Circulating AMH reflects ovarian morphology by magnetic resonance imaging and 3D ultrasound in 121 healthy girls

Casper P Hagen; Annette Mouritsen; Mikkel G Mieritz; Jeanette Tinggaard; Christine Wohlfart-Veje; Eva Fallentin; Vibeke Brocks; Karin Sundberg; Lisa Neerup Jensen; Richard A Anderson; Anders Juul; Katharina Maria Main

doi:10.1210/jc.2014-3336

Circulating AMH reflects ovarian morphology by magnetic resonance imaging and 3D ultrasound in 121 healthy girls

Casper P Hagen, Annette Mouritsen, Mikkel G Mieritz, Jeanette Tinggaard, Christine Wohlfart-Veje, Eva Fallentin, Vibeke Brocks, Karin Sundberg, Lisa Neerup Jensen, Richard A Anderson, Anders Juul, Katharina Maria Main

Department of Clinical Medicine

33 Citations (Scopus)

Abstract

Context: In adult women, Anti-Müllerian hormone (AMH) is produced by small growing follicles, and circulating levels of AMH reflect the number of antral follicles as well as primordial follicles. Whether AMH reflects follicle numbers in healthy girls remains to be elucidated. Objective: This study aimed to evaluate whether serum levels of AMH reflects ovarian morphology in healthy girls. Design and Setting: This was a population-based cohort study involving the general community. Participants: Included in the study were 121 healthy girls 9.8-14.7 years of age. Main Outcome Measures: Clinical examination, including pubertal breast stage (Tanner's classification B1-5), ovarian volume, as well as the number and size of antral follicles were assessed by two independent modalities: magnetic resonance imaging (MRI), Ellipsoid volume, follicles ≥2 mm; and Transabdominal ultrasound, Ellipsoid and 3D volume, follicles ≥1 mm. Circulating levels of AMH, inhibin B, estradiol, FSH, and LH were assessed by immunoassays; T and androstenedione were assessed by liquid chromatography-tandem mass spectrometry. Results: AMH reflected the number of small (MRI 2-3 mm) and medium (4-6 mm) follicles (Pearson's Rho [r] = 0.531 and r = 0.512, P < .001) but not large follicles (≥7 mm) (r = 0.109, P = .323). In multiple regression analysis, small and medium follicles (MRI ≤ 6 mm) remained the main contributors to circulating AMH (β, 0.501; P < .001) whereas the correlation between AMH and estradiol was negative (β, -0.318; P = .005). In early puberty (B1-B3), the number of AMH-producing follicles (2-6 mm) correlated positively with pubertal stages (r = 0.453, P = .001), whereas AMH levels were unaffected (-0.183, P = .118). Conclusions: Similarly to adult women, small and medium antral follicles (≤6 mm) were the main contributors to circulating levels of AMH in girls.

Original language	English
Journal	Journal of Clinical Endocrinology and Metabolism
Volume	100
Issue number	3
Pages (from-to)	880-90
Number of pages	11
ISSN	0021-972X
DOIs	https://doi.org/10.1210/jc.2014-3336
Publication status	Published - 1 Mar 2015

Keywords

Adolescent
Anti-Mullerian Hormone
Child
Cohort Studies
Female
Health
Humans
Imaging, Three-Dimensional
Magnetic Resonance Imaging
Organ Size
Ovarian Follicle
Ovary
Ultrasonography

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Hagen, C. P., Mouritsen, A., Mieritz, M. G., Tinggaard, J., Wohlfart-Veje, C., Fallentin, E., Brocks, V., Sundberg, K., Jensen, L. N., Anderson, R. A., Juul, A., & Main, K. M. (2015). Circulating AMH reflects ovarian morphology by magnetic resonance imaging and 3D ultrasound in 121 healthy girls. Journal of Clinical Endocrinology and Metabolism, 100(3), 880-90. https://doi.org/10.1210/jc.2014-3336

