BOSTON — The daughters of women with polycystic ovary syndrome have elevated levels of antimüllerian hormone from infancy to the perimenarche, suggesting the underpinnings of PCOS may be present long before clinical symptoms develop.
Folliculogenesis may be altered in these girls, said Dr. Nicolas Crisosto of the University of Chile, Santiago, at the annual meeting of the Androgen Excess Society. He compared anthropometric, hormonal, and metabolic parameters in 58 daughters of women with PCOS and in 65 daughters of control women at three time points: early infancy (2–3 months), childhood (4–7 years), and the perimenarchal period (8–15 years).
At each of the time points, the girls received a physical exam that included assessment of weight, height, waist-to-hip ratio, and sexual development. A panel of tests was performed for serum hormone levels (gonadotropins, sex steroids, sex hormone-binding globulin, and antimüllerian hormone). The girls in perimenarche also had a transabdominal ultrasound of their ovaries.
There were no significant anthropometric differences between the two groups at any of the exams, Dr. Crisosto said. Antimüllerian hormone levels were significantly increased in the PCOS group at all three stages. Free androgen level was elevated in the PCOS group at the perimenarchal exam.
The mean antimüllerian hormone levels in infants were 20.4 pmol/L in the girls born to women with PCOS vs. 9.2 pmol/L in girls born to women without PCOS. In childhood, the values for the two groups were 14.8 pmol/L and 7.7 pmol/L. In the perimenarchal period, the respective values were 25.2 pmol/L vs. 15.0 pmol/L. The results of the transabdominal ultrasound showed slightly higher ovarian volume (8.8 cm
The findings, recently published in the Journal of Clinical Endocrinology and Metabolism (DOI:10.1210/jc.2005–2693), led the investigators to conclude that serum antimüllerian hormone levels seem to be correlated with the development of preantral and small antral follicles, from puberty to the end of reproductive life. Elevated serum antimüllerian hormone concentrations in daughters of PCOS women during childhood, at a time when the gonadal axis is relatively quiescent and other hormonal markers of ovarian function are very low, suggests that antimüllerian hormone may be used as an early marker of ovarian follicular development.
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