Anti-Müllerian Hormone Level Determinants Among Non-Polycystic-Ovary-Syndrome Women Undergoing In Vitro Fertilization: A Retrospective Cross-Sectional Study

Overview

Journal Medicina (Kaunas)

Publisher MDPI

Specialty General Medicine

Date 2024 Sep 28

PMID 39336427

Authors

Melinda Kolcsar

Laszlo Szabo

Renata Mihaly

Erzsebet Rozalia Vass

Zsolt Gall

Affiliations

Soon will be listed here.

Abstract

: The anti-Müllerian hormone (AMH) is a crucial biomarker in regulating ovarian follicle development and female fertility. AMH levels predict ovarian responses in in vitro fertilization (IVF) cycles, helping clinicians tailor treatment strategies. This study aims to determine whether thyroid autoimmunity, age, body mass index (BMI), sexual hormone levels, and 25-hydroxyvitamin D levels influence serum AMH in non-polycystic-ovary-syndrome (PCOS) euthyroid women. : This retrospective cross-sectional study examined 52 female patients at Zygota Fertility Clinic between 2018 and 2022. Women aged 20-45 years with regular menstrual cycles were included, while conditions such as abnormal thyroid-stimulating hormone (TSH) levels, PCOS, and systemic autoimmune diseases were excluded. A number of parameters were measured in the study, including the subjects' age, BMI, 25-hydroxyvitamin D, serum free thyroxine (fT4), TSH, various antibodies, and a range of reproductive hormones. An analysis of the relationships between AMH and other variables was conducted using Spearman's correlation coefficient, and an assessment of the impact of confounding factors on AMH levels was conducted using a multivariable linear regression model. : The results revealed significant negative correlations between AMH levels and age (rho: -0.484, < 0.001) and follicle-stimulating hormone (FSH) (rho: -0.550, < 0.001), while positive correlations existed between AMH and estradiol (rho: 0.352, = 0.011) and total testosterone (rho: 0.542, < 0.001). No significant correlations were found between AMH levels and BMI, LH, or 25-hydroxyvitamin D. : In this study, ovarian reserve was influenced by age, estradiol, and total testosterone in non-PCOS euthyroid women undergoing IVF. Conversely, BMI and vitamin D status did not significantly impact AMH levels. In order to better understand and possibly manage ovarian reserve, a holistic approach is absolutely essential, taking into account age, weight, hormonal balance, nutrition, and thyroid health.

References

McLennan I, Pankhurst M . Anti-Müllerian hormone is a gonadal cytokine with two circulating forms and cryptic actions. J Endocrinol. 2015; 226(3):R45-57. DOI: 10.1530/JOE-15-0206. View

Grynberg M, Pierre A, Rey R, Leclerc A, Arouche N, Hesters L . Differential regulation of ovarian anti-müllerian hormone (AMH) by estradiol through α- and β-estrogen receptors. J Clin Endocrinol Metab. 2012; 97(9):E1649-57. DOI: 10.1210/jc.2011-3133. View

Robertson D . Predictors of IVF outcome: markers and protocols. Womens Health (Lond). 2009; 2(3):385-8. DOI: 10.2217/17455057.2.3.385. View

Zeng X, Huang Y, Zhang M, Chen Y, Ye J, Han Y . Anti-Müllerian hormone was independently associated with central obesity but not with general obesity in women with PCOS. Endocr Connect. 2021; 11(1). PMC: 8789017. DOI: 10.1530/EC-21-0243. View

Bahri S, Ramezani Tehrani F, Amouzgar A, Rahmati M, Tohidi M, Vasheghani M . Overtime trend of thyroid hormones and thyroid autoimmunity and ovarian reserve: a longitudinal population study with a 12-year follow up. BMC Endocr Disord. 2019; 19(1):47. PMC: 6505305. DOI: 10.1186/s12902-019-0370-7. View

Dewailly D, Robin G, Peigne M, Decanter C, Pigny P, Catteau-Jonard S . Interactions between androgens, FSH, anti-Müllerian hormone and estradiol during folliculogenesis in the human normal and polycystic ovary. Hum Reprod Update. 2016; 22(6):709-724. DOI: 10.1093/humupd/dmw027. View

