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      Correlation between the Serum Luteinizing Hormone to Folliclestimulating Hormone Ratio and the Anti-Müllerian Hormone Levels in Normo-ovulatory Women

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          Abstract

          Serum anti-Müllerian hormone (AMH) levels are regarded as an age-specific marker for predicting the ovarian reserve in women of reproductive age. Some studies have shown that the luteinizing hormone (LH)/follicle stimulating hormone (FSH) ratio can be used as a predictor of ovarian reserve. The purpose of this study was to assess the variation of LH/FSH ratio with aging and to evaluate the correlation between serum LH/FSH ratio and AMH levels as a predictor of the ovarian reserve in normo-ovulatory women. We retrospectively analyzed the day 3 serum hormone levels in 1,251 patients (age range: 20-50 yr) between January 2010 and January 2011. We divided the patients into 6 groups according to their age. Relation between serum AMH level and LH/FSH ratio was analyzed statistically. The serum AMH level was inversely correlated with age ( r = -0.400, P < 0.001). A significant negative correlation was found between serum LH/FSH ratio and age ( r = -0.213, P < 0.001). There was a significant partial correlation between serum LH/FSH ratio and AMH level when adjusted by age ( r = 0.348, P < 0.001). The LH/FSH ratio could be considered as a useful marker for the ovarian reserve and could be applied to the clinical evaluation with AMH.

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          Age-specific serum anti-Müllerian hormone values for 17,120 women presenting to fertility centers within the United States.

          To determine age-specific serum anti-Müllerian hormone (AMH) values for women presenting to U.S. fertility clinics. Retrospective study. Single clinical reference laboratory. A total of 17,120 women of reproductive age ranging from 24 to 50 years old. None. Determination of single-year median and mean AMH values with SDs. Single-year-specific median, mean, and SD values are summarized in Table 1. Both median and mean AMH values decreased steadily in a manner highly correlated with advancing age. The average yearly decrease in the median serum AMH value was 0.2 ng/mL/year through age 35 and then diminished to 0.1 ng/mL/year after age 35. The rate of decline in mean AMH values was 0.2 ng/mL/year through age 40 and then diminished to 0.1 ng/mL/year thereafter. Median and mean AMH levels decreased steadily with increasing age from 24 to 50 years of age. Such data may be of value to physicians and their patients who are considering reproductive options. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
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            Anti-Müllerian hormone (AMH) in female reproduction: is measurement of circulating AMH a useful tool?

            Anti-Müllerian hormone (AMH) is a dimeric glycoprotein, a member of the transforming growth factor (TGF) superfamily. It is produced exclusively in the gonads and is involved in the regulation of follicular growth and development. In the ovary AMH is produced by the granulosa cells of early developing follicles and seems to be able to inhibit the initiation of primordial follicle growth and FSH-induced follicle growth. As AMH is largely expressed throughout folliculogenesis, from the primary follicular stage towards the antral stage, serum levels of AMH may represent both the quantity and quality of the ovarian follicle pool. Compared to other ovarian tests, AMH seems to be the best marker reflecting the decline of reproductive age. AMH measurement could be useful in the prediction of the menopausal transition. It could also be used to predict poor ovarian response and possibly the prognosis of in vitro fertilization (IVF) cycles. AMH has been shown to be a good surrogate marker for polycystic ovary syndrome (PCOS). Finally, its use as a marker for granulosa cell tumours has been proposed. A clearer understanding of its role in ovarian physiology may help clinicians to find a role for AMH measurement in the field of reproductive medicine.
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              Defining ovarian reserve to better understand ovarian aging

              Though a widely utilized term and clinical concept, ovarian reserve (OR) has been only inadequately defined. Based on Medline and PubMed searches we here define OR in its various components, review genetic control of OR, with special emphasis on the FMR1 gene, and discuss whether diminished OR (DOR) is treatable. What is generally referred to as OR reflects only a small portion of total OR (TOR), a pool of growing (recruited) follicles (GFs) at different stages of maturation. Functional OR (FOR) depends on size of the follicle pool at menarche and the follicle recruitment rate. Both vary between individuals and, at least partially, are under genetic control. The FMR1 gene plays a role in defining FOR at all ages. Infertility treatments have in the past almost exclusively only centered on the last two weeks of folliculogenesis, the gonadotropin-sensitive phase. Expansions of treatments into earlier stages of maturation will offer opportunity to significantly improve ovarian stimulation protocols, especially in women with DOR. Dehydroepiandrosterone (DHEA) may represent a first such intervention. Data generated in DHEA-supplemented women, indeed, suggest a new ovarian aging concept, based on aging of ovarian environments and not, as currently is believed, aging oocytes.
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                Author and article information

                Journal
                J Korean Med Sci
                J. Korean Med. Sci
                JKMS
                Journal of Korean Medical Science
                The Korean Academy of Medical Sciences
                1011-8934
                1598-6357
                March 2015
                16 February 2015
                : 30
                : 3
                : 296-300
                Affiliations
                [1 ]Department of Obstetrics and Gynecology, Dongguk University Ilsan Hospital, Goyang, Korea.
                [2 ]Department of Obstetrics and Gynecology, Kwandong University, Cheil General Hospital, Seoul, Korea.
                Author notes
                Address for Correspondence: Sang Ho Yoon, MD. Department of Obstetrics and Gynecology, Dongguk University Ilsan Hospital, 27 Dongguk-ro, Ilsandong-gu, Goyang 410-773, Korea. Tel: +82.31-961-7365, Fax: +82.31-961-7977, yoonprou@ 123456dumc.or.kr
                Author information
                http://orcid.org/0000-0002-2933-9265
                http://orcid.org/0000-0003-1754-2212
                http://orcid.org/0000-0002-3899-7710
                http://orcid.org/0000-0003-1701-4997
                Article
                10.3346/jkms.2015.30.3.296
                4330485
                b630b47b-230d-4785-b20d-244131ea45eb
                © 2015 The Korean Academy of Medical Sciences.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 04 August 2014
                : 20 October 2014
                Categories
                Original Article
                Obstetrics & Gynecology

                Medicine
                anti-müllerian hormone,lh/fsh ratio,regular menstruation,ovarian reserve
                Medicine
                anti-müllerian hormone, lh/fsh ratio, regular menstruation, ovarian reserve

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