La hormona antimulleriana y el síndrome de ovario poliquístico

Gilda Monteagudo Peña, Aimee Álvarez Álvarez, Gisel Ovies Carballo, Manuel Gómez Alzugaray, Maité Cabrera Gámez

Texto completo:

PDF

Resumen

Introducción: El diagnóstico del síndrome de ovario poliquístico, por su gran diversidad fenotípica ha sido y es objeto de debate. Es en este contexto que en los últimos años se ha propuesto la medición de la hormona antimulleriana como un indicador más eficaz en la evaluación de la disfunción folicular.

Objetivo: Compilar información sobre la hormona antimulleriana y su utilidad diagnóstica en el síndrome de ovario poliquístico.

Métodos: Revisión bibliográfica de 57 artículos obtenidos de las bases de datos Google Académico, Medline y Pubmed.

Conclusiones: La concentración intrafolicular de hormona antimulleriana es inversamente proporcional al tamaño del folículo ovárico y sus niveles séricos son proporcionales a la reserva de folículos en estadio preantral o antral pequeño. En mujeres con síndrome de ovario poliquístico se ha observado incremento de hormona antimulleriana que se cree juega un papel en la patogenia de las alteraciones de la foliculogénesis y la disfunción ovárica. Por ello, la determinación de hormona antimulleriana se ha empleado con fines diagnósticos, como indicador de reserva folicular o como predictor de la respuesta a los tratamientos. Sin embargo, las dificultades técnicas para la medición y la variabilidad poblacional e interindividual, han llevado a que su utilidad práctica para el diagnóstico del síndrome de ovario poliquístico no haya podido establecerse consistentemente.

Palabras clave: síndrome de ovario poliquístico; hormona antimulleriana; diagnóstico síndrome de ovario poliquístico.

Referencias

Wolf WM, Wattick RA, Kinkade ON, Olfert MD. Geographical Prevalence of Polycystic Ovary Syndrome as Determined by Region and Race/Ethnicity. Int J Environ Res Public Health. 2018;15(11):2589. DOI: https://doi.org/10.3390/ijerph15112589

Azziz R. Polycystic Ovary Syndrome. Obstet Gynecol. 2018;132(2):321-336. DOI: https://doi.org/10.1097/AOG.0000000000002698

McCartney CR, Marshall JC. Clinical practice. Polycystic Ovary Syndrome. N Engl J Med. 2016;375(1):54-64. DOI: https://doi.org/10.1056/NEJMcp1514916

Azziz R, Carmina E, Chen Z, Dunaif A, Laven JS, Legro RS, et al. Polycystic ovary syndrome. Nat Rev Dis Primers. 2016 [acceso: 28/12/2021];2:16057. Disponible en: https://www.nature.com/articles/nrdp201657

Pasquali R. Contemporary approaches to the management of polycystic ovary syndrome. Ther Adv Endocrinol Metab. 2018;9(4):123-34. DOI: https://doi.org/10.1177/2042018818756790

Rocha AL, Oliveira FR, Azevedo RC, Silva VA, Peres TM, Candido AL, et al. Recent advances in the understanding and management of polycystic ovary syndrome. F1000Res. 2019;8:565. DOI: https://doi.org/10.12688/f1000research.15318.1

Lizneva D, Kirubakaran R, Mykhalchenko K, Suturina L, Chernukha G, Diamond MP, et al. Phenotypes and body mass in women with polycystic ovary syndrome identified in referral versus unselected populations: systematic review and meta-analysis. Fertil Steril. 2016;106(6):1510-20. DOI: https://doi.org/10.1016/j.fertnstert.2016.07.1121

Mohd M, Maqbool M, Dar MA, Mushtaq I. Polycystic Ovary Syndrome, a modern epidemic: An overview. JDDT. 2019 [acceso: 28/12/2021];9(3):641-4. Disponible en: http://jddtonline.info/index.php/jddt/article/view/2661

Popescu I, Ionescu C, Dimitriu M, Bohîlțea R, Viezuină R, Davitoiu B, et al. Controversies in polycystic ovarian syndrome. Gineco. 2017 [acceso: 28/12/2021];13:42-5. Disponible en: http://gineco.eu/system/revista/37/42-45.pdf

Sujata K, Swoyam S. 2D and 3D Trans-vaginal Sonography to Determine Cut-offs for Ovarian Volume and Follicle Number per Ovary for Diagnosis of Polycystic Ovary Syndrome in Indian Women. J Reprod Infertil. 2018 [acceso: 28/12/2021];19(3):146-51. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6104427/