Zhao H, Zhou D, Liu C, Zhang L . The Relationship Between Insulin Resistance and Obesity and Serum Anti-Mullerian Hormone Level in Chinese Women with Polycystic Ovary Syndrome: A Retrospective, Single-Center Cohort Study. Int J Womens Health. 2023; 15:151-166. PMC: 9911904. DOI: 10.2147/IJWH.S393594. View

Alavi N, Ebrahimi M, Akbari-Asbagh F . The effect of vitamin D status on ovarian reserve markers in infertile women: A prospective cross-sectional study. Int J Reprod Biomed. 2020; 18(2):85-92. PMC: 7097167. DOI: 10.18502/ijrm.v18i2.6501. View

Yoo J, Kim H, Cha S, Park C, Yang K, Song I . Age specific serum anti-Müllerian hormone levels in 1,298 Korean women with regular menstruation. Clin Exp Reprod Med. 2012; 38(2):93-7. PMC: 3283054. DOI: 10.5653/cerm.2011.38.2.93. View

10.

Cotellessa L, Giacobini P . Role of Anti-Müllerian Hormone in the Central Regulation of Fertility. Semin Reprod Med. 2024; 42(1):34-40. DOI: 10.1055/s-0044-1786050. View

11.

Oh S, Choe S, Cho Y . Clinical application of serum anti-Müllerian hormone in women. Clin Exp Reprod Med. 2019; 46(2):50-59. PMC: 6572668. DOI: 10.5653/cerm.2019.46.2.50. View

12.

Drakopoulos P, van de Vijver A, Schutyser V, Milatovic S, Anckaert E, Schiettecatte J . The effect of serum vitamin D levels on ovarian reserve markers: a prospective cross-sectional study. Hum Reprod. 2016; 32(1):208-214. DOI: 10.1093/humrep/dew304. View

13.

Kuroda K, Uchida T, Nagai S, Ozaki R, Yamaguchi T, Sato Y . Elevated serum thyroid-stimulating hormone is associated with decreased anti-Müllerian hormone in infertile women of reproductive age. J Assist Reprod Genet. 2014; 32(2):243-7. PMC: 4354178. DOI: 10.1007/s10815-014-0397-7. View

14.

Meng X, Zhang J, Wan Q, Huang J, Han T, Qu T . Influence of Vitamin D supplementation on reproductive outcomes of infertile patients: a systematic review and meta-analysis. Reprod Biol Endocrinol. 2023; 21(1):17. PMC: 9896710. DOI: 10.1186/s12958-023-01068-8. View

15.

Liu L, Sun X, Yang H, Feng X, Lan Y . Predictive value of anti-Mullerian hormone for pregnancy outcomes following assisted reproductive techniques (ART) in Southwest China. Reprod Health. 2022; 19(1):224. PMC: 9749145. DOI: 10.1186/s12978-022-01524-5. View

16.

de Kat A, van der Schouw Y, Eijkemans M, Herber-Gast G, Visser J, Verschuren W . Back to the basics of ovarian aging: a population-based study on longitudinal anti-Müllerian hormone decline. BMC Med. 2016; 14(1):151. PMC: 5046975. DOI: 10.1186/s12916-016-0699-y. View

17.

Halder A, Kumar H, Sharma M, Jain M, Kalsi A, Pandey S . Serum anti-Müllerian hormone: A potential biomarker for polycystic ovary syndrome. Indian J Med Res. 2023; 158(4):397-406. PMC: 10793823. DOI: 10.4103/ijmr.IJMR_4608_20. View

18.

Ozalp Akin E, Aycan Z . Evaluation of the Ovarian Reserve in Adolescents with Hashimoto’s Thyroiditis Using Serum Anti-Müllerian Hormone Levels. J Clin Res Pediatr Endocrinol. 2018; 10(4):331-335. PMC: 6280326. DOI: 10.4274/jcrpe.0047. View

19.

Moridi I, Chen A, Tal O, Tal R . The Association between Vitamin D and Anti-Müllerian Hormone: A Systematic Review and Meta-Analysis. Nutrients. 2020; 12(6). PMC: 7352921. DOI: 10.3390/nu12061567. View

20.

Umarsingh S, Adam J, Krishna S . The relationship between anti-Müllerian hormone (AMH) levels and pregnancy outcomes in patients undergoing assisted reproductive techniques (ART). PeerJ. 2021; 8:e10390. PMC: 7761264. DOI: 10.7717/peerj.10390. View