Abstract
To investigate whether there is an association between androgens and ovarian reserve, expressed through anti-Mullerian hormone. This is a retrospective cross-sectional analysis of all consecutive women attending a tertiary fertility center, who presented with regular menstrual cycles. Patients had their AMH values measured with the same AMH assay (Immunotech (IOT) Beckmann Coulter assay), the same day in which androgens sampling was performed. Women with PCOS or other forms of androgen excess or untreated endocrine or metabolic disorders were excluded. A total of 942 women were included. Significant correlation was observed between total testosterone/free androgens index (FAI)/DHEAS and AMH (Spearman’s r = 0.20/0.14/0.13, P value < 0.001, P value < 0.001, and P value < 0.001, respectively). After multiple linear regression analysis adjusting for confounders (age, BMI, cause of infertility, day of the menstrual cycle when the blood sample was performed), the regression slope in all participants for total testosterone predicting logAMH was 0.20 (P value < 0.001). Similarly, FAI was significantly associated with logAMH (regression coefficient = 0.04, P value = 0.04). In contrast, DHEAS was not significantly associated with logAMH. There was a significant, but weak relation between testosterone and AMH, while no significant association was observed between DHEAS and AMH. Future research is needed to elucidate whether testosterone supplementation may have any effect on ovarian function.
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The database for this retrospective study would be provided if need be.
Change history
07 April 2021
A Correction to this paper has been published: https://doi.org/10.1007/s43032-021-00569-4
References
Dohle GR, Smit M, Weber RF. Androgens and male fertility. World J Urol. 2003;21(5):341–5.
Di Guardo F, Vloeberghs V, Bardhi E, Blockeel B, Verheyen G, Tournaye H, et al. Low testosterone and semen parameters in male partners of infertile couples undergoing IVF with a total sperm count greater than 5 million. J Clin Med. 2020;9(12):3824. https://doi.org/10.3390/jcm9123824.
Walters KA, Rodriguez Paris V, Aflatounian A, Handelsman D J. Androgens and ovarian function: translation from basic discovery research to clinical impact. J Endocrinol. 2019;242(2):R23–R50. https://doi.org/10.1530/JOE-19-0096.
Vendola KA, Zhou J, Adesanya OO, Weil SJ, Bondy CA. Androgens stimulate early stages of follicular growth in the primate ovary. J Clin Invest. 1998;101(12):2622–9.
Vendola K, Zhou J, Wang J, Famuyiwa OA, Bievre M, Bondy CA. Androgens promote oocyte insulin-like growth factor I expression and initiation of follicle development in the primate ovary. Biol Reprod. 1999;61(2):353–7.
Gleicher N, Weghofer A, Barad DH. The role of androgens in follicle maturation and ovulation induction: friend or foe of infertility treatment? Reprod Biol Endocrinol. 2011;9:116.
Polyzos NP, Davis SR, Drakopoulos P, Humaidan P, de Geyter C, Vega AG, et al. Testosterone for poor ovarian responders: lessons from ovarian physiology. Reprod Sci. 2018;25(7):980–2.
Dewailly D, Andersen CY, Balen A, Broekmans F, Dilaver N, Fanchin R, et al. The physiology and clinical utility of anti-Mullerian hormone in women. Hum Reprod Update. 2014;20(3):370–85.
Davison SL, Bell R, Donath S, Montalto JG, Davis SR. Androgen levels in adult females: changes with age, menopause, and oophorectomy. J Clin Endocrinol Metab. 2005;90(7):3847–53.
Sowers MF, Zheng H, McConnell D, et al. Testosterone, sex hormone-binding globulin and free androgen index among adult women: chronological and ovarian aging. Hum Reprod. 2009;24(9):2276–85.
Salonia A, Pontillo M, Nappi RE, Zanni G, Fabbri F, Scavini M, et al. Menstrual cycle-related changes in circulating androgens in healthy women with self-reported normal sexual function. J Sex Med. 2008;5(4):854–63.
