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Serum antimüllerian hormone is associated with the number of oocytes matured in vitro and with primordial follicle density in candidates for fertility preservation

  • Nathalie Sermondade
    Correspondence
    Reprint requests: Nathalie Sermondade, M.D., Ph.D., Department of Reproductive Biology, Hôpital Tenon, Hôpitaux Universitaires Est Parisien, Assistance Publique, Hôpitaux de Paris, Paris 75020, France.
    Affiliations
    Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique, Hôpitaux de Paris, Bondy, France
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  • Charlotte Sonigo
    Affiliations
    Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique, Hôpitaux de Paris, Bondy, France

    Inserm U1185, Université Paris-Sud, Université Paris Saclay, Le Kremlin Bicêtre, France
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  • Christophe Sifer
    Affiliations
    Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique, Hôpitaux de Paris, Bondy, France
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  • Sophie Valtat
    Affiliations
    Inserm UMR1169, Université Paris-Sud, Université Paris Saclay, Le Kremlin Bicêtre, France
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  • Marianne Ziol
    Affiliations
    Service d’Anatomie Pathologique, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique, Hôpitaux de Paris, Bondy, France

    Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris 13, Communauté d’Universités et Etablissements Sorbonne Paris Cité, Paris, France
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  • Florence Eustache
    Affiliations
    Department of Cytogenetic and Reproductive Biology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique, Hôpitaux de Paris, Bondy, France
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  • Michaël Grynberg
    Affiliations
    Department of Reproductive Medicine and Fertility Preservation, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique, Hôpitaux de Paris, Bondy, France

    Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris 13, Communauté d’Universités et Etablissements Sorbonne Paris Cité, Paris, France

    Inserm U1133 Université Paris Diderot, Paris, France
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      Objective

      To assess whether serum antimüllerian hormone (AMH) levels and antral follicle count (AFC) can predict primordial follicle density within ovarian cortex and the number of oocytes cryopreserved after in vitro maturation (IVM).

      Design

      Retrospective analysis of a case series of patients.

      Setting

      University hospital.

      Patient(s)

      Fifty-four women, 18 to 35 years of age, with breast cancer who were candidates for fertility preservation (FP) using ovarian tissue cryopreservation (OTC) associated with oocyte vitrification after unstimulated IVM between July 2013 and December 2016.

      Intervention(s)

      Serum AMH levels and transvaginal AFC evaluated before FP, cumulus–oocyte complexes (COC) recovered under ultrasound guidance and incubated for IVM, and ovarian tissue laparoscopically harvested and cryopreserved.

      Main Outcome Measure(s)

      Univariate and multivariate analysis between ovarian reserve tests, number of recovered and in vitro matured oocytes, and primordial follicle density histologically obtained within ovarian cortex.

      Result(s)

      Univariate analysis showed a statistically significant correlation between AMH or AFC and primordial follicle density. Multivariate analysis showed a predominant statistically significant correlation of serum AMH with density. Antimüllerian hormone also correlated with the number of COC and in vitro matured oocytes.

      Conclusion(s)

      Serum AMH levels may reflect the primordial follicle stockpile and may predict outcomes of IVM and OTC when performed for FP. Further analyses are required to evaluate the relevance of performing such procedures in young women who have low values on ovarian reserve tests.
      La hormona antimülleriana sérica está asociada con el número de ovocitos madurados in vitro y con la densidad de folículos primordiales en candidatas para preservación de la fertilidad

      Objetivo

      Evaluar si los niveles séricos de hormona antimülleriana (HAM) y el recuento de folículos antrales (RFA) pueden predecir la densidad de folículos primordiales en corteza ovárica y el número de ovocitos criopreservados luego de maduración in vitro (MIV).

      Diseño

      Análisis retrospectivo de una serie de casos de pacientes.

      Ámbito

      Hospital universitario.

      Paciente(s)

      Cincuenta y cuatro mujeres, de 18 a 35 años de edad, con cáncer de mama que eran candidatas para preservación de la fertilidad (PF) utilizando criopreservación de tejido ovárico (CTO) asociada con vitrificación ovocitaria después de MIV sin estimulación entre julio de 2013 y diciembre de 2016.

      Intervención(es)

      Niveles séricos de HAM y RFA transvaginal evaluados antes de PF, complejos cúmulus-ovocito (CCO) recuperados bajo guía ecográfica e incubados para MIV, y tejido ovárico obtenido laparoscópicamente y criopreservado.

      Principal(es) variable(s) de resultado

      Análisis univariado y multivariado entre tests de reserva ovárica, número de ovocitos recuperados y madurados in vitro, y densidad de folículos primordiales histológicamente obtenidos en corteza ovárica.

      Resultado(s)

      El análisis univariado mostró una correlación estadísticamente significativa entre HAM o RFA y densidad de folículos primordiales. El análisis multivariado mostró una correlación estadísticamente significativa predominante de HAM sérica con densidad. La hormona antimülleriana también correlacionó con el número de CCO y ovocitos madurados in vitro.

      Conclusión(es)

      Los niveles séricos de HAM podrían reflejar la reserva de folículos primordiales y podrían predecir los resultados de MIV y CTO cuando se llevan a cabo para PF. Se requieren análisis más extensos para evaluar la relevancia de realizar dichos procedimientos en mujeres jóvenes que tienen valores bajos en los tests de reserva ovárica.

      Key Words

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