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Hum. Reprod. Advance Access published online on March 31, 2005

Human Reproduction, doi:10.1093/humrep/deh873
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Received December 29, 2004
Revised February 13, 2005
Accepted February 23, 2005

Article

Serum anti-Mullerian hormone levels during controlled ovarian hyperstimulation in women with polycystic ovaries with and without hyperandrogenism

Talia Eldar-Geva 1*, Ehud J. Margalioth 2, Michael Gal 2, Avraham Ben-Chetrit 2, Nurit Algur 3, Edit Zylber-Haran 2, Baruch Brooks 2, Michael Huerta 2, and Irving M. Spitz 3

1 IVF Unit, Department of Obstetrics and Gynecology, Shaare-Zedek Medical Center, Ben Gurion University of the Negev, Jerusalem, Israel; Institute of Hormone Research, Shaare-Zedek Medical Center, Ben Gurion University of the Negev, Jerusalem, Israel
2 IVF Unit, Department of Obstetrics and Gynecology, Shaare-Zedek Medical Center, Ben Gurion University of the Negev, Jerusalem, Israel
3 Institute of Hormone Research, Shaare-Zedek Medical Center, Ben Gurion University of the Negev, Jerusalem, Israel

* To whom correspondence should be addressed.
Talia Eldar-Geva, E-mail: gevat{at}szmc.org.il


   Abstract

BACKGROUND: Anti-Mullerian hormone (AMH) is expressed in pre- and small-antral follicles. High serum levels are found in women with polycystic ovaries (PCO), accordant with their increased content of small follicles. To evaluate the relationship between AMH, folliculogenesis and hyperandrogenism, we compared serum AMH levels between women with PCO with and without hyperandrogenism and normal controls during controlled ovarian hyperstimulation (COH). METHODS: Nineteen women with PCO and hyperandrogenism (group A), 10 women with PCO but no hyperandrogenism (group B) and 23 ovulatory women with normal ovarian morphology (group C, controls) underwent COH with the long protocol. Serum levels of AMH, estradiol, androstenedione and follicular tracking were determined before gonadotropins treatment (day 0) and every 2-4 days up to the day of HCG administration. RESULTS: AMH levels declined gradually throughout COH in the three groups, but remained higher in groups A and B compared with the controls. Significantly higher levels were found in group A compared with group B, despite comparable numbers of small follicles. Multiple regression analysis revealed that both the number of small follicles and serum androgens were correlated to AMH. CONCLUSIONS: Women with PCO have higher serum AMH levels during COH than controls. Hyperandrogenism is associated with an additional increase in AMH. It is conceivable that hyperandrogenism may reflect more severe disruption of folliculogenesis in women with PCO or may affect AMH secretion.

Keywords: anti-Mullerian hormone; controlled ovarian hyperstimulation; hyperandrogenism; polycystic ovaries.
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