Ovarian cortical follicle density in infertile women with low anti-Müllerian hormone
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Ovarian cortical follicle density in infertile women with low anti-Müllerian hormone. / Lunding, Stine Aagaard; Pors, Susanne Elisabeth; Kristensen, Stine Gry; Bøtkjær, Jane Alrø; Ramløse, Maja; Jeppesen, Janni Vikkelsø; Flachs, Esben Meulengracht; Pinborg, Anja; Macklon, Kirsten Tryde; Pedersen, Anette Tønnes; Andersen, Claus Yding; Andersen, Anders Nyboe.
In: Journal of Assisted Reproduction and Genetics, Vol. 37, No. 1, 01.2020, p. 109-117.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Ovarian cortical follicle density in infertile women with low anti-Müllerian hormone
AU - Lunding, Stine Aagaard
AU - Pors, Susanne Elisabeth
AU - Kristensen, Stine Gry
AU - Bøtkjær, Jane Alrø
AU - Ramløse, Maja
AU - Jeppesen, Janni Vikkelsø
AU - Flachs, Esben Meulengracht
AU - Pinborg, Anja
AU - Macklon, Kirsten Tryde
AU - Pedersen, Anette Tønnes
AU - Andersen, Claus Yding
AU - Andersen, Anders Nyboe
PY - 2020/1
Y1 - 2020/1
N2 - PURPOSE: To evaluate the association between anti-Müllerian hormone (AMH) and follicle density in infertile women with diminished ovarian reserve (DOR) versus women with normal ovarian reserve?METHODS: Case-control study comparing follicle densities in ovarian cortex from 20 infertile women with DOR (AMH ≤ 5 pmol/L) and 100 controls with presumed normal ovarian reserve.RESULTS: For all women > 25 years, the follicle densities correlated positively with AMH levels. For each single picomole per liter increase in AMH the follicle density increased by 6% (95% CI 3.3-8.5%) when adjusted for age. This was similar for women with DOR and controls. The follicle density was 1.8 follicles/mm3 cortical tissue in women with DOR versus 7.0 in age-paired controls (p = 0.04). The women with DOR had a median AMH of 1.8 pmol/L versus 14.4 pmol/L in the age-paired control group (p < 0.001). The ratio of AMH/follicle density was 1:1 (1.8/1.8) in women with DOR and 2:1 (14.4/7.0) in the age-paired controls. Analyses for gonadotropin receptor polymorphisms could not explain the characteristics of women with DOR. The proportion of secondary follicles was higher in women with DOR compared with controls (4.6% versus 1.4%, p = 0.0003). Pooling all patients, the follicle density decreased significantly by 7.7% for every year added (p < 0.0001). The women with DOR had lower follicle densities than the controls, but the slopes were equal in the two cohorts.CONCLUSIONS: Follicle density and AMH concentrations correlate also when AMH is low. However, AMH is only a reliable marker for the true ovarian reserve when age is included in the estimation and women with DOR may have more follicles than their AMH levels imply.
AB - PURPOSE: To evaluate the association between anti-Müllerian hormone (AMH) and follicle density in infertile women with diminished ovarian reserve (DOR) versus women with normal ovarian reserve?METHODS: Case-control study comparing follicle densities in ovarian cortex from 20 infertile women with DOR (AMH ≤ 5 pmol/L) and 100 controls with presumed normal ovarian reserve.RESULTS: For all women > 25 years, the follicle densities correlated positively with AMH levels. For each single picomole per liter increase in AMH the follicle density increased by 6% (95% CI 3.3-8.5%) when adjusted for age. This was similar for women with DOR and controls. The follicle density was 1.8 follicles/mm3 cortical tissue in women with DOR versus 7.0 in age-paired controls (p = 0.04). The women with DOR had a median AMH of 1.8 pmol/L versus 14.4 pmol/L in the age-paired control group (p < 0.001). The ratio of AMH/follicle density was 1:1 (1.8/1.8) in women with DOR and 2:1 (14.4/7.0) in the age-paired controls. Analyses for gonadotropin receptor polymorphisms could not explain the characteristics of women with DOR. The proportion of secondary follicles was higher in women with DOR compared with controls (4.6% versus 1.4%, p = 0.0003). Pooling all patients, the follicle density decreased significantly by 7.7% for every year added (p < 0.0001). The women with DOR had lower follicle densities than the controls, but the slopes were equal in the two cohorts.CONCLUSIONS: Follicle density and AMH concentrations correlate also when AMH is low. However, AMH is only a reliable marker for the true ovarian reserve when age is included in the estimation and women with DOR may have more follicles than their AMH levels imply.
U2 - 10.1007/s10815-019-01633-4
DO - 10.1007/s10815-019-01633-4
M3 - Journal article
C2 - 31758514
VL - 37
SP - 109
EP - 117
JO - Journal of Assisted Reproduction and Genetics
JF - Journal of Assisted Reproduction and Genetics
SN - 1058-0468
IS - 1
ER -
ID: 236989866