynecol Assoc

Publisher Galenos Publishing House

Specialty Gynecology & Obstetrics

Date 2024 May 22

PMID 38775713

Authors

Ipek Betul Ozcivit Erkan

Mahmut Oncul

Zafer Basibuyuk

Ceren Cebi

Ismail Cepni

Affiliations

Soon will be listed here.

Abstract

Objective: Our aim was to show that anti-Mullerian hormone (AMH) may be used as a quantitative marker of ovarian reserve in Turkish girls aged 18 years and younger and establish the reference values for AMH in Turkish girls.

Material And Methods: This retrospective study included girls between 8-18 years old, without premature ovarian failure or without genetic factors resulting in ovarian dysgenesis. Blood specimens were collected after overnight fasting early in the morning during the early follicular phase. Measurement of serum levels of gonadotropins and AMH was done. Mean serum AMH levels of different age groups and best fitting curve representing AMH percentiles (10, 25, 50, 75, 90) were calculated.

Results: In total 785 girls with a mean age of 16.16±1.90 years were included, divided into seven age groups. The mean serum AMH level for the total cohort was 5.20±4.19 ng/mL. There was a significant difference between the mean values of AMH in age groups as follows: ≤12 and 17-≤18 (p=0.011). The best fitting curves for AMH percentiles were 4 order polynomial functions. There was a significant correlation between AMH and age and follicle stimulating hormone levels (r=0.148, p<0.001 and r=-0.092, p=0.010).

Conclusion: Our results reflect the real-life data for serum AMH values in Turkish girls. Our nomogram may be useful for counseling adolescents about their ovarian reserve and diagnosing other gynecological diseases. A longitudinal study is necessary for improving the predictive value of AMH values in girls aged 18 and younger.

References

Lindhardt Johansen M, Hagen C, Holm Johannsen T, Main K, Picard J, Jorgensen A . Anti-müllerian hormone and its clinical use in pediatrics with special emphasis on disorders of sex development. Int J Endocrinol. 2013; 2013:198698. PMC: 3866787. DOI: 10.1155/2013/198698. View

Sahmay S, Guralp O, Senturk L, Imamoglu M, Kucuk M, Irez T . Serum anti-müllerian hormone concentrations in reproductive age women with and without polycystic ovary syndrome: the influence of body mass index. Reprod Med Biol. 2018; 10(2):113-120. PMC: 5904598. DOI: 10.1007/s12522-011-0078-5. View

Sehested A, Juul A, Andersson A, Petersen J, Jensen T, Muller J . Serum inhibin A and inhibin B in healthy prepubertal, pubertal, and adolescent girls and adult women: relation to age, stage of puberty, menstrual cycle, follicle-stimulating hormone, luteinizing hormone, and estradiol levels. J Clin Endocrinol Metab. 2000; 85(4):1634-40. DOI: 10.1210/jcem.85.4.6512. View

Miazgowski T, Martopullo I, Widecka J, Miazgowski B, Brodowska A . National and regional trends in the prevalence of polycystic ovary syndrome since 1990 within Europe: the modeled estimates from the Global Burden of Disease Study 2016. Arch Med Sci. 2021; 17(2):343-351. PMC: 7959048. DOI: 10.5114/aoms.2019.87112. View

Nelson S, Messow M, Michael Wallace A, Fleming R, McConnachie A . Nomogram for the decline in serum antimüllerian hormone: a population study of 9,601 infertility patients. Fertil Steril. 2010; 95(2):736-41.e1-3. DOI: 10.1016/j.fertnstert.2010.08.022. View

Lie Fong S, Visser J, Welt C, de Rijke Y, Eijkemans M, Broekmans F . Serum anti-müllerian hormone levels in healthy females: a nomogram ranging from infancy to adulthood. J Clin Endocrinol Metab. 2012; 97(12):4650-5. PMC: 3683801. DOI: 10.1210/jc.2012-1440. View

Li L, Chen X, Mo Y, Chen Y, Wenig M, Yang D . Elevated serum anti-mullerian hormone in adolescent and young adult Chinese patients with polycystic ovary syndrome. Wien Klin Wochenschr. 2010; 122(17-18):519-24. DOI: 10.1007/s00508-010-1426-x. View

