Serum Levels of Anti-Mullerian Hormone as a Marker of Ovarian Function in 926 Healthy Females from Birth to Adulthood and in 172 Turner Syndrome Patients

Casper P Hagen, Lise Aksglaede, Kaspar Sørensen, Katharina M Main, Malene Boas, Line Cleemann, Kirsten Holm, Claus H Gravholt, Anna-Maria Andersson, Anette T Pedersen, Jørgen Holm Petersen, Allan Linneberg, Susanne Kjaergaard, Anders Juul

    Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

    Abstract

    Context: In adult women, anti-Müllerian hormone (AMH) is related to the ovarian follicle pool. Little is known about AMH in girls. Objective: The objective of the study was to provide a reference range for AMH in girls and adolescents and to evaluate AMH as a marker of ovarian function. Setting: The study was conducted at a tertiary referral center for pediatric endocrinology. Main Outcome Measures: We measured AMH in 926 healthy females (longitudinal values during infancy) as well as in 172 Turner syndrome (TS) patients according to age, karyotype (A: 45,X; B: miscellaneous karyotypes; C: 45,X/46,XX), and ovarian function (1: absent puberty; 2: cessation of ovarian function; 3: ongoing ovarian function). Results: AMH was undetectable in 54% (38 of 71) of cord blood samples (<2; <2-15 pmol/liter) (median; 2.5th to 97.5th percentile) and increased in all (37 of 37) infants from birth to 3 months (15; 4.5-29.5 pmol/liter). From 8 to 25 yr, AMH levels were stable (19.9; 4.7-60.1 pmol/liter), with the lower level of the reference range clearly above the detection limit. AMH levels were associated with TS-karyotype groups (median A vs. B: <2 vs. 3 pmol/liter, P = 0.044; B vs. C: 3 vs. 16 pmol/liter, P < 0.001) as well as with ovarian function (absent puberty vs. cessation of ovarian function: <2 vs. 6 pmol/liter, P = 0.004; cessation of ovarian function vs. ongoing ovarian function: 6 vs. 14 pmol/liter, P = 0.001). As a screening test of premature ovarian failure in TS, the sensitivity and specificity of AMH less than 8 pmol/liter was 96 and 86%, respectively. Conclusion: AMH seems to be a promising marker of ovarian function in healthy girls and TS patients.
    Original languageEnglish
    JournalJournal of Clinical Endocrinology and Metabolism
    Volume95
    Issue11
    Pages (from-to)5003-7
    Number of pages8
    ISSN0021-972X
    DOIs
    Publication statusPublished - 2010

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