Christ JP, Vanden Brink H, Brooks ED, Pierson RA, Chizen DR, Lujan ME. Ultrasound features of polycystic ovaries relate to degree of reproductive and metabolic disturbance in polycystic ovary syndrome. Fertil Steril. 2015;103(3):787-94. DOI: https://doi.org/10.1016/j.fertnstert.2014.12.094

Tam M, Le MT, Le VN, Le DD, Nguyen VQ, Chen C, et al. Exploration of the role of anti‐Mullerian hormone and LH/FSH ratio in diagnosis of polycystic ovary syndrome. Clin Endocrinol (Offo). 2019;90(4):579-85. DOI: https://doi.org/10.1111/cen.13934

Singh AK, Singh R. Can anti-Mullerian hormone replace ultrasonographic evaluation in polycystic ovary syndrome? A review of current progress. Indian J Endocr Metab. 2015 [acceso: 28/12/2021];19(6):731-43. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4673800/

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. DOI: https://doi.org/10.1093/humupd/dmt062

McLennan IS, Pankhurst MW. Anti-Müllerian hormone is a gonadal cytokine with two circulating forms and cryptic actions. J Endocrinol. 2015;226(3):R45-57. DOI: https://doi.org/10.1530/JOE-15-0206.

Edelsztein NY, Grinspon RP, Schteingart HF, Rey RA. Anti-Müllerian hormone as a marker of steroid and gonadotropin action in the testis of children and adolescents with disorders of the gonadal axis. Int J Pediatr Endocrinol. 2016;2016:20. DOI: https://doi.org/10.1186/s13633-016-0038-2

Karakas SE. New biomarkers for diagnosis and management of polycystic ovary syndrome. Clin Chim Acta. 2017;471:248-53. DOI: https://doi.org/10.1016/j.cca.2017.06.009

Cimino I, Casoni F, Liu X, Messina A, Parkash J, Jamin SP, et al. Novel role for anti-Müllerian hormone in the regulation of GnRH neuron excitability and hormone secretion. Nat Commun. 2016;7:10055. DOI: https://doi.org/10.1038/ncomms10055

Carlsson IB, Scott JE, Visser JA, Ritvos O, Themmen AP, Hovatta O. Anti-Müllerian hormone inhibits initiation of growth of human primordial ovarian follicles in vitro. Hum Reprod. 2006;21(9):2223-7. DOI: https://doi.org/10.1093/humrep/del165

Vigier B, Picard JY, Tran D, Legeai L, Josso N. Production of anti-Müllerian hormone: another homology between Sertoli and granulosa cells. Endocrinology. 1984;114(4):1315-20. DOI: https://doi.org/10.1210/endo-114-4-1315

Pellatt L, Rice S, Dilaver N, Heshri A, Galea R, Brincat M, et al. Anti-Müllerian hormone reduces follicle sensitivity to follicle-stimulating hormone in human granulosa cells. Fertil Steril. 2011;96(5):1246-51. DOI: https://doi.org/10.1016/j.fertnstert.2011.08.015

Durlinger AL, Gruijters MJ, Kramer P, Karels B, Kumar TR, Matzuk MM, et al. Anti-Müllerian hormone attenuates the effects of FSH on follicle development in the mouse ovary. Endocrinology. 2001;142(11):4891-9. DOI: https://doi.org/10.1210/endo.142.11.8486.

Xu J, Bishop CV, Lawson MS, Park BS, Xu F. Anti-Müllerian hormone promotes pre-antral follicle growth, but inhibits antral follicle maturation and dominant follicle selection in primates. Hum Reprod. 2016;31(7):1522-30. DOI: https://doi.org/10.1093/humrep/dew100.

La Marca A, Stabile G, Artenisio AC, Volpe A. Serum anti-Mullerian hormone throughout the human menstrual cycle. Hum Reprod. 2006;21(12):3103-7. DOI: https://doi.org/10.1093/humrep/del291.

Pankhurst MW, Mc Lennan IS. Human blood contains both the uncleaved precursor of anti-Mullerian hormone and a complex of the NH2- and COOH-terminal peptides. Am J Physiol Endocrinol Metab. 2013;305(10):E1241-7. DOI: https://doi.org/10.1152/ajpendo.00395.2013.

Dilaver N, Pellatt L, Jameson E, Ogunjimi M, Bano G, Homburg R, et al. The regulation and signalling of anti-Müllerian hormone in human granulosa cells: relevance to polycystic ovary syndrome. Hum Reprod. 2019;34(12):2467-79. DOI: https://doi.org/10.1093/humrep/dez214.

