INTERRELATIONSHIP OF AMH WITH CLINICAL, HORMONAL AND SONOGRAPHIC PARAMETERS IN PATIENTS WITH POLYCYSTIC OVARIAN DISEASE

2021 ◽  
pp. 66-68
Author(s):  
Uma Jain ◽  
Urvi Gupta
Keyword(s):  
Cycle Length ◽  
Polycystic Ovary ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Reproductive Age ◽  
Ovarian Volume ◽  
Diagnostic Potential ◽  
The Mean ◽  
Criteria For Diagnosis ◽  
High Level

INTRODUCTION: Polycystic ovary syndrome (PCOS) is a frequently encountered problem in reproductive endocrinology, affecting approximately 6% of women of reproductive age. anti-mullerian hormone (AMH) also known as Mullerian inhibiting, substance is produced by granulosa cells of the preantral and small antral ovarian follicles in women and reect the ovarian reserve. Women with PCOS will often have a high number of antral follicles and, as a result, an equally high level of AMH in their blood. it has an inhibitory inuence on the actions of FSH and positively correlated with LH. Various studies demonstrated that oligo/anovulatory women with PCOS have signicantly higher serum concentrations of AMH. MATERIAL AND METHOD: This is a retro respective study of 54 PCOS patients from rst January 2019 to 13 April 2021 at a private gynaecology clinic in district Shivpuri. Data were collected from the medical records of the patients including age, height, weight, waist circumference, BP and modied Ferriman gallway score for hirsutism, Biochemical and hormonal values like LH, FSH, LH/FSH ratio, TSH, Prolactin and AMH, and lipid prole values were also obtained from the records. Abdominal or Vaginal ultrasound was used to assess the ovarian volume antral follicular count. RESULTS: In our study, the age of patients ranges from 20-39 years and a majority of the patients were in the age group of 21-30 years 75.28%) The Mean age of PCOS patients was 23.89. In our study, the mean cycle length of patients was 54.08 and it ranged from 28-190 days. The mean 2 BMI 25.8kg/m2 and modied FG score were 8.1. On ultrasound mean antral follicle count was 26.2 and the mean ovarian volume was 9.4 cm . In hormonal studies mean LH was 11.5, mean FSH was 3.4 and AMH was 4.34 and Testosterone was 2.1. In bio-chemical parameters increased Cholesterol, triglycerides, LDL, VLDL level and decreased HDL level were found in 31.48% of patients and with increased AMH. CONCLUSION: In our study, we found increased AMH concentration in correlation with increased cycle length in cases of oligomenorrhea, clinical hyperandrogenism, increased LH, increased AFC and increased ovarian volume. Our study concluded that AMH levels as an adjunct to existing Rotterdam criteria for diagnosis of PCOS had good diagnostic potential.

Effect of resveratrol administration on ovarian morphology, determined by transvaginal ultrasound for the women with PCOS

2021 ◽  
pp. 1-18
Author(s):  
Amir Pejman Hashemi Taheri ◽  
Behnaz Moradi ◽  
Amir Reza Radmard ◽  
Milad Sanginabadi ◽  
Mostafa Qorbani ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Polycystic Ovary ◽  
Transvaginal Ultrasound ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Ovarian Volume ◽  
Exact Test ◽  
Ovarian Morphology ◽  
The Mean

Abstract Background: Intake of resveratrol has been associated with improved ovarian morphology under in vitro and in the animal models; however, this finding has not been confirmed in trials. The aim of our study was, therefore, to use a placebo-controlled approach with the detailed assessment of the ovarian morphology by applying transvaginal ultrasound to examine the effectiveness of this therapeutic approach in this group of women. Methods: Forty-one women with polycystic ovary syndrome (PCOS) were randomly assigned (1:1) to 3 months of daily 1000 mg resveratrol or placebo. Random assignment was done by blocked randomisation. Our primary endpoints were the change in the ovarian volume, stromal area and antral follicle count per ovary (FNPO) from the baseline to 3 months. Secondary endpoints were improvement in the distribution of follicles and ovarian echogenicity. Differences between the resveratrol and control groups were evaluated by Chi-square, fisher’s exact test and repeated-measures of ANOVA. Results: The mean age of all participants was 28.61 ± 4.99 years, with the mean BMI of 28.26 ± 5.62 kg/m2. Resveratrol therapy, as compared with placebo, was associated with a significantly higher rate of improvement in the ovarian morphology (p= 0.02). Women who received resveratrol had a more dominant follicle than those getting placebo, with a significant reduction in the ovarian volume (p<0.05). However, the number of FNPO, stromal area, ovarian echogenicity and distribution of follicles were not significantly altered (P>0.05). Conclusions: Treatment with resveratrol significantly reduced the ovarian volume and PCOM, thus suggesting a disease-modifying effect in PCOS. Trial registration: IRCT, IRCT2017061917139N2. Registered 7 July 2017, http://irct.ir/trial/15836.

Left–right differences in ovarian volume and antral follicle count in 1423 women of reproductive age

2016 ◽  
Vol 33 (4) ◽  
pp. 320-323 ◽  
Author(s):  
Anne-Sofie Korsholm ◽  
Helene Westring Hvidman ◽  
Janne Gasseholm Bentzen ◽  
Anders Nyboe Andersen ◽  
Kathrine Birch Petersen
Keyword(s):  
Antral Follicle ◽  
Antral Follicle Count ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Ovarian Volume

scholarly journals Controversies in the diagnosis of polycystic ovary syndrome

2020 ◽  
Vol 14 ◽  
pp. 263349412091303
Author(s):  
Preetham Rao ◽  
Priya Bhide
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Reproductive Age ◽  
Polycystic Ovaries ◽  
Women Of Reproductive Age ◽  
Androgen Excess ◽  
Ovary Syndrome ◽  
Ultrasound Features

Polycystic ovary syndrome is a common endocrinological condition which is found to be prevalent in 5–10% of women of reproductive age. Historically, a combination of anovulation and androgen excess was considered a hallmark in the diagnosis of polycystic ovary syndrome. Addition of ultrasound features of polycystic ovary syndrome has improved the detection of variation in the polycystic ovary syndrome phenotype. Despite the widespread use of consensus diagnostic criteria, there remain several unresolved controversies in the diagnosis of polycystic ovary syndrome. Difficulty arises in methods of assessment and types of androgens to be measured to detect biochemical hyperandrogenism, setting a cut-off value for the diagnosis of clinical hyperandrogenism, setting an ultrasound threshold of antral follicle count to diagnose polycystic ovaries and also diagnosing this condition in adolescence where there is no clear definition for ‘irregular cycles’. This article looks at various controversies in the diagnosis of polycystic ovary syndrome.

scholarly journals Evaluation of Ovarian Reserve with Anti-Müllerian Hormone in Familial Mediterranean Fever

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Ali Şahin ◽  
Savaş Karakuş ◽  
Yunus Durmaz ◽  
Çağlar Yıldız ◽  
Hüseyin Aydın ◽  
...  
Keyword(s):  
Familial Mediterranean Fever ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Reproductive Age ◽  
Healthy Individuals ◽  
Ovarian Volume ◽  
Pelvic Ultrasonography ◽  
M694v Mutation ◽  
Significant Difference ◽  
Mediterranean Fever

Objective. To investigate ovarian reserves in attack-free familial Mediterranean fever (AF-FMF) patients at the reproductive age by anti-Müllerian hormone (AMH), antral follicle count (AFC), ovarian volume, and hormonal parameters.Methods. Thirty-three AF-FMF patients aging 18–45 years and 34 healthy women were enrolled and FSH, LH, E2, PRL, and AMH levels were measured in the morning blood samples at 2nd–4th days of menstruation by ELISA. Concomitant pelvic ultrasonography was performed to calculate AFC and ovarian volumes.Results. In FMF patient group, median AMH levels were statistically significantly lower in the M69V mutation positive group than in the negative ones (P=0.018). There was no statistically significant difference in median AMH levels between E148Q mutation positive patients and the negative ones (P=0.920). There was also no statistically significant difference in median AMH levels between M680I mutation positive patients and the negative ones (P=0.868). No statistically significant difference was observed in median AMH levels between patients who had at least one mutation and those with no mutations (P=0.868). We realized that there was no difference in comparisons between ovarian volumes, number of follicles, and AMH levels ovarian reserves when compared with FMF patients and healthy individuals.Conclusions. Ovarian reserves of FMF pateints were similar to those of healthy subjects according to AMH. However, AMH levels were lower in FMF patients with M694V mutation.

scholarly journals Study of prevalence of insulin resistance and other metabolic abnormalities in various phenotypes of polycystic ovary syndrome in central India

2020 ◽  
Vol 9 (7) ◽  
pp. 2978
Author(s):  
Deepti Gupta ◽  
Rini Upadhyaya ◽  
Anjlina Bhati
Keyword(s):  
Insulin Resistance ◽  
Fasting Glucose ◽  
Polycystic Ovary ◽  
Central India ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Ovarian Volume ◽  
Appropriate Treatment ◽  
Post Hoc ◽  
Lipid Parameters

Background: Till recent times, defining symptoms of PCOS remained a debatable topic. In 2012, National Institute of health consensus panel proposed diagnostic criteria based on phenotypes. Evidence showed higher incidence of diabetes mellitus, insulin resistance and compensatory hyperinsulinemia among women with PCOS. So, the present study was undertaken to compare the clinical, metabolic and hormonal profile among various phenotypes in women with PCOS and to find out the prevalence of insulin resistance among the PCOS phenotypes.Methods: The prospective, observational study was done on 292 women with PCOS-related infertility. These women were divided into 4 phenotypes. Ferriman-Gallwey score, HOMA-IR, OGTT, lipid parameters, hormonal parameters, mean ovarian volume and mean antral follicle counts were compared among the 4 phenotypic groups. One-way ANOVA followed by post-hoc Tukey was applied.Results: Mean weight, BMI, waist circumference, SBP, DBP and Ferriman-Gallwey score, fasting glucose, fasting insulin, OGTT (1 hour) and HOMA-IR was highest in phenotype A, while fasting glucose / insulin ratio was lowest in phenotype A. Total triglycerides, total cholesterol, LDL were higher and HDL was lowest, testosterone, mean ovarian volume and mean antral follicle count were highest and vitamin D was lowest in Phenotype A.Conclusions: Phenotype A is the group with all features of PCOS syndrome, while phenotype D is associated with milder metabolic profile. Women with phenotype A and B are at a higher risk for metabolic syndrome. Identifying various phenotypes will assist in providing appropriate treatment and prognosticating the patients with PCOS-related infertility.

Antimüllerian hormone, antral follicle count and ovarian volume predict menstrual cycle length in healthy women

2015 ◽  
Vol 84 (6) ◽  
pp. 870-877 ◽  
Author(s):  
Ruoyan Zhu ◽  
Bao Hui Lee ◽  
Zhongwei Huang ◽  
Inthrani Raja Indran ◽  
Jun Li ◽  
...  
Keyword(s):  
Menstrual Cycle ◽  
Cycle Length ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Ovarian Volume ◽  
Healthy Women ◽  
Antimullerian Hormone ◽  
Menstrual Cycle Length ◽  
Antimüllerian Hormone

scholarly journals Impact of the newly recommended antral follicle count cutoff for polycystic ovary in adult women with polycystic ovary syndrome

2020 ◽  
Vol 35 (3) ◽  
pp. 652-659 ◽  
Author(s):  
Jin Ju Kim ◽  
Kyu Ri Hwang ◽  
Soo Jin Chae ◽  
Sang Ho Yoon ◽  
Young Min Choi
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Metabolic Parameters ◽  
Adult Women ◽  
Ovary Syndrome ◽  
Ovarian Volume ◽  
Irregular Menstruation ◽  
Rotterdam Criteria

Abstract STUDY QUESTION What is the impact of the newly recommended antral follicle count (AFC) cutoff for polycystic ovary (PCO) on the diagnostic status of polycystic ovary syndrome (PCOS)? SUMMARY ANSWER Among patients with phenotypes requiring the presence of PCO for diagnosis, approximately half (48.2%) were excluded from having PCOS based on the new AFC cutoff, although these excluded women had worse metabolic and hormonal profiles than the controls and were indistinguishable from the remaining patients with regard to major hormonal and metabolic parameters. WHAT IS KNOWN ALREADY In the Rotterdam criteria, PCO is defined as either 12 or more follicles measuring 2–9 mm in diameter or an increased ovarian volume &gt;10 cm3. Recently, an international PCOS guideline development group recommended an AFC threshold for PCO of ≥20 in adult women when using transducers with a high-resolution frequency, including 8 MHz. STUDY DESIGN, SIZE, DURATION The current study used a case control design. PARTICIPANTS/MATERIALS, SETTING, METHODS PCOS was diagnosed according to the Rotterdam criteria. Ultrasonography examinations were conducted with wide band frequency (5–9 MHz) transvaginal transducers and the centre frequency was 8 MHz. In patients who show both irregular menstruation and hyperandrogenism (HA), a diagnosis of PCOS can be made irrespective of the ovarian criteria change. Patients who were diagnosed according to HA and PCO (n = 86) or irregular menstruation and PCO (n = 443) were initially included among a total of 1390 adult women with PCOS (aged 20–40 years). Regardless of the AFC, if the ovarian volume is ≥10 cm3, a diagnosis of PCO can still be made. Thus, only patients who had an ovarian volume of &lt;10 cm3 were analysed. Subjects who had an AFC of 12–19 and an ovarian volume &lt;10 cm3 were designated as the ‘low AFC group’ (n = 255) and were the main focus of the study because they were excluded from having PCOS based on the new cutoff. Subjects with an AFC ≥20 and an ovarian volume &lt;10 cm3 were designated as the ‘high AFC group’ (n = 101). A total of 562 premenopausal women without PCOS were enrolled as controls. MAIN RESULTS AND THE ROLE OF CHANCE Among patients with irregular menstruation and PCO or HA and PCO phenotypes, approximately half (48.2%, 255/529) were excluded from having PCOS, which corresponded to one-fifth (18.3%, 255/1390) of the total adult patients. However, compared to the control group, these excluded women had worse metabolic profiles and were more androgenised. Notably, they were indistinguishable from the ‘high AFC group’ with regard to major hormonal and metabolic parameters (BMI and diabetic classification status, and the prevalence of insulin resistance, metabolic syndrome and HA). LIMITATIONS, REASONS FOR CAUTION We cannot exclude the possibility of inter- and intraobserver variation in the evaluation of AFC. WIDER IMPLICATIONS OF THE FINDINGS With the newly recommended follicle count cutoff, a substantial proportion of women with PCOS might be classified as not having PCOS despite visiting a hospital due to irregular menstruation or hyperandrogenic symptoms. A practical approach to them would involve controlling the menstrual or hyperandrogenic symptoms in hand and regularly evaluating them regarding newly developed or worsening PCOS-related symptoms or metabolic abnormalities. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by a grant from the Seoul National University Hospital Research Fund (No. 2520140090), Republic of Korea. The authors have no conflicts of interest to disclose. TRIAL REGISTRATION NUMBER Not applicable.

