Anti-müllerian hormone deficiency in females with Fanconi Anemia

Martha M. Sklavos, Neelam Giri, Pamela Stratton, Blanche P. Alter, Ligia A. Pinto

Research output: Contribution to journalArticle

Abstract

Context: In females with Fanconi anemia (FA), infertility is often accompanied by diminished ovarian reserve and hypergonadotropic amenorrhea before the age of 30 years, suggesting primary ovarian insufficiency (POI). POI is typically diagnosed only after perimenopausal symptoms are observed. Objective: The objective of the study was to assess whether serum anti-Müllerian hormone (AMH) levels can serve as a cycle-independent marker for the diagnosis of POI in patients with FA. Design and Setting: This observational study used the National Cancer Institute's inherited bone marrow failure syndrome cohort at the National Institutes of Health Clinical Center. Participants: The study included 22 females with FA, 20 unaffected female relatives of patients with FA, and 21 unrelated healthy females under 41 years of age. Main Outcome Measure: Serum AMH, a marker of ovarian reserve, was measured in all participants. Results: Females with FA had very low AMH levels (median 0.05 ng/mL; range 0-2.32 ng/mL; P .001) when compared with unaffected relatives (median 2.10 ng/mL; range 0.04-4.73 ng/mL) and unrelated healthy females (median 1.92 ng/mL; range 0.31-6.64 ng/mL). All patients with FA older than 25 years of age were diagnosed with POI and had undetectable AMH levels. Conclusions: AMH deficiency appears to be a shared trait across this heterogeneous FA cohort. Substantially reduced AMH levels in females with FA suggest a primary ovarian defect associated with reduced fertility. Measurement of AMH at the time of FA diagnosis and subsequent monitoring of AMH levels at regular intervals may be useful for the timely management of complications related to POI such as subfertility/infertility, osteoporosis, and menopausal symptoms.

Original languageEnglish (US)
Pages (from-to)1608-1614
Number of pages7
JournalJournal of Clinical Endocrinology and Metabolism
Volume99
Issue number5
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Fanconi Anemia
Primary Ovarian Insufficiency
Hormones
Infertility
National Cancer Institute (U.S.)
Amenorrhea
National Institutes of Health (U.S.)
Serum
Bone
Osteoporosis
Observational Studies
Fertility
Health
Outcome Assessment (Health Care)
Defects
Monitoring

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

Cite this

Anti-müllerian hormone deficiency in females with Fanconi Anemia. / Sklavos, Martha M.; Giri, Neelam; Stratton, Pamela; Alter, Blanche P.; Pinto, Ligia A.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 99, No. 5, 2014, p. 1608-1614.

Research output: Contribution to journalArticle

Sklavos, MM, Giri, N, Stratton, P, Alter, BP & Pinto, LA 2014, 'Anti-müllerian hormone deficiency in females with Fanconi Anemia', Journal of Clinical Endocrinology and Metabolism, vol. 99, no. 5, pp. 1608-1614. https://doi.org/10.1210/jc.2013-3559
Sklavos, Martha M. ; Giri, Neelam ; Stratton, Pamela ; Alter, Blanche P. ; Pinto, Ligia A. / Anti-müllerian hormone deficiency in females with Fanconi Anemia. In: Journal of Clinical Endocrinology and Metabolism. 2014 ; Vol. 99, No. 5. pp. 1608-1614.
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AU - Giri, Neelam

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AU - Alter, Blanche P.

AU - Pinto, Ligia A.

PY - 2014

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N2 - Context: In females with Fanconi anemia (FA), infertility is often accompanied by diminished ovarian reserve and hypergonadotropic amenorrhea before the age of 30 years, suggesting primary ovarian insufficiency (POI). POI is typically diagnosed only after perimenopausal symptoms are observed. Objective: The objective of the study was to assess whether serum anti-Müllerian hormone (AMH) levels can serve as a cycle-independent marker for the diagnosis of POI in patients with FA. Design and Setting: This observational study used the National Cancer Institute's inherited bone marrow failure syndrome cohort at the National Institutes of Health Clinical Center. Participants: The study included 22 females with FA, 20 unaffected female relatives of patients with FA, and 21 unrelated healthy females under 41 years of age. Main Outcome Measure: Serum AMH, a marker of ovarian reserve, was measured in all participants. Results: Females with FA had very low AMH levels (median 0.05 ng/mL; range 0-2.32 ng/mL; P .001) when compared with unaffected relatives (median 2.10 ng/mL; range 0.04-4.73 ng/mL) and unrelated healthy females (median 1.92 ng/mL; range 0.31-6.64 ng/mL). All patients with FA older than 25 years of age were diagnosed with POI and had undetectable AMH levels. Conclusions: AMH deficiency appears to be a shared trait across this heterogeneous FA cohort. Substantially reduced AMH levels in females with FA suggest a primary ovarian defect associated with reduced fertility. Measurement of AMH at the time of FA diagnosis and subsequent monitoring of AMH levels at regular intervals may be useful for the timely management of complications related to POI such as subfertility/infertility, osteoporosis, and menopausal symptoms.

AB - Context: In females with Fanconi anemia (FA), infertility is often accompanied by diminished ovarian reserve and hypergonadotropic amenorrhea before the age of 30 years, suggesting primary ovarian insufficiency (POI). POI is typically diagnosed only after perimenopausal symptoms are observed. Objective: The objective of the study was to assess whether serum anti-Müllerian hormone (AMH) levels can serve as a cycle-independent marker for the diagnosis of POI in patients with FA. Design and Setting: This observational study used the National Cancer Institute's inherited bone marrow failure syndrome cohort at the National Institutes of Health Clinical Center. Participants: The study included 22 females with FA, 20 unaffected female relatives of patients with FA, and 21 unrelated healthy females under 41 years of age. Main Outcome Measure: Serum AMH, a marker of ovarian reserve, was measured in all participants. Results: Females with FA had very low AMH levels (median 0.05 ng/mL; range 0-2.32 ng/mL; P .001) when compared with unaffected relatives (median 2.10 ng/mL; range 0.04-4.73 ng/mL) and unrelated healthy females (median 1.92 ng/mL; range 0.31-6.64 ng/mL). All patients with FA older than 25 years of age were diagnosed with POI and had undetectable AMH levels. Conclusions: AMH deficiency appears to be a shared trait across this heterogeneous FA cohort. Substantially reduced AMH levels in females with FA suggest a primary ovarian defect associated with reduced fertility. Measurement of AMH at the time of FA diagnosis and subsequent monitoring of AMH levels at regular intervals may be useful for the timely management of complications related to POI such as subfertility/infertility, osteoporosis, and menopausal symptoms.

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