Qi X, Pang Y, Qiao J. The role of anti-Müllerian hormone in the pathogenesis and pathophysiological characteristics of polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol. 2016;199:82-7. DOI: https://doi.org/10.1016/j.ejogrb.2016.01.029

Oh SR, Choe SY, Cho YJ. Clinical application of serum anti-Müllerian hormone in women. Clin Exp Reprod Med. 2019;46(2):50-9. DOI: https://doi.org/10.5653/cerm.2019.46.2.50

Iliodromiti S, Kelsey TW, Anderson RA, Nelson SM. Can anti-Mullerian hormone predict the diagnosis of polycystic ovary syndrome? A systematic review and meta-analysis of extracted data. J Clin Endocrinol Metab. 2013;98(8):3332-40. DOI: https://doi.org/10.1210/jc.2013-1393

Liu XY, Yang YJ, Tang CL, Wang K, Chen JJ, Teng XM, et al. Elevation of antimüllerian hormone in women with polycystic ovary syndrome undergoing assisted reproduction: effect of insulin. Fertil Steril. 2019;111(1):157-67. DOI: https://doi.org/10.1016/j.fertnstert.2018.09.022

Jamil Z, Fatima SS, Ahmed K, Malik R. Anti-Mullerian Hormone: Above and Beyond Conventional Ovarian Reserve Markers. Dis Markers. 2016;2016:5246217. DOI: https://doi.org/10.1155/2016/5246217

Teede H, Misso M, Tassone EC, Dewailly D, Ng EH, Azziz R, et al. Anti-Müllerian Hormone in PCOS: A Review Informing International Guidelines. Trends Endocrinol Metab. 2019;30(7):467-78. DOI: https://doi.org/10.1016/j.tem.2019.04.006

Han X, McShane M, Sahertian R, White C, Ledger W. Pre-mixing serum samples with assay buffer is a prerequisite for reproducible anti-Mullerian hormone measurement using the Beckman Coulter Gen II assay. Hum Reprod. 2014;29(5):1042-8. DOI: https://doi.org/10.1093/humrep/deu050.

Rustamov O, Smith A, Roberts SA, Yates AP, Fitzgerald C, Krishnan M, et al. Anti-Mullerian hormone: poor assay reproducibility in a large cohort of subjects suggests sample instability. Hum Reprod. 2012;27(10):3085-91. DOI: https://doi.org/10.1093/humrep/des260.

Seifer DB, Golub ET, Lambert G, Benning L, Anastos K, Watts DH, et al. Variations in serum müllerian inhibiting substance between white, black, and Hispanic women. Fertil Steril. 2009;92(5):1674-8. DOI: https://doi.org/10.1016/j.fertnstert.2008.08.110.

Tal R, Seifer DB. Potential mechanisms for racial and ethnic differences in antimüllerian hormone and ovarian reserve. Int J Endocrinol. 2013;2013:818912. DOI: https://doi.org/10.1155/2013/818912.

Meczekalski B, Czyzyk A, Kunicki M, Podfigurna A, Plociennik L, Jakiel G, et al. Fertility in women of late reproductive age: the role of serum anti-Müllerian hormone (AMH) levels in its assessment. J Endocrinol Invest. 2016;39(11):1259-65. DOI: https://doi.org/10.1007/s40618-016-0497-6.

Pankhurst MW. A putative role for anti-Müllerian hormone (AMH) in optimising ovarian reserve expenditure. J Endocrinol. 2017;233(1):R1-R13. DOI: https://doi.org/10.1530/JOE-16-0522.

Łebkowska A, Kowalska I. Anti-Müllerian hormone and polycystic ovary syndrome. Endokrynol Pol. 2017;68(1):74-8. DOI: https://doi.org/10.5603/EP.a2016.0065.

Bhide P, Homburg R. Anti-Müllerian hormone and polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol. 2016;37:38-45. DOI: https://doi.org/10.1016/j.bpobgyn.2016.03.004.

La Marca A, Orvieto R, Giulini S, Jasonni VM, Volpe A, De Leo V. Mullerian-inhibiting substance in women with polycystic ovary syndrome: relationship with hormonal and metabolic characteristics. Fertil Steril. 2004;82(4):970-2. DOI: https://doi.org/10.1016/j.fertnstert.2004.06.001.

Dewailly D, Barbotin AL, Dumont A, Catteau S, Robin G. Role of Anti-Müllerian Hormone in the Pathogenesis of Polycystic Ovary Syndrome. Front Endocrinol (Lausanne). 2020;11:641. DOI: https://doi.org/10.3389/fendo.2020.00641.

Dewailly D, Robin G, Peigne M, Decanter C, Pigny P, Catteau S. Interactions between androgens, FSH, anti-Müllerian hormone and estradiol during folliculogenesis in the human normal and polycystic ovary. Hum Reprod Update. 2016;22(6):709-24. DOI: https://doi.org/10.1093/humupd/dmw027.

