Hélène Bry-Gauillard1,2,3, Florence Larrat-Ledoux1,2, Jean-Marc Levaillant1,4,5,3, Nathalie Massin3, Luigi Maione1,2,6,5, Isabelle Beau2,5,7, Nadine Binart5,7, Philippe Chanson1,2,5,7, Sylvie Brailly-Tabard1,6,5,7, Janet E Hall8,9, Jacques Young1,2,5,7. 1. Assistance Publique-Hôpitaux de Paris. 2. Department of Reproductive Endocrinology. 3. Medical Procreation Unit, Gynecology-Obstetrics Department, University of Paris XII, Créteil Hospital, 94000 Créteil, France. 4. Department of Gynecology-Obstetrics, and. 5. University of Paris-Sud, Paris-Sud Medical School, 94276 Le Kremlin-Bicêtre, France. 6. Department of Hormonology and Molecular Genetics, Bicêtre Hospital, 94275 Le Kremlin-Bicêtre, France. 7. INSERM Unité 1185, 94276 Le Kremlin-Bicêtre, France. 8. Reproductive Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114. 9. Clinical Research Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina 27709.
Abstract
CONTEXT: Isolated hypogonadotropic hypogonadism (IHH), characterized by gonadotropin deficiency and absent puberty, is very rare in women. IHH prevents pubertal ovarian stimulation, but anti-Müllerian hormone (AMH) and antral follicle count (AFC) have not been studied. OBJECTIVES: (1) To compare, in IHH vs controls, AMH, ovarian volume (OV), and AFC. (2) To compare, in IHH, ovarian responses to recombinant human follicle-stimulating hormone (rhFSH) and rhFSH plus recombinant human luteinizing hormone (rhLH). SUBJECTS: Sixty-eight IHH women; 51 matched healthy women. METHODS: Serum LH, FSH, sex steroids, inhibin B (InhB), AMH, and OV and AFC (sonography) were compared. Ovarian response during rhFSH administration was assessed in 12 IHH women with low AMH levels and low AFC and compared with hormonal changes observed in six additional IHH women receiving rhFSH plus rhLH. RESULTS: InhB was lower in IHH than in controls. AMH levels were also significantly lower in the patients, but two-thirds had normal values. Mean OV and total, larger, and smaller AFCs were lower in IHH than in controls. Ovarian stimulation by rhFSH led to a significant increase in serum estradiol and InhB levels and in the number of larger antral follicles. AMH and smaller AFC increased early during rhFSH stimulation but then declined despite continued stimulation. rhFSH plus rhLH stimulation led to a significantly higher increase in estradiol levels but to similar changes in circulating InhB and AMH than with rhFSH alone. CONCLUSIONS: IHH women have both low AMH levels and low AFC. However, their decrease can be reversed by follicle-stimulating hormone. Serum AMH and AFC should not serve as prognostic markers of fertility in this population.
CONTEXT: Isolated hypogonadotropic hypogonadism (IHH), characterized by gonadotropin deficiency and absent puberty, is very rare in women. IHH prevents pubertal ovarian stimulation, but anti-Müllerian hormone (AMH) and antral follicle count (AFC) have not been studied. OBJECTIVES: (1) To compare, in IHH vs controls, AMH, ovarian volume (OV), and AFC. (2) To compare, in IHH, ovarian responses to recombinant human follicle-stimulating hormone (rhFSH) and rhFSH plus recombinant human luteinizing hormone (rhLH). SUBJECTS: Sixty-eight IHH women; 51 matched healthy women. METHODS: Serum LH, FSH, sex steroids, inhibin B (InhB), AMH, and OV and AFC (sonography) were compared. Ovarian response during rhFSH administration was assessed in 12 IHH women with low AMH levels and low AFC and compared with hormonal changes observed in six additional IHH women receiving rhFSH plus rhLH. RESULTS: InhB was lower in IHH than in controls. AMH levels were also significantly lower in the patients, but two-thirds had normal values. Mean OV and total, larger, and smaller AFCs were lower in IHH than in controls. Ovarian stimulation by rhFSH led to a significant increase in serum estradiol and InhB levels and in the number of larger antral follicles. AMH and smaller AFC increased early during rhFSH stimulation but then declined despite continued stimulation. rhFSH plus rhLH stimulation led to a significantly higher increase in estradiol levels but to similar changes in circulating InhB and AMH than with rhFSH alone. CONCLUSIONS: IHH women have both low AMH levels and low AFC. However, their decrease can be reversed by follicle-stimulating hormone. Serum AMH and AFC should not serve as prognostic markers of fertility in this population.
Authors: Vitaly A Kushnir; David B Seifer; David H Barad; Aritro Sen; Norbert Gleicher Journal: J Assist Reprod Genet Date: 2017-06-22 Impact factor: 3.412
Authors: Soumia Brakta; Lynn P Chorich; Hyung-Goo Kim; Laurel A Coons; John A Katzenellenbogen; Janet E Hall; Kenneth S Korach; Lawrence C Layman Journal: J Clin Endocrinol Metab Date: 2020-05-01 Impact factor: 5.958
Authors: Robert P Millar; Charlotte Sonigo; Richard A Anderson; Jyothis George; Luigi Maione; Sylvie Brailly-Tabard; Philippe Chanson; Nadine Binart; Jacques Young Journal: J Endocr Soc Date: 2017-10-16