Interactions between serum FSH, inhibin B and antral follicle count in the decline of serum AMH during the menstrual cycle in late reproductive age
Abstract Objective To investigate the hormonal interrelationships during the menstrual cycle in women of late reproductive age with suppressed serum AMH and antral follicle count (AFC). Methods Serum hormones (AMH, FSH, LH, estradiol, progesterone, inhibin A, inhibin B), AFC (2‐10 mm) and AMH/AFC ra...
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| Format: | Article |
| Language: | English |
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Wiley
2021-04-01
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| Series: | Endocrinology, Diabetes & Metabolism |
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| Online Access: | https://doi.org/10.1002/edm2.172 |
| _version_ | 1818360418743091200 |
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| author | David M. Robertson Chel Hee Lee Angela Baerwald |
| author_facet | David M. Robertson Chel Hee Lee Angela Baerwald |
| author_sort | David M. Robertson |
| collection | DOAJ |
| description | Abstract Objective To investigate the hormonal interrelationships during the menstrual cycle in women of late reproductive age with suppressed serum AMH and antral follicle count (AFC). Methods Serum hormones (AMH, FSH, LH, estradiol, progesterone, inhibin A, inhibin B), AFC (2‐10 mm) and AMH/AFC ratio (an estimate of AMH/follicle) were assessed every 2‐3 days across the menstrual cycle in 26 healthy ovulatory women aged 18‐50 years. Results An 11‐fold fall in AMH/AFC was observed in women aged ≥45 years compared to those 18‐45 years (P < .001). Although women ≥45 years exhibited normal menstrual cycle patterns of serum estradiol, progesterone, LH and inhibin A, FSH was elevated (P < .001) and inhibin B suppressed (P < .001) compared to the younger group. Overall FSH was inversely correlated (r = .55, P < .05) and AMH directly correlated (r = .88, P < .01) with AFC; however, these relationships were curvilinear and more pronounced when AFC was low. Inhibin B was directly linearly correlated (r = .70, P < .01) with AFC across both high and low AMH/follicle groups. Conclusions It is hypothesized that the marked fall in AMH/follicle in late reproductive age is attributed to the change in the hormonal interplay between the pituitary and ovary. The fall in AFC leads to a decrease in inhibin B and a concomitant increase in FSH by a recognized feedback mechanism. It is postulated the elevated FSH suppresses AMH either directly or indirectly through oocyte‐specific growth factors leading to a marked fall in AMH/follicle. We propose that pituitary‐ovarian and intra‐ovarian regulatory systems underpin the accelerated fall in AMH/follicle during the transition to menopause. |
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| format | Article |
| id | doaj.art-a4b26a770f34409d8514faa965e9e4b1 |
| institution | Directory Open Access Journal |
| issn | 2398-9238 |
| language | English |
| last_indexed | 2024-12-13T21:00:29Z |
| publishDate | 2021-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Endocrinology, Diabetes & Metabolism |
| spelling | doaj.art-a4b26a770f34409d8514faa965e9e4b12022-12-21T23:31:36ZengWileyEndocrinology, Diabetes & Metabolism2398-92382021-04-0142n/an/a10.1002/edm2.172Interactions between serum FSH, inhibin B and antral follicle count in the decline of serum AMH during the menstrual cycle in late reproductive ageDavid M. Robertson0Chel Hee Lee1Angela Baerwald2Centre for Endocrinology and Metabolism Hudson Institute of Medical Research, Clayton, VictoriaMonash University Clayton Victoria AustraliaDepartment of Mathematics and Statistics University of Calgary Alberta CanadaDepartment of Academic Family Medicine College of MedicineUniversity of Saskatchewan Saskatchewan CanadaAbstract Objective To investigate the hormonal interrelationships during the menstrual cycle in women of late reproductive age with suppressed serum AMH and antral follicle count (AFC). Methods Serum hormones (AMH, FSH, LH, estradiol, progesterone, inhibin A, inhibin B), AFC (2‐10 mm) and AMH/AFC ratio (an estimate of AMH/follicle) were assessed every 2‐3 days across the menstrual cycle in 26 healthy ovulatory women aged 18‐50 years. Results An 11‐fold fall in AMH/AFC was observed in women aged ≥45 years compared to those 18‐45 years (P < .001). Although women ≥45 years exhibited normal menstrual cycle patterns of serum estradiol, progesterone, LH and inhibin A, FSH was elevated (P < .001) and inhibin B suppressed (P < .001) compared to the younger group. Overall FSH was inversely correlated (r = .55, P < .05) and AMH directly correlated (r = .88, P < .01) with AFC; however, these relationships were curvilinear and more pronounced when AFC was low. Inhibin B was directly linearly correlated (r = .70, P < .01) with AFC across both high and low AMH/follicle groups. Conclusions It is hypothesized that the marked fall in AMH/follicle in late reproductive age is attributed to the change in the hormonal interplay between the pituitary and ovary. The fall in AFC leads to a decrease in inhibin B and a concomitant increase in FSH by a recognized feedback mechanism. It is postulated the elevated FSH suppresses AMH either directly or indirectly through oocyte‐specific growth factors leading to a marked fall in AMH/follicle. We propose that pituitary‐ovarian and intra‐ovarian regulatory systems underpin the accelerated fall in AMH/follicle during the transition to menopause.https://doi.org/10.1002/edm2.172BMP15cumulinestradiolGDF9inhibin Amenopause |
| spellingShingle | David M. Robertson Chel Hee Lee Angela Baerwald Interactions between serum FSH, inhibin B and antral follicle count in the decline of serum AMH during the menstrual cycle in late reproductive age Endocrinology, Diabetes & Metabolism BMP15 cumulin estradiol GDF9 inhibin A menopause |
| title | Interactions between serum FSH, inhibin B and antral follicle count in the decline of serum AMH during the menstrual cycle in late reproductive age |
| title_full | Interactions between serum FSH, inhibin B and antral follicle count in the decline of serum AMH during the menstrual cycle in late reproductive age |
| title_fullStr | Interactions between serum FSH, inhibin B and antral follicle count in the decline of serum AMH during the menstrual cycle in late reproductive age |
| title_full_unstemmed | Interactions between serum FSH, inhibin B and antral follicle count in the decline of serum AMH during the menstrual cycle in late reproductive age |
| title_short | Interactions between serum FSH, inhibin B and antral follicle count in the decline of serum AMH during the menstrual cycle in late reproductive age |
| title_sort | interactions between serum fsh inhibin b and antral follicle count in the decline of serum amh during the menstrual cycle in late reproductive age |
| topic | BMP15 cumulin estradiol GDF9 inhibin A menopause |
| url | https://doi.org/10.1002/edm2.172 |
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