Fanchin R, Schonäuer LM, Righini C, Guibourdenche J, Frydman R, Taieb J. Serum anti-Müllerian hormone is more strongly related to ovarian follicular status than serum inhibin B, estradiol, FSH and LH on day 3. Hum Reprod. 2003;18(2):323-7. DOI: https://doi.org/10.1093/humrep/deg042.

Hart R, Doherty DA, Norman RJ, Franks S, Dickinson JE, Hickey M, et al. Serum antimullerian hormone (AMH) levels are elevated in adolescent girls with polycystic ovaries and the polycystic ovarian syndrome (PCOS). Fertil Steril. 2010;94(3):1118-21. DOI: https://doi.org/10.1016/j.fertnstert.2009.11.002.

Li L, Chen X, Mo Y, Chen Y, Wenig M, Yang D. Elevated serum anti-mullerian hormone in adolescent and young adult Chinese patients with polycystic ovary syndrome. Wien Klin Wochenschr. 2010;122(17-18):519-24. DOI: https://doi.org/10.1007/s00508-010-1426-x.

Sopher AB, Grigoriev G, Laura D, Cameo T, Lerner JP, Chang RJ, et al. Anti-Mullerian hormone may be a useful adjunct in the diagnosis of polycystic ovary syndrome in nonobese adolescents. J Pediatr Endocrinol Metab. 2014;27(11-12):1175-9. DOI: https://doi.org/10.1515/jpem-2014-0128.

Carmina E, Fruzzetti F, Lobo RA. Increased anti-Mullerian hormone levels and ovarian size in a subgroup of women with functional hypothalamic amenorrhea: further identification of the link between polycystic ovary syndrome and functional hypothalamic amenorrhea. Am J Obstet Gynecol. 2016;214(6):714.e1-6. DOI: https://doi.org/10.1016/j.ajog.2015.12.055.

Eldar T, Margalioth EJ, Gal M, Ben A, Algur N, Zylber E, et al. Serum anti-Mullerian hormone levels during controlled ovarian hyperstimulation in women with polycystic ovaries with and without hyperandrogenism. Hum Reprod. 2005;20(7):1814-9. DOI: https://doi.org/10.1093/humrep/deh873.

Xi W, Yang Y, Mao H, Zhao X, Liu M, Fu S. Circulating anti-mullerian hormone as predictor of ovarian response to clomiphene citrate in women with polycystic ovary syndrome. J Ovarian Res. 2016;9:3. DOI: https://doi.org/10.1186/s13048-016-0214-2

Ramezanali F, Ashrafi M, Hemat M, Arabipoor A, Jalali S, Moini A. Assisted reproductive outcomes in women with different polycystic ovary syndrome phenotypes: the predictive value of anti-Müllerian hormone. Reprod Biomed Online. 2016;32(5):503-12. DOI: https://doi.org/10.1016/j.rbmo.2016.01.010.

Franks S, Stark J, Hardy K. Follicle dynamics and anovulation in polycystic ovary syndrome. Hum Reprod Update. 2008;14(4):367-78. DOI: https://doi.org/10.1093/humupd/dmn015.

Fonseca HP, Brondi RS, Piovesan FX, Miklos TG, Aldrighi JM. Anti-Mullerian hormone and insulin resistance in polycystic ovary syndrome. Gynecol Endocrinol. 2014;30(9):667-70. DOI: https://doi.org/10.3109/09513590.2014.920004.

Pellatt L, Rice S, Mason HD. Anti-Müllerian hormone and polycystic ovary syndrome: a mountain too high? Reproduction. 2010;139(5):825-33. DOI: https://doi.org/10.1530/REP-09-0415.

Laven JS, Mulders AG, Visser JA, Themmen AP, De Jong FH, Fauser BC. Anti-Müllerian hormone serum concentrations in normoovulatory and anovulatory women of reproductive age. J Clin Endocrinol Metab. 2004;89(1):318-23. DOI: https://doi.org/10.1210/jc.2003-030932.

La Marca A, Pati M, Orvieto R, Stabile G, Carducci A, Volpe A. Serum anti-müllerian hormone levels in women with secondary amenorrhea. Fertil Steril. 2006;85(5):1547-9. DOI: https://doi.org/10.1016/j.fertnstert.2005.10.057.

Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, et al. International PCOS Network. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Hum Reprod. 2018;33(9):1602-18. DOI: https://doi.org/10.1093/humrep/dey256.

Enlaces refback

  • No hay ningún enlace refback.


Copyright (c) 2022 Gilda Monteagudo Peña, Aimee Álvarez Álvarez, Gisel Ovies Carballo, Manuel Gómez Alzugaray, Maité Cabrera Gámez

Licencia de Creative Commons
Esta obra está bajo una licencia de Creative Commons Reconocimiento-NoComercial 4.0 Internacional.