scholarly journals Correlation between Anti-Mullerian Hormone Levels and Antral Follicle Numbers in Polycystic Ovary and Metabolic Syndromes

2020 ◽  
Author(s):  
Huo Fu ◽  
Youshi Lin ◽  
Xueqing Deng ◽  
Lin Wu

Abstract Background Anti-Mullerian hormone (AMH) is expressed by granulosa cells of the pre-antral and small antral follicles in the ovary. Serum AMH levels are significantly higher in women with polycystic ovary syndrome (PCOS) due to an increased number of antral follicles and also a higher production per antral follicle. We proposed diagnostic criteria for the identification of PCOS that are based on variation in the AMH concentrations.Methods This study explored the relationship between serum AMH levels and other hormonal markers in patients with polycystic ovary syndrome (PCOS) and metabolic syndrome. One hundred fifty patients with PCOS and normally cycling women were examined in a cohort study. Of these, some were candidates for the assisted reproductive methods. The following serum levels were measured in all patients on day 5 of the menstrual cycle: AMH, glucose, HOMA/IP, BMI, testosterone and cholesterol, lipoproteins and triglycerides.Results In the PCOS group, a 2-fold increase in the serum AMH level was observed as compared to the controls. With AMH, the following increments were seen: testosterone (by 184%); fasting blood glucose (by 18%); fasting insulin (83.86%); HOMA/IR (by 64.23%); mean cholesterol (by 30%); mean triglycerides (by 17%); and BMI (by 26.75%). The high-density lipoprotein concentration decreased by 29.3%.Conclusion Thus, monitoring the level of AMH allows predicting for OHSS during the ovulation induction and during the use of assistive reproductive technologies. Such a practice also allows deciding on the treatment strategy for obesity, hirsutism, type II diabetes, infertility and cardiovascular diseases.

2020 ◽  
Vol 21 (6) ◽  
Author(s):  
Leili Hafizi ◽  
Akram Behrouznia ◽  
Maliheh Amirian ◽  
Mina Baradaran ◽  
Seyedeh Azam Pourhoseini

Background: Laparoscopic ovarian drilling (LOD) is recommended for the treatment of women with polycystic ovary syndrome (PCOS) resistant to clomiphene citrate. Objectives: This study aimed to evaluate the effect of ovarian drilling on the serum levels of anti-mullerian hormone (AMH), androgens, and the number of antral follicles. Methods: This was a pre- and post-clinical trial performed on 30 infertile women with PCOS resistant to clomiphene citrate. Patients underwent standard laparoscopic ovarian drilling. Serum levels of AMH and androgens and antral follicle count (AFC) were surveyed before LOD and three and six months after LOD. The ovarian ovulation rate in each month was also monitored for six months. Then, the association between changes in these parameters, especially the level of AMH, and postoperative ovulation was investigated. A P < 0.05 was considered statistically significant. Results: The number of antral follicles three (3.00 ± 8.00) and six months (7.73 ± 4.14) after ovarian drilling showed a significant decrease compared to preoperative values (12.40 ± 4.02) (repeated-measures ANOVA, P < 0.001). The mean AMH (6.78 ± 1.08 versus 12.25 ± 1.35; P = 0.005) and the antral follicle count (7.71 ± 0.54 versus 12.29 ± 0.67 and P < 0.001) were lower in ovulation than in non-ovulation patients. The significantly more AMH reductions were seen in pregnant women (3.63 ± 5.61) than in non-pregnant women (3.63 ± 1.24) (P = 0.01). Conclusions: It may be possible to use the changes in AMH and AFC to predict the success rate of LOD.


2003 ◽  
Vol 88 (12) ◽  
pp. 5957-5962 ◽  
Author(s):  
Pascal Pigny ◽  
Emilie Merlen ◽  
Yann Robert ◽  
Christine Cortet-Rudelli ◽  
Christine Decanter ◽  
...  

