排卵後3-4天後AMH會下降到最低值

打完hCG排卵後3-4天後AMH會下降到最低值
AMH由小卵子濾泡之顆粒細胞分泌
大卵子濾泡之顆粒細胞不太分泌AMH

http://humrep.oxfordjournals.org/content/20/3/747.full

Dynamics of serum anti-Müllerian hormone levels during the luteal phase of controlled ovarian hyperstimulation

1. Renato Fanchin1,4, 
2. Daniel H. Méndez Lozano1, 
3. Nabil Louafi1,
4. Nelly Achour-Frydman2, 
5. René Frydman1 and 
6. Joëlle Taieb3

+Author Affiliations

1. Departments of ¹Obstetrics and Gynecology and Reproductive Medicine, ²Biology and Genetics of Reproduction, and ³Biochemistry and Hormonology, Clamart, France

1. 4To whom correspondence should be addressed at: Department of Obstetrics and Gynecology and Reproductive Medicine, Hôpital Antoine Béclère, 157, rue de la Porte de Trivaux, 92141, Clamart, France. Email: renato.fanchin@abc.ap-hop-paris.fr

• Received October 6, 2004.
• Revision received November 3, 2004.
• Accepted November 22, 2004.

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Abstract

BACKGROUND: To investigate the dynamics of serum anti-Müllerian hormone (AMH) levels during the luteal phase of controlled ovarian hyperstimulation (COH) and its possible association with follicle development. METHODS: We prospectively studied 34 women undergoing COH with GnRH agonist and FSH. On the day of hCG (dhCG), serum AMH, estradiol (E₂), progesterone and hCG levels were measured, and ovarian follicles were sorted into three size classes: <12, 12–15 and 16–22 mm. Hormonal measurements were repeated 4 days (hCG+4) and 7 days (hCG+7) after hCG. RESULTS: From dhCG to hCG+4, we observed a decline in serum AMH levels (−64±3%; P<0.0001), which paralleled that of E₂ levels. From hCG+4 to hCG+7, an increase in AMH levels occurred (82±28%; P<0.02), whose magnitude was correlated with the number of < 12 mm follicles (r=0.68; P<0.0001) but not with other follicle size classes nor with the remaining hormone levels. CONCLUSIONS: After hCG, AMH levels initially decline, presumably as an effect of follicle luteinization, then increase during the mid-luteal phase. Although the mechanisms implicated in the mid-luteal AMH increase are unclear, its positive association with small follicle count, but not with luteal progesterone and E₂ levels, supports the hypothesis that AMH levels might reflect luteal follicle development.

Figure 1.

Box-and-whisker plots showing serum anti-Müllerian hormone (AMH), estradiol (E₂), progesterone (P₄) and hCG levels on the day of hCG administration (dhCG) and 4 and 7 days later (hCG +4 and hCG +7 respectively). Horizontal lines inside the boxes represent median levels. Upper and lower limits of the boxes and whiskers represent the 75th and 25th centiles and 90th and 10th centiles. Values outside the 90th and 10th centile limits are represented as dots. All longitudinal hormone changes reached statistical significance (*P<0.0001 and **P<0.02).