Chang H, Klausen C, Leung P . Antimüllerian hormone inhibits follicle-stimulating hormone-induced adenylyl cyclase activation, aromatase expression, and estradiol production in human granulosa-lutein cells. Fertil Steril. 2013; 100(2):585-92.e1. DOI: 10.1016/j.fertnstert.2013.04.019. View

Jeffery A, Streeter A, Hosking J, Wilkin T, Nelson S . Anti-Müllerian hormone in children: a ten-year prospective longitudinal study (EarlyBird 39). J Pediatr Endocrinol Metab. 2015; 28(9-10):1153-62. DOI: 10.1515/jpem-2014-0517. View

10.

Wallace W, Kelsey T . Human ovarian reserve from conception to the menopause. PLoS One. 2010; 5(1):e8772. PMC: 2811725. DOI: 10.1371/journal.pone.0008772. View

11.

Dokuzeylul Gungor N, Gungor K, Celik N, Onal M, Madenli A . Impact of body mass index and vitamin D on serum AMH levels and antral follicle count in PCOS. Eur Rev Med Pharmacol Sci. 2023; 27(1):179-187. DOI: 10.26355/eurrev_202301_30870. View

12.

Zhang M, Liu X, Xu X, Li J, Bu Z, Yang Q . The reference value of anti-Müllerian hormone to diagnose polycystic ovary syndrome is inversely associated with BMI: a retrospective study. Reprod Biol Endocrinol. 2023; 21(1):15. PMC: 9890853. DOI: 10.1186/s12958-023-01064-y. View

13.

Sahmay S, Atakul N, Oncul M, Tuten A, Aydogan B, Seyisoglu H . Serum anti-Mullerian hormone levels in the main phenotypes of polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol. 2013; 170(1):157-61. DOI: 10.1016/j.ejogrb.2013.05.019. View

14.

Hagen C, Sorensen K, Anderson R, Juul A . Serum levels of antimüllerian hormone in early maturing girls before, during, and after suppression with GnRH agonist. Fertil Steril. 2012; 98(5):1326-30. DOI: 10.1016/j.fertnstert.2012.07.1118. View

15.

Kuiri-Hanninen T, Kallio S, Seuri R, Tyrvainen E, Liakka A, Tapanainen J . Postnatal developmental changes in the pituitary-ovarian axis in preterm and term infant girls. J Clin Endocrinol Metab. 2011; 96(11):3432-9. DOI: 10.1210/jc.2011-1502. View

16.

Lashen H, Dunger D, Ness A, Ong K . Peripubertal changes in circulating antimüllerian hormone levels in girls. Fertil Steril. 2013; 99(7):2071-5. PMC: 3906604. DOI: 10.1016/j.fertnstert.2013.01.139. View

17.

Albu D, Albu A . The relationship between anti-Müllerian hormone serum level and body mass index in a large cohort of infertile patients. Endocrine. 2018; 63(1):157-163. DOI: 10.1007/s12020-018-1756-4. View

18.

Tokmak A, Timur H, Aksoy R, Cinar M, Yilmaz N . Is anti-Mullerian hormone a good diagnostic marker for adolescent and young adult patients with Polycystic ovary syndrome?. Turk J Obstet Gynecol. 2017; 12(4):199-204. PMC: 5588471. DOI: 10.4274/tjod.21549. View

19.

Dewailly D, Andersen C, Balen A, Broekmans F, Dilaver N, Fanchin R . The physiology and clinical utility of anti-Mullerian hormone in women. Hum Reprod Update. 2014; 20(3):370-85. DOI: 10.1093/humupd/dmt062. View

20.

Gracia C, Shin S, Prewitt M, Chamberlin J, Lofaro L, Jones K . Multi-center clinical evaluation of the Access AMH assay to determine AMH levels in reproductive age women during normal menstrual cycles. J Assist Reprod Genet. 2018; 35(5):777-783. PMC: 5984885. DOI: 10.1007/s10815-018-1141-5. View