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Anti-Müllerian hormone may predict premature ovarian failure
Hagen CP. J Clin Endocrinol Metab. 2010;95:5003-5010.
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New data suggest a correlation between anti-Müllerian hormone levels and ovarian function, and suggest the hormone’s potential as a marker of premature ovarian failure in girls and women with Turner’s syndrome.
To test the capability of anti-Müllerian hormone levels in predicting ovarian function, researchers measured hormone levels in 926 healthy girls and women and 172 patients with Turner’s syndrome at ages 0, 3 and 12 months.
Anti-Müllerian hormone levels were undetectable (<2 pmol/L) in 54% of infants with available umbilical cord blood samples and were low (<15.5 pmol/L) among the rest of the population. Levels increased significantly, however, by age 3 months (8 pmol/L and 5.5 pmol/L to 29.5 pmol/L, respectively; P<.001), with all participants experiencing considerable increases in levels during longitudinal follow-up.
Between ages 8 and 25 years, antimüllerian hormone levels were stable. In 99.9% of the cohort, levels remained detectable from birth to age 32 years. Median levels became undetectable, however, by age 46.7 years.
In patients with Turner's syndrome, anti-Müllerian hormone levels correlated with karyotype, according to the researchers. Median levels for karyotype A vs. B were less than 2 pmol/L vs. 3 pmol/L (P=.044), and median levels for karyotype B vs. C were 3 pmol/L vs. 16 pmol/L (P<.001).
Anti-Müllerian hormone levels also demonstrated a significant association with remaining ovarian function in patients aged 12 to 25 years with Turner's syndrome. Results indicated, for instance, that the median anti-Müllerian hormone level in those with absent puberty was less than 2 pmol/L compared with a median of 6 pmol/L in those with cessation of ovarian function. Median anti-Müllerian hormone level in those with ongoing ovarian function was also significantly higher — 14 pmol/L — than in those with ovarian failure.
Data also suggested that measurement of anti-Müllerian hormone levels as a test for premature ovarian failure had a sensitivity of 96% and a specificity of 86%.
As a result of their findings, the researchers said antimüllerian hormone "seems to be a promising marker of ovarian function" and may augment fertility counseling for patients with Turner’s syndrome. – by Melissa Foster
This article gives a nice overview of antimüllerian hormone throughout the life cycle. The data are corroborative but useful for persons interested in following patients who may be subfertile.
– Michelle P. Warren, MD
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