La Marca A, Grisendi V, Griesinger G. How much does AMH really vary in normal women? Int J Endocrinol. 2013;2013:959487.
Rotterdam EA-SPcwg. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19(1):41–7.
Rivera-Woll LM, Papalia M, Davis SR, Burger HG. Androgen insufficiency in women: diagnostic and therapeutic implications. Hum Reprod Update. 2004;10(5):421–32.
Abraham GE. Ovarian and adrenal contribution to peripheral androgens during the menstrual cycle. J Clin Endocrinol Metab. 1974;39(2):340–6.
Nelson SM, Iliodromiti S, Fleming R, Anderson R, McConnachie A, Messow CM. Reference range for the antimullerian hormone Generation II assay: a population study of 10,984 women, with comparison to the established Diagnostics Systems Laboratory nomogram. Fertil Steril. 2014;101(2):523–9.
Zhang Y, Wang SF, Zheng JD, Zhao CB, Zhang YN, Liu LL, et al. Effects of testosterone on the expression levels of AMH, VEGF and HIF-1alpha in mouse granulosa cells. Exp Ther Med. 2016;12(2):883–8.
Cui L, Qin Y, Gao X, Lu J, Geng L, Ding L, et al. Antimullerian hormone: correlation with age and androgenic and metabolic factors in women from birth to postmenopause. Fertil Steril. 2016;105(2):481–5 e1.
Gleicher N, Kim A, Weghofer A, Kushnir VA, Shohat-Tal A, Lazzaroni E, et al. Hypoandrogenism in association with diminished functional ovarian reserve. Hum Reprod. 2013;28(4):1084–91.
Jung S, Allen N, Arslan AA, Baglietto L, Brinton LA, Egleston BL, et al. Demographic, lifestyle, and other factors in relation to antimullerian hormone levels in mostly late premenopausal women. Fertil Steril. 2017;107(4):1012–22 e2.
Murray AA, Gosden RG, Allison V, Spears N. Effect of androgens on the development of mouse follicles growing in vitro. J Reprod Fertil. 1998;113(1):27–33.
Wang H, Andoh K, Hagiwara H, Xiaowei L, Kikuchi N, Abe Y, et al. Effect of adrenal and ovarian androgens on type 4 follicles unresponsive to FSH in immature mice. Endocrinology. 2001;142(11):4930–6.
Narkwichean A, Jayaprakasan K, Maalouf WE, Hernandez-Medrano JH, Pincott-Allen C, Campbell BK. Effects of dehydroepiandrosterone on in vivo ovine follicular development. Hum Reprod. 2014;29(1):146–54.
Walters KA. Role of androgens in normal and pathological ovarian function. Reproduction. 2015;149(4):R193–218.
Montoya-Botero P, Rodriguez-Purata J, Polyzos NP. Androgen supplementation in assisted reproduction: where are we in 2019? Curr Opin Obstet Gynecol. 2019;31(3):188–94.
Bardhi E, Blockeel C, Cools W, Santos-Ribeiro S, Racca A, Mackens S, et al. Is ovarian response associated with adverse perinatal outcomes in GnRH antagonist IVF/ICSI cycles? Reprod BioMed Online. 2020;41(2):263–70.
Machado Fernandez ADP, Rosetti J, Uvin V, Mackens S, Bardhi E, De Vos M, et al. IVF in women of 43 years and older: a 20 years’ experience. Reprod BioMed Online. 2020. https://doi.org/10.1016/j.rbmo.2020.12.002.
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The authors would like to thank Walter Meul for his invaluable help during data collection and abstraction.
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This article was updated to correct author Nikolaos P. Polyzos's name.
Panagiotis Drakopoulos and Erlisa Bardhi are equally contributing first joint authors
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Drakopoulos, P., Bardhi, E., Scherer, S. et al. Androgens and Anti-Müllerian Hormone in Infertile Patients. Reprod. Sci. 28, 2816–2821 (2021). https://doi.org/10.1007/s43032-021-00539-w
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DOI: https://doi.org/10.1007/s43032-021-00539-w