Abstract The serum level of anti-Mullerian hormone (AMH), a product from granulosa cells involved in follicle growth, has been shown to correlate tightly with the small antral follicle number (FN) at ultrasonography (U/S) in women who do not have polycystic ovary syndrome (PCOS). Because PCOS is associated with a 2- to 3-fold increase in growing FN, we investigated whether an increased AMH serum level correlates to other hormonal and/or U/S features of PCOS. Serum AMH has been assayed in 104 women (59 symptomatic PCOS, 45 controls) between d 2 and 7 after the last either spontaneous or progestin-induced (in PCOS) menstrual period. Mean serum AMH level was markedly increased in the PCOS group (47.1 ± 22.9 vs. 20.8 ± 11.6 pmol/liter in controls; P &lt; 0.0001), an increase in the same order of magnitude as the one of the FN in the 2- to 5-mm range at U/S (12.8 ± 8.3 vs. 4.8 ± 1.9; P &lt; 0.0001, respectively). The ratio AMH/FN was similar between the two groups (4.8 ± 3.4 vs. 4.8 ± 2.9; P = 0.55). By simple regression, both in PCOS and controls, the AMH level was positively related to the 2- to 5-mm FN at U/S (P &lt; 0.0001 and P &lt; 0.03, respectively), but not to the 6- to 9-mm FN, and was negatively correlated to the serum FSH level (P &lt; 0.02 and P &lt; 0.04, respectively). AMH was also positively related to the serum testosterone and androstenedione levels, in PCOS exclusively (P &lt; 0.0005 and &lt;0.002, respectively). No relationship was found between AMH and age, serum estradiol, inhibin B, and LH levels in both groups. After multiple regression only the 2- to 5-mm FN remained significantly related to AMH in PCOS whereas testosterone, androstenedione, and FSH were no longer. In conclusion, the assay of the serum AMH may represent an important breakthrough in the diagnosis and in the understanding of PCOS. Our data suggest that the increase of AMH serum level in PCOS is the consequence of the androgen-induced excess in small antral FN and that each follicle produces a normal amount of AMH. We hypothesize that an increased AMH tone within the cohort could be involved in the follicular arrest of PCOS, by interacting negatively with FSH at the time of selection.


2021 ◽  
Vol 53 (08) ◽  
pp. 504-511
Author(s):  
Xiang-Juan Li ◽  
Hui Wang ◽  
Dan-Yang Lu ◽  
Tian-Tian Yu ◽  
Kamran Ullah ◽  
...  

AbstractInsulin resistance (IR) is one of the most common features of polycystic ovary syndrome (PCOS), which is related to obesity. Whether increased anti-Müllerian hormone (AMH) levels in PCOS are involved in the pathogenesis of insulin resistance remains unclear. We investigated serum levels of leptin and AMH along with basic clinical and metabolic parameters in 114 PCOS patients and 181 non-PCOS women. PCOS patients presented higher fasting blood glucose, insulin concentrations and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) in addition to body mass index (BMI), lipids profiles and hormone levels. HOMA-IR showed a positive correlation with BMI, AMH, leptin, and low-density lipoprotein-cholesterol (LDL-c) levels. Interestingly, AMH is strongly positively correlated with HOMA-IR and insulin concentrations for 1st and 2nd hours of glucose treatment after fasting. Among PCOS women with BMI≥25 kg/m2, high AMH level group showed an increased HOMA-IR when compared to normal AMH level. However, among PCOS women with normal BMI, women with high AMH presented an elevated fasting insulin levels but not HOMA-IR when compared to normal AMH group. In vitro treatment of isolated islet cells with high concentration of leptin (200 ng/ml) or high leptin plus high concentration of AMH (1 ng/ml) significantly enhanced insulin secretion. Importantly, co-treatment of AMH plus leptin upregulates the expression of pro-apoptotic proteins, such as Bax, caspase-3, and caspase-8 after incubating with a high level of glucose. These results suggest that AMH may involve in the pathological process of pancreatic β-cells in obese PCOS women.


2021 ◽  
Author(s):  
Yang Li ◽  
Dongmei Huang ◽  
Wang Zhi ◽  
Dong Haoxu ◽  
Wang Qing ◽  
...  

