Baseline AMH level associated with ovulation following ovulation induction in women with polycystic ovary syndrome

Sunni L. Mumford, Richard S. Legro, Michael P. Diamond, Christos Coutifaris, Anne Z. Steiner, William D. Schlaff, Ruben Alvero, Gregory M. Christman, Peter R. Casson, Hao Huang, Nanette Santoro, Esther Eisenberg, Heping Zhang, Marcelle I. Cedars

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Context: Anti-Müllerian hormone (AMH) reduces aromatase activity and sensitivity of follicles to FSH stimulation. Therefore, elevated serum AMH may indicate a higher threshold for response to ovulation induction in women with polycystic ovary syndrome (PCOS). Objective: This study sought to determine the association between AMH levels and ovulatory response to treatment among the women enrolled into the Pregnancy in PCOS II (PPCOS II) trial. Design and setting: This was a secondary analysis of data from a randomized clinical trial in academic health centers throughout the United States Participants: A total of 748 women age 18-40 years, with PCOS and measured AMH levels at baseline, were included in this study. Main Outcome Measures: Couples were followed for up to five treatment cycles to determine ovulation (midluteal serum progesterone > 5 ng/mL) and the dose required to achieve ovulation. Results: A lower mean AMH and AMH per follicle was observed among women who ovulated compared with women who never achieved ovulation during the study (geometric mean AMH, 5.54 vs 7.35 ng/mL; P = .0001; geometric mean AMH per follicle, 0.14 vs 0.18; P = .01) after adjustment for age, body mass index, T, and insulin level. As AMH levels increased, the dose of ovulation induction medication needed to achieve ovulation also increased. No associations were observed between antral follicle count and ovulation. Conclusions: These results suggest that high serum AMH is associated with a reduced response to ovulation induction among women with PCOS. Women with higher AMH level smayrequire higher doses of medication to achieve ovulation.

Original languageEnglish (US)
Pages (from-to)3288-3296
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Volume101
Issue number9
DOIs
StatePublished - Sep 2016

Fingerprint

Ovulation Induction
Polycystic Ovary Syndrome
Ovulation
Hormones
Serum
Aromatase
Progesterone
Body Mass Index
Randomized Controlled Trials
Outcome Assessment (Health Care)
Health
Insulin

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Mumford, Sunni L. ; Legro, Richard S. ; Diamond, Michael P. ; Coutifaris, Christos ; Steiner, Anne Z. ; Schlaff, William D. ; Alvero, Ruben ; Christman, Gregory M. ; Casson, Peter R. ; Huang, Hao ; Santoro, Nanette ; Eisenberg, Esther ; Zhang, Heping ; Cedars, Marcelle I. / Baseline AMH level associated with ovulation following ovulation induction in women with polycystic ovary syndrome. In: Journal of Clinical Endocrinology and Metabolism. 2016 ; Vol. 101, No. 9. pp. 3288-3296.
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title = "Baseline AMH level associated with ovulation following ovulation induction in women with polycystic ovary syndrome",
abstract = "Context: Anti-M{\"u}llerian hormone (AMH) reduces aromatase activity and sensitivity of follicles to FSH stimulation. Therefore, elevated serum AMH may indicate a higher threshold for response to ovulation induction in women with polycystic ovary syndrome (PCOS). Objective: This study sought to determine the association between AMH levels and ovulatory response to treatment among the women enrolled into the Pregnancy in PCOS II (PPCOS II) trial. Design and setting: This was a secondary analysis of data from a randomized clinical trial in academic health centers throughout the United States Participants: A total of 748 women age 18-40 years, with PCOS and measured AMH levels at baseline, were included in this study. Main Outcome Measures: Couples were followed for up to five treatment cycles to determine ovulation (midluteal serum progesterone > 5 ng/mL) and the dose required to achieve ovulation. Results: A lower mean AMH and AMH per follicle was observed among women who ovulated compared with women who never achieved ovulation during the study (geometric mean AMH, 5.54 vs 7.35 ng/mL; P = .0001; geometric mean AMH per follicle, 0.14 vs 0.18; P = .01) after adjustment for age, body mass index, T, and insulin level. As AMH levels increased, the dose of ovulation induction medication needed to achieve ovulation also increased. No associations were observed between antral follicle count and ovulation. Conclusions: These results suggest that high serum AMH is associated with a reduced response to ovulation induction among women with PCOS. Women with higher AMH level smayrequire higher doses of medication to achieve ovulation.",
author = "Mumford, {Sunni L.} and Legro, {Richard S.} and Diamond, {Michael P.} and Christos Coutifaris and Steiner, {Anne Z.} and Schlaff, {William D.} and Ruben Alvero and Christman, {Gregory M.} and Casson, {Peter R.} and Hao Huang and Nanette Santoro and Esther Eisenberg and Heping Zhang and Cedars, {Marcelle I.}",
year = "2016",
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doi = "10.1210/jc.2016-1340",
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Mumford, SL, Legro, RS, Diamond, MP, Coutifaris, C, Steiner, AZ, Schlaff, WD, Alvero, R, Christman, GM, Casson, PR, Huang, H, Santoro, N, Eisenberg, E, Zhang, H & Cedars, MI 2016, 'Baseline AMH level associated with ovulation following ovulation induction in women with polycystic ovary syndrome', Journal of Clinical Endocrinology and Metabolism, vol. 101, no. 9, pp. 3288-3296. https://doi.org/10.1210/jc.2016-1340