Hagen, CP, Mouritsen, A, Mieritz, MG, Tinggaard, J, Wohlfart-Veje, C, Fallentin, E, Brocks, V, Sundberg, K, Jensen, LN, Anderson, RA, Juul, A & Main, KM 2015, 'Circulating AMH reflects ovarian morphology by magnetic resonance imaging and 3D ultrasound in 121 healthy girls', Journal of Clinical Endocrinology and Metabolism, vol. 100, no. 3, pp. 880-90. https://doi.org/10.1210/jc.2014-3336

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title = "Circulating AMH reflects ovarian morphology by magnetic resonance imaging and 3D ultrasound in 121 healthy girls",

abstract = "Context: In adult women, Anti-M{\"u}llerian hormone (AMH) is produced by small growing follicles, and circulating levels of AMH reflect the number of antral follicles as well as primordial follicles. Whether AMH reflects follicle numbers in healthy girls remains to be elucidated. Objective: This study aimed to evaluate whether serum levels of AMH reflects ovarian morphology in healthy girls. Design and Setting: This was a population-based cohort study involving the general community. Participants: Included in the study were 121 healthy girls 9.8-14.7 years of age. Main Outcome Measures: Clinical examination, including pubertal breast stage (Tanner's classification B1-5), ovarian volume, as well as the number and size of antral follicles were assessed by two independent modalities: magnetic resonance imaging (MRI), Ellipsoid volume, follicles ≥2 mm; and Transabdominal ultrasound, Ellipsoid and 3D volume, follicles ≥1 mm. Circulating levels of AMH, inhibin B, estradiol, FSH, and LH were assessed by immunoassays; T and androstenedione were assessed by liquid chromatography-tandem mass spectrometry. Results: AMH reflected the number of small (MRI 2-3 mm) and medium (4-6 mm) follicles (Pearson's Rho [r] = 0.531 and r = 0.512, P < .001) but not large follicles (≥7 mm) (r = 0.109, P = .323). In multiple regression analysis, small and medium follicles (MRI ≤ 6 mm) remained the main contributors to circulating AMH (β, 0.501; P < .001) whereas the correlation between AMH and estradiol was negative (β, -0.318; P = .005). In early puberty (B1-B3), the number of AMH-producing follicles (2-6 mm) correlated positively with pubertal stages (r = 0.453, P = .001), whereas AMH levels were unaffected (-0.183, P = .118). Conclusions: Similarly to adult women, small and medium antral follicles (≤6 mm) were the main contributors to circulating levels of AMH in girls.",

keywords = "Adolescent, Anti-Mullerian Hormone, Child, Cohort Studies, Female, Health, Humans, Imaging, Three-Dimensional, Magnetic Resonance Imaging, Organ Size, Ovarian Follicle, Ovary, Ultrasonography",

author = "Hagen, {Casper P} and Annette Mouritsen and Mieritz, {Mikkel G} and Jeanette Tinggaard and Christine Wohlfart-Veje and Eva Fallentin and Vibeke Brocks and Karin Sundberg and Jensen, {Lisa Neerup} and Anderson, {Richard A} and Anders Juul and Main, {Katharina Maria}",

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language = "English",

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T1 - Circulating AMH reflects ovarian morphology by magnetic resonance imaging and 3D ultrasound in 121 healthy girls

AU - Hagen, Casper P

AU - Mouritsen, Annette

AU - Mieritz, Mikkel G

AU - Tinggaard, Jeanette

AU - Wohlfart-Veje, Christine

AU - Fallentin, Eva

AU - Brocks, Vibeke

AU - Sundberg, Karin

AU - Jensen, Lisa Neerup

AU - Anderson, Richard A

AU - Juul, Anders

AU - Main, Katharina Maria

PY - 2015/3/1

Y1 - 2015/3/1

N2 - Context: In adult women, Anti-Müllerian hormone (AMH) is produced by small growing follicles, and circulating levels of AMH reflect the number of antral follicles as well as primordial follicles. Whether AMH reflects follicle numbers in healthy girls remains to be elucidated. Objective: This study aimed to evaluate whether serum levels of AMH reflects ovarian morphology in healthy girls. Design and Setting: This was a population-based cohort study involving the general community. Participants: Included in the study were 121 healthy girls 9.8-14.7 years of age. Main Outcome Measures: Clinical examination, including pubertal breast stage (Tanner's classification B1-5), ovarian volume, as well as the number and size of antral follicles were assessed by two independent modalities: magnetic resonance imaging (MRI), Ellipsoid volume, follicles ≥2 mm; and Transabdominal ultrasound, Ellipsoid and 3D volume, follicles ≥1 mm. Circulating levels of AMH, inhibin B, estradiol, FSH, and LH were assessed by immunoassays; T and androstenedione were assessed by liquid chromatography-tandem mass spectrometry. Results: AMH reflected the number of small (MRI 2-3 mm) and medium (4-6 mm) follicles (Pearson's Rho [r] = 0.531 and r = 0.512, P < .001) but not large follicles (≥7 mm) (r = 0.109, P = .323). In multiple regression analysis, small and medium follicles (MRI ≤ 6 mm) remained the main contributors to circulating AMH (β, 0.501; P < .001) whereas the correlation between AMH and estradiol was negative (β, -0.318; P = .005). In early puberty (B1-B3), the number of AMH-producing follicles (2-6 mm) correlated positively with pubertal stages (r = 0.453, P = .001), whereas AMH levels were unaffected (-0.183, P = .118). Conclusions: Similarly to adult women, small and medium antral follicles (≤6 mm) were the main contributors to circulating levels of AMH in girls.

AB - Context: In adult women, Anti-Müllerian hormone (AMH) is produced by small growing follicles, and circulating levels of AMH reflect the number of antral follicles as well as primordial follicles. Whether AMH reflects follicle numbers in healthy girls remains to be elucidated. Objective: This study aimed to evaluate whether serum levels of AMH reflects ovarian morphology in healthy girls. Design and Setting: This was a population-based cohort study involving the general community. Participants: Included in the study were 121 healthy girls 9.8-14.7 years of age. Main Outcome Measures: Clinical examination, including pubertal breast stage (Tanner's classification B1-5), ovarian volume, as well as the number and size of antral follicles were assessed by two independent modalities: magnetic resonance imaging (MRI), Ellipsoid volume, follicles ≥2 mm; and Transabdominal ultrasound, Ellipsoid and 3D volume, follicles ≥1 mm. Circulating levels of AMH, inhibin B, estradiol, FSH, and LH were assessed by immunoassays; T and androstenedione were assessed by liquid chromatography-tandem mass spectrometry. Results: AMH reflected the number of small (MRI 2-3 mm) and medium (4-6 mm) follicles (Pearson's Rho [r] = 0.531 and r = 0.512, P < .001) but not large follicles (≥7 mm) (r = 0.109, P = .323). In multiple regression analysis, small and medium follicles (MRI ≤ 6 mm) remained the main contributors to circulating AMH (β, 0.501; P < .001) whereas the correlation between AMH and estradiol was negative (β, -0.318; P = .005). In early puberty (B1-B3), the number of AMH-producing follicles (2-6 mm) correlated positively with pubertal stages (r = 0.453, P = .001), whereas AMH levels were unaffected (-0.183, P = .118). Conclusions: Similarly to adult women, small and medium antral follicles (≤6 mm) were the main contributors to circulating levels of AMH in girls.

KW - Adolescent

KW - Anti-Mullerian Hormone

KW - Child

KW - Cohort Studies

KW - Female

KW - Health

KW - Humans

KW - Imaging, Three-Dimensional

KW - Magnetic Resonance Imaging

KW - Organ Size

KW - Ovarian Follicle

KW - Ovary

KW - Ultrasonography

U2 - 10.1210/jc.2014-3336

DO - 10.1210/jc.2014-3336

M3 - Journal article

C2 - 25485726

SN - 0021-972X

VL - 100

SP - 880

EP - 890

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

IS - 3

ER -

Circulating AMH reflects ovarian morphology by magnetic resonance imaging and 3D ultrasound in 121 healthy girls

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Keywords

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