: Polycystic ovary syndrome often starts in puberty, and its pathogenesis is not clear. This study aimed to explore the pathogenesis of pubertal polycystic ovary syndrome (PCOS) and assess the therapeutic effect of electroacupuncture on pubertal PCOS. Methods: Dihydrotestosterone (DHT) was used to induce rat models of pubertal PCOS. pubertal rats with PCOS were randomly divided into a model group (M), an electroacupuncture group (EA), and a sham acupuncture group (SA). Age-matched normal rats were regarded as normal controls (N). Rats were treated with EA or SA five times a week for 25 minutes during their 6 th –7 th week. At the end of the experiment, we observed any changes in ovarian morphology; detected levels of metabolic indices in serum, the hypothalamus and pancreas. Results: EA significantly improved estrous cycle disorders and the ovarian polycystic morphology in pubertal rats with PCOS, but SA only improved disorders of the estrous cycle. The serum levels of insulin, neuropeptide Y(NPY) and fasting blood glucose(FBG) increased significantly, while the serum levels of ghrelin(GHRL) decreased in the model group. After treatment with EA, the levels of NPY and FBG went into decrease, whereas the levels of GHRL and insulin increased. There was few differences in the hypothalamic expression of galanin (GAL), galanin-like peptide (GALP) and ghrelin receptor(GHSR) between the four groups. The upregulation of NPY mRNA and neuropeptide Y2 receptor(NPY2R) mRNA and the downregulation of GHRL protein and mRNA in the hypothalamus, and the increased expression of NPY and NPY2R as well as the decreased expression of GHRL in the arcuate nucleus (ARC) can be rescued by EA. But, surprisingly, SA seem to make no difference to the levels of FBG and insulin, and the protein expression of ghrelin in the hypothalamus and ARC. Co-expression of kisspeptin and GHSR, and co-expression of gonadotrophin releasing hormone(GnRH) and NPY2R were observed in ARC. No differences were found between groups in protein of GAL, GALP and GHRL expression in the pancreas. Neither EA nor SA can attenuate the upregulated kisspeptin protein expression in the pancreas of PCOS model rats. EA and SA improved the symptoms of pubertal PCOS rats, and the mechanism might be associated with regulating hypothalamic NPY and ghrelin levels.


2005 ◽  
Vol 152 (2) ◽  
pp. 269-275 ◽  
Author(s):  
K Rautio ◽  
J S Tapanainen ◽  
A Ruokonen ◽  
L C Morin-Papunen

Objective: Women with polycystic ovary syndrome (PCOS) exhibit risk factors for cardiovascular diseases such as abdominal obesity, insulin resistance and dyslipidemia. Insulin sensitizers, especially metformin, have been shown to improve these metabolic disturbances, but there are only a few studies on their effects on serum lipids in polycystic ovary syndrome. Methods: Thirty-five women with PCOS (18 obese and 17 non-obese) were randomized to 6-month treatments with metformin or ethinyl estradiol–cyproterone acetate oral contraceptive pills. Results: In the whole-study population (non-obese and obese women) serum levels of high-density lipoprotein cholesterol increased from 1.4±0.2 to 1.6±0.1 mmol/l (means ±s.e. throughout) at 3 and 6 months (P < 0.001), the total cholesterol:high-density lipoprotein cholesterol ratio decreased significantly from 3.8±0.3 to 3.3±0.2 at 6 months (P < 0.001) and a similar trend was observed in serum triglyceride levels during metformin treatment. In the oral contraceptive group, serum levels of total cholesterol increased from 4.9±0.3 to 5.4±0.3 mmol/l (P < 0.05), high-density lipoprotein cholesterol increased from 1.2±0.1 to 1.5±0.1 mmol/l (P < 0.001), the total cholesterol:high-density lipoprotein cholesterol ratio decreased from 4.6±0.4 to 3.7±0.2 (P < 0.001) and triglycerides increased from 1.3±0.1 to 1.9±0.2 mmol/l at 6 months of treatment (P < 0.001). Serum low-density lipoprotein cholesterol levels remained unchanged during both treatments. Milder but similar changes in the subgroups of obese and non-obese women were observed during both treatments. Moreover, in the whole-study population both systolic (P = 0.02) and diastolic (P = 0.05) blood pressures decreased over the 6 months of metformin treatment. Conclusion: In women with PCOS, metformin treatment had beneficial effects on lipid profile and blood pressure, and therefore it could be useful in the prevention of cardiovascular complications in these women.


2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Chuyan Wu ◽  
Feng Jiang ◽  
Ke Wei ◽  
Feng Lin ◽  
Zhongli Jiang

