Background: Anti-Mullerian Hormone (AMH) is becoming a useful marker for ovarian function and prospective fertility. It is known to reflect ovarian reserve and response to ovarian stimulation in aided reproductive protocols. Levels are decreased in adults with chronic medical conditions such as Crohns disease and Turners Syndrome and in survivors of childhood cancers. AMH levels are increased in polyscystic ovarian syndrome as a reflection of increased numbers of antral follicles and may be a more sensitive diagnostic marker than ultrasound.
Objective and hypothesis: This study investigates the effect of chronic illness on the reproductive development of pediatric girls. AMH levels are compared to those observed in healthy girls where there is an increase in serum AMH associated with puberty.
Methods: A convenience sample of pediatric female patients was used. This included healthy subjects who had screening bloodwork, and subjects from various medical clinics. A biotinylated sandwich ELISA method was used (Beckman & Coulter Gen II) which has previously been validated in the pediatric population by multiple sources.
Results: AMH levels remained low in all groups of chronic medical conditions including gastroenterology, cardiac, metabolic, oncologic, and solid organ transplant patients. The control patients demonstrated the expected rise in AMH at 68 years of age.
Conclusion: Pediatric females with chronic medical conditions had a trend towards lower AMH levels. This may reflect impaired pubertal progression or reproductive potential. A larger sample size and sequential sampling is needed to determine if development is delayed or permanently impaired and if there is a correlation to severity of disease.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology