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The influence of circulating anti-Müllerian hormone on ovarian responsiveness to ovulation induction with gonadotrophins in women with polycystic ovarian syndrome: a pilot study

Amer, Saad A.; Mahran, Ahmad; Abdelmaged, Ayman; El-Adawy, Ahmad R.; Eissa, Moustafa K.; Shaw, Robert W.

Authors

Saad A. Amer

Ahmad Mahran

Ayman Abdelmaged

Ahmad R. El-Adawy

Moustafa K. Eissa

Robert W. Shaw



Abstract

Background
Women with polycystic ovarian syndrome (PCOS) are known to have elevated circulating Anti-Müllerian hormone (AMH), which has been found to desensitize ovarian follicles to follicle stimulating hormone (FSH). The purpose of this study was to investigate the impact of high circulating AMH on ovarian responsiveness to ovulation induction with gonadotrophins in PCOS women.

Methods
This prospective observational pilot study was conducted in two collaborating Fertility Centres in the UK and Egypt. The study included 20 consecutive anovulatory women with PCOS who underwent 34 cycles of human menopausal gonadotrophin (hMG) ovarian stimulation using chronic low-dose step up protocol. Blood samples were collected for the measurement of serum AMH concentrations in the early follicular (day 2-3) phase in all cycles of hMG treatment. The serum levels of AMH were compared between cycles with good vs. poor response. The good response rates and the total dose and duration of hMG treatment were compared between cycles with high vs. low serum AMH concentrations.

Results
Cycles with poor response (no or delayed ovulation requiring >20 days of hMG treatment) had significantly (p = .007) higher median{range} serum AMH concentration (6.5{3.2-13.4}ng/ml) compared to that (4.0{2.2-10.2}ng/ml) of cycles with good response (ovulation within 20 days of hMG treatment). ROC curve showed AMH to be a useful predictor of poor response to hMG stimulation (AUC, 0.772; P = 0.007). Using a cut-off level of 4.7 ng/ml, AMH had a sensitivity of 100% and specificity of 58% in predicting poor response. The good response rate was significantly (p  10.2 ng/ml) were associated with poor response. Cycles with high AMH (> = 4.7 ng/ml) required significantly (p 

Journal Article Type Article
Publication Date Dec 17, 2013
Journal Reproductive Biology and Endocrinology
Electronic ISSN 1477-7827
Publisher Humana Press
Peer Reviewed Peer Reviewed
Volume 11
Issue 115
Article Number 115
APA6 Citation Amer, S. A., Mahran, A., Abdelmaged, A., El-Adawy, A. R., Eissa, M. K., & Shaw, R. W. (2013). The influence of circulating anti-Müllerian hormone on ovarian responsiveness to ovulation induction with gonadotrophins in women with polycystic ovarian syndrome: a pilot study. Reproductive Biology and Endocrinology, 11(115), doi:10.1186/1477-7827-11-115
DOI https://doi.org/10.1186/1477-7827-11-115
Publisher URL http://www.rbej.com/content/11/1/115/abstract
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0





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