Exercise can reduce androgen and insulin levels in polycystic ovary syndrome (PCOS) patients. Finasteride is also presumed to improve the developing follicle environment. Therefore, the aim of this study was to observe the effects of the combination of exercise and finasteride therapy on hormone levels and ovarian morphology in rats with polycystic ovary syndrome. Forty female rats were randomly divided into five groups (n=8 each group): the PCOS sedentary group (P-Sed), PCOS exercise group (P-Ex), PCOS finasteride and sedentary group (P-FSed), and PCOS finasteride and exercise group (P-FEx), and healthy, age-matched rats were used as controls (CO). The results indicated that the levels of FINS in the P-FEx group were significantly lower than those in the P-Sed and P-FSed groups, while the ratio of fasting blood glucose (FBG)/fasting serum levels of insulin (FINS) in the P-FEx group was significantly higher than that in the P-Sed and P-FSed groups. Compared to the P-FEx group, serum levels of TT (total testosterone) in the P-Sed and P-FSed groups were significantly increased. The thickness of the follicular membrane and the number of atresia follicles in the P-FEx and CO groups were significantly lower than those in the P-Sed group, but there was no significant difference between the P-Ex and P-Sed groups. These results show that the combined usage of exercise and finasteride does not alter the effects of exercise on increasing insulin sensitivity and reducing androgen levels. There is also a synergistic effect of exercise and finasteride on the morphology of the ovary, including a reduced number of atresia follicles and thickness of the follicular membrane.


Author(s):  
Gislaine Satyko Kogure ◽  
Victor Barbosa Ribeiro ◽  
Flávia Ganoa de Oliveira Gennaro ◽  
Rui Alberto Ferriani ◽  
Cristiana Libardi Miranda-Furtado ◽  
...  

Abstract Objective The present study aimed to investigate the physical performance of handgrip strength (HGS) in women with polycystic ovary syndrome (PCOS). Methods A case-control study that included 70 women with PCOS and 93 age-matched healthy women aged between 18 and 47 years with body mass index (BMI) between 18 Kg/m2–39.9 Kg/m2. The serum levels of total testosterone, androstenedione, insulin, estradiol, thyroid-stimulating hormone (TSH), prolactin, sex hormone-binding globulin (SHBG), and 17-hydroxyprogesterone (17-OHP) were measured. The free androgen index (FAI) and the homeostatic model assessment of insulin resistance (HOMA-IR) were calculated. The body composition regions of interest (ROIs) were assessed by dual-energy X-ray absorptiometry (DXA), and the handgrip strength (HGS) was evaluated for both the dominant and the non-dominant hands with a manual Sammons Preston (Bolingbrook, IL, US) bulb dynamometer. Results Women with PCOS had high serum levels of total testosterone (p < 0.01), androstenedione (p = 0.03), and insulin (p < 0.01), as well as high FAI (p < 0.01) and HOMA-IR (p = 0.01) scores. Compared with the non-PCOS group, the PCOS group had greater total lean mass in the dominant hand (p < 0.03) and greater HGS in both the dominant and the non-dominant hands (p < 0.01). The HGS was correlated with lean mass (p < 0.01). Conclusion Women with PCOS have greater HGS. This may be associated with age and BMI, and it may be related to lean mass. In addition, the dominance effect on muscle mass may influence the physical performance regarding HGS in women with PCOS.


2011 ◽  
Vol 23 (4) ◽  
pp. 520 ◽  
Author(s):  
Yun Liu ◽  
Hong Jiang ◽  
Ling-Yun He ◽  
Wu-Jian Huang ◽  
Xiao-Yu He ◽  
...  

Polycystic ovary syndrome (PCOS) may result from hypersensitivity to insulin, which is negatively regulated by uncoupling protein (UCP)-2. Because cholesterol side-chain cleavage enzyme (CYP11A1) is closely linked to PCOS, the expression of UCP-2 and CYP11A1 in ovarian tissues from PCOS patients was examined in the present study. Twelve PCOS patients with hyperandrogenaemia who underwent laparoscopic ovarian wedge resection and 12 age-matched control patients who underwent contralateral ovarian biopsy were enrolled in the study. UCP-2 expression in early stage (primordial, primary and secondary) and late stage (sinus and mature) follicles was examined using immunohistochemistry, whereas UCP-2 and CYP11A1 mRNA and protein levels in ovarian tissue were determined using quantitative reverse transcription–polymerase chain reaction and western blot analyses, respectively. UCP-2 expression increased significantly with follicular development in both control and PCOS tissue, with expression in early stage follicles from PCOS patients significantly greater than that in controls. In addition, both UCP-2 and CYP11A1mRNA and protein levels, mean fasting blood glucose concentrations and fasting serum insulin levels were significantly higher in PCOS patients compared with the control group. Finally, a significant correlation between UCP-2 and CYP11A1 expression was found in PCOS but not control patients. In conclusion, in PCOS patients, there was a correlation between UCP-2 and CYP11A1 expression, which was significantly higher than in the control group. These changes in UCP-2 and CYP11A1 expression may mediate follicle development in PCOS.


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