TY - JOUR

T1 - Ovarian antral follicle subclasses and anti-mullerian hormone during normal reproductive aging

AU - Bentzen, J G

AU - Forman, J L

AU - Johannsen, T H

AU - Pinborg, A

AU - Larsen, E C

AU - Andersen, A Nyboe

PY - 2013

Y1 - 2013

N2 - CONTEXT: The interindividual variation in the age-related decline of ovarian follicles is wide. Hence, it is important to identify reliable, sensitive, and specific markers to assess the ovarian reserve of the individual woman.OBJECTIVE: The aim of this study was to characterize the relation between age and ovarian reserve parameters in a population of healthy women with regular menstrual cycle.DESIGN AND SETTING: We conducted a prospective, population-based, cross-sectional study.PARTICIPANTS: A total of 366 health care workers aged 21-41 years employed at a University Hospital were included. Interventions: There were no interventions.MAIN OUTCOME MEASURES: Serum anti-Müllerian hormone (AMH) concentration, antral follicle count (AFC), antral follicle size categories (small: 2-4 mm; intermediate: 5-7 mm; and large: 8-10 mm), and ovarian volume were measured.RESULTS: Serum AMH level declined by 5.6% per year (95% confidence interval 3.7-7.4%, P < .001), AFC (2-10 mm) declined by 4.4% per year (3.2-5.7%, P < .001), and ovarian volume declined by 1.1% per year (0.2-2.0, P = .002), respectively. The mean proportion of small follicles decreased with age (P = .04), the proportion of intermediate follicles displayed no significant change with age (P = .58), and the mean proportion of large follicles increased with age (P < .001). The prevalence of large follicles increased with decreasing serum AMH concentration [odds ratio 1.04 per 1 pmol/L (1.02-1.06), P < .001, area under the curve 0.66], and with decreasing total AFC [odds ratio 1.04 per follicle (1.02-1.05), P < .001, area under the curve 0.62].CONCLUSION: Chronological age was inversely related to serum AMH concentration, total AFC, and ovarian volume. Subclasses of AFC sized 2-4 and 5-7 mm decreased with increasing age, whereas AFC sized 8-10 mm increased with increasing age. Within AFC, a shift toward larger follicles with increasing age was observed. The occurrence of large follicles was more strongly related to biological age in terms of AMH and AFC than chronological age.

AB - CONTEXT: The interindividual variation in the age-related decline of ovarian follicles is wide. Hence, it is important to identify reliable, sensitive, and specific markers to assess the ovarian reserve of the individual woman.OBJECTIVE: The aim of this study was to characterize the relation between age and ovarian reserve parameters in a population of healthy women with regular menstrual cycle.DESIGN AND SETTING: We conducted a prospective, population-based, cross-sectional study.PARTICIPANTS: A total of 366 health care workers aged 21-41 years employed at a University Hospital were included. Interventions: There were no interventions.MAIN OUTCOME MEASURES: Serum anti-Müllerian hormone (AMH) concentration, antral follicle count (AFC), antral follicle size categories (small: 2-4 mm; intermediate: 5-7 mm; and large: 8-10 mm), and ovarian volume were measured.RESULTS: Serum AMH level declined by 5.6% per year (95% confidence interval 3.7-7.4%, P < .001), AFC (2-10 mm) declined by 4.4% per year (3.2-5.7%, P < .001), and ovarian volume declined by 1.1% per year (0.2-2.0, P = .002), respectively. The mean proportion of small follicles decreased with age (P = .04), the proportion of intermediate follicles displayed no significant change with age (P = .58), and the mean proportion of large follicles increased with age (P < .001). The prevalence of large follicles increased with decreasing serum AMH concentration [odds ratio 1.04 per 1 pmol/L (1.02-1.06), P < .001, area under the curve 0.66], and with decreasing total AFC [odds ratio 1.04 per follicle (1.02-1.05), P < .001, area under the curve 0.62].CONCLUSION: Chronological age was inversely related to serum AMH concentration, total AFC, and ovarian volume. Subclasses of AFC sized 2-4 and 5-7 mm decreased with increasing age, whereas AFC sized 8-10 mm increased with increasing age. Within AFC, a shift toward larger follicles with increasing age was observed. The occurrence of large follicles was more strongly related to biological age in terms of AMH and AFC than chronological age.

KW - Adult

KW - Age Distribution

KW - Aging

KW - Algorithms

KW - Anti-Mullerian Hormone

KW - Cell Count

KW - Cross-Sectional Studies

KW - Female

KW - Humans

KW - Menstrual Cycle

KW - Organ Size

KW - Ovarian Follicle

KW - Ovary

KW - Reproduction

KW - Young Adult

U2 - 10.1210/jc.2012-1829

DO - 10.1210/jc.2012-1829

M3 - Journal article

C2 - 23463653

VL - 98

SP - 1602

EP - 1611

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

SN - 0021-972X

IS - 4

ER -