Baseline AMH level associated with ovulation following ovulation induction in women with polycystic ovary syndrome. / Mumford, Sunni L.; Legro, Richard S.; Diamond, Michael P.; Coutifaris, Christos; Steiner, Anne Z.; Schlaff, William D.; Alvero, Ruben; Christman, Gregory M.; Casson, Peter R.; Huang, Hao; Santoro, Nanette; Eisenberg, Esther; Zhang, Heping; Cedars, Marcelle I.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 101, No. 9, 09.2016, p. 3288-3296.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Baseline AMH level associated with ovulation following ovulation induction in women with polycystic ovary syndrome

AU - Mumford, Sunni L.

AU - Legro, Richard S.

AU - Diamond, Michael P.

AU - Coutifaris, Christos

AU - Steiner, Anne Z.

AU - Schlaff, William D.

AU - Alvero, Ruben

AU - Christman, Gregory M.

AU - Casson, Peter R.

AU - Huang, Hao

AU - Santoro, Nanette

AU - Eisenberg, Esther

AU - Zhang, Heping

AU - Cedars, Marcelle I.

PY - 2016/9

Y1 - 2016/9

N2 - Context: Anti-Müllerian hormone (AMH) reduces aromatase activity and sensitivity of follicles to FSH stimulation. Therefore, elevated serum AMH may indicate a higher threshold for response to ovulation induction in women with polycystic ovary syndrome (PCOS). Objective: This study sought to determine the association between AMH levels and ovulatory response to treatment among the women enrolled into the Pregnancy in PCOS II (PPCOS II) trial. Design and setting: This was a secondary analysis of data from a randomized clinical trial in academic health centers throughout the United States Participants: A total of 748 women age 18-40 years, with PCOS and measured AMH levels at baseline, were included in this study. Main Outcome Measures: Couples were followed for up to five treatment cycles to determine ovulation (midluteal serum progesterone > 5 ng/mL) and the dose required to achieve ovulation. Results: A lower mean AMH and AMH per follicle was observed among women who ovulated compared with women who never achieved ovulation during the study (geometric mean AMH, 5.54 vs 7.35 ng/mL; P = .0001; geometric mean AMH per follicle, 0.14 vs 0.18; P = .01) after adjustment for age, body mass index, T, and insulin level. As AMH levels increased, the dose of ovulation induction medication needed to achieve ovulation also increased. No associations were observed between antral follicle count and ovulation. Conclusions: These results suggest that high serum AMH is associated with a reduced response to ovulation induction among women with PCOS. Women with higher AMH level smayrequire higher doses of medication to achieve ovulation.

AB - Context: Anti-Müllerian hormone (AMH) reduces aromatase activity and sensitivity of follicles to FSH stimulation. Therefore, elevated serum AMH may indicate a higher threshold for response to ovulation induction in women with polycystic ovary syndrome (PCOS). Objective: This study sought to determine the association between AMH levels and ovulatory response to treatment among the women enrolled into the Pregnancy in PCOS II (PPCOS II) trial. Design and setting: This was a secondary analysis of data from a randomized clinical trial in academic health centers throughout the United States Participants: A total of 748 women age 18-40 years, with PCOS and measured AMH levels at baseline, were included in this study. Main Outcome Measures: Couples were followed for up to five treatment cycles to determine ovulation (midluteal serum progesterone > 5 ng/mL) and the dose required to achieve ovulation. Results: A lower mean AMH and AMH per follicle was observed among women who ovulated compared with women who never achieved ovulation during the study (geometric mean AMH, 5.54 vs 7.35 ng/mL; P = .0001; geometric mean AMH per follicle, 0.14 vs 0.18; P = .01) after adjustment for age, body mass index, T, and insulin level. As AMH levels increased, the dose of ovulation induction medication needed to achieve ovulation also increased. No associations were observed between antral follicle count and ovulation. Conclusions: These results suggest that high serum AMH is associated with a reduced response to ovulation induction among women with PCOS. Women with higher AMH level smayrequire higher doses of medication to achieve ovulation.

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DO - 10.1210/jc.2016-1340

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