Anti-Mullerian hormone levels in the spontaneous menstrual cycle do not show substantial fluctuation
Anti-Mullerian hormone levels in the spontaneous menstrual cycle do not show substantial fluctuation
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DOI：
10.1210/jc.2006-0331
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发表时间：
2006-10-01
影响因子：
5.8
通讯作者：
Broekmans, Frank J. M.
中科院分区：
文献类型：
--
作者：
Hehenkamp, Wouter J. K.;Looman, Caspar W. N.;Broekmans, Frank J. M.
背景：抗苗勒氏管激素 (AMH) 是卵巢储备功能的定量标志物，被认为与月经周期的经典内分泌波动无关。目的：本研究的目的是确定与 FSH、LH 和雌二醇相比，AMH 水平在整个月经周期中是否恒定。设计/患者：在一次完整月经期间，对 44 名有生育能力、定期周期的女性志愿者进行频繁的血液采样周期。地点：该研究在一所大学医院进行。主要结果指标：AMH、FSH、LH 和雌二醇测量被分配到七个周期阶段之一，并进行多水平分析。通过将正弦模式与数据拟合来测试一致的波动模式。最后，研究了随机选择的个体样本保留在每个变量的五个预设水平类别（五分位数）之一的频率。结果：适合 AMH 数据的正弦模式不具有统计显着性（P = 0.40）。相比之下，FSH、LH 和雌二醇的正弦模式非常显着。比较七个周期阶段，特定阶段的 AMH 水平之间没有观察到显着差异 (P = 0.06)。对每个个体重复选择 AMH 样本表明，71.5% 的选择中，AMH 值保持在同一五分位数，而 27.9% 的值落在相邻的五分位数。结论：与 FSH、LH 和雌二醇水平相比，整个月经周期测量的 AMH 水平并未表现出一致的波动模式。此外，随机波动很小，表明 AMH 可以作为卵巢储备功能的周期独立标志物。
Context: Anti-Mullerian hormone (AMH), a quantitative marker for ovarian reserve, has been suggested to be independent of the classical endocrine fluctuations of the menstrual cycle.Objective: The objective of the study was to determine whether AMH levels are constant throughout the menstrual cycle, compared with those of FSH, LH, and estradiol.Design/Patients: Frequent blood sampling was performed in 44 fertile, regularly cycling, female volunteers during one full menstrual cycle.Setting: The study was conducted at a university hospital.Main Outcome Measures: AMH, FSH, LH, and estradiol measurements were allocated to one of seven cycle phases, and a multilevel analysis was performed. Consistent fluctuation patterns were tested by fitting sine patterns to the data. Finally, the frequency in which randomly selected individual samples would remain in one of five preset level categories (quintiles) for each of the variables was studied.Results: A sine pattern fitted to the AMH data was not statistically significant (P = 0.40). In contrast, sine patterns for FSH, LH, and estradiol were highly significant. Comparing the seven cycle phases, no significant differences could be observed between phase-specific AMH levels (P = 0.06). Repeated selection of AMH samples for each individual showed that in 71.5% of selections, AMH values remained in the same quintile, whereas in 27.9% values fell in an adjacent quintile.Conclusions: AMH levels measured through a full menstrual cycle did not show consistent fluctuation patterns in contrast to levels of FSH, LH, and estradiol. Furthermore, random fluctuations were small, indicating that AMH can be relied on as a cycle-independent marker for ovarian reserve.