scholarly journals Ovarian reserve in women with obesity

2019 ◽  
Vol 16 (3) ◽  
pp. 69-75
Author(s):  
Olga R. Grigoryan ◽  
Robert K. Mikheev ◽  
Elena N. Andreeva ◽  
Ivan I. Dedov
Keyword(s):  
Ovarian Reserve ◽  
Antral Follicle ◽  
Reproductive Age ◽  
Reference Ranges ◽  
Obese Patients ◽  
Class Iii ◽  
Multicenter Studies ◽  
Ovarian Volume ◽  
Obesity Class ◽  
Significant Difference

BACKGROUND: One of the consequences of obesity for the female body is a decrease in fertility. It is shown that impaired reproductive function in obese patients can be associated, in particular, with a decrease in ovarian reserve. AIMS: To evaluate the ovarian reserve function in female patients of reproductive age with different classes of obesity in comparison with women without obesity. MATERIALS AND METHODS: This study evaluated 320 caucasian women, age 20-30 years, without obesity (BMI30, n=80) and with obesity WHO class I-III (n=80 per class). Anthropometrics, serum concentrations of anti-Mullerian hormone (AMH), inhibin B, follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol, progesterone, and testosterone were compared on the 2-3 day of menstrual cycle as ovarian volume and antral follicle count (AFC). RESULTS: We reveal statistically significant difference in following parameters in normal BMI women in comparison with obesity women: AMH, testosterone, ovarian volume and AFC. Moreover, we reveal significant difference between patients with different WHO class of obesity. But even in class III obesity parameters remained within reference ranges. CONCLUSIONS: Ovarian reserve function parameters progressively decrease with increase of obesity class in subjects, but ovarian reserve parameters were in normal reference range even in class III obese patients. Further large randomized multicenter studies are required to find influence of obesity in relation to ethnicity and other factors to ovarian reserve function.

scholarly journals Reproductive capacity in iron overloaded women with thalassemia major

Blood ◽  
2011 ◽  
Vol 118 (10) ◽  
pp. 2878-2881 ◽  
Author(s):  
Sylvia T. Singer ◽  
Elliott P. Vichinsky ◽  
Ginny Gildengorin ◽  
Jereon van Disseldorp ◽  
Mitchell Rosen ◽  
...  
Keyword(s):  
Antral Follicle ◽  
Thalassemia Major ◽  
Antral Follicle Count ◽  
Reproductive Capacity ◽  
Gonadotropin Secretion ◽  
Ovarian Volume ◽  
Cardiac Iron ◽  
Labile Iron ◽  
Sensitive Marker

Abstract The pathophysiology of iron-induced compromised fertility in women with thalassemia major (TM) was evaluated in 26 adult TM females. Low gonadotropin secretion resulted in reduced ovarian antral follicle count and ovarian volume, but levels of anti-müllerian hormone (AMH), a sensitive marker for ovarian reserve independent of gonadotropin effect, were mostly normal. AMH correlated with non–transferrin-bound iron (NTBI), suggesting a role of labile iron in the pathogenesis of decreased reproductive capacity, possibly occurring in parallel to cardiac iron toxicity, as cardiac iron was associated with the presence of amenorrhea and with NTBI levels. AMH emerges as an important biomarker for assessment of reproductive capacity in TM, demonstrating that fertility is preserved in the majority of those younger than 30 to 35 years. AMH can be useful in future studies aiming at improved chelation for fertility preservation, whereas NTBI and labile plasma iron may be valuable for monitoring iron effect on the reproductive system.

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