Anti-müllerian hormone and insulin-like 3 levels in healthy normal-weight ovulatory and anovulatory eumenorrheic late adolescent females: potential early biomarkers of ovarian dysfunction?

ObjectiveThe aim of this study was to evaluate differences in anti-müllerian hormone (AMH) and insulin-like 3 (INSL3) levels and their association with gonadotropin and ovarian steroid hormones, as expression of ovarian function, between healthy normal-weight ovulatory and anovulatory eumenorrheic late adolescent females.Study designThis study analyzed AMH and INSL3 levels in forty healthy eumenorrheic late adolescent females (aged 16–19 ys), selected from a cross-sectional epidemiological study performed on the prevalence of hyperandrogenic states. The subjects were divided into ovulatory (n: 28) and anovulatory (n: 12) groups in accordance to a previous cluster analysis based on progesterone (P) distribution measured once in the latter part of the cycle. Both groups were compared for anthropometric, biochemical and hormonal parameters.ResultsINSL3 and AMH were detectable in all samples. Testosterone (P = 0.01), the free-androgen index (FAI) (P = 0.051), gonadotropins (LH: P = 0.02; FSH: P = 0.004) and AMH (P = 0.02) levels were significantly higher in the anovulatory group with respect to their ovulatory counterpart. A trend toward significantly higher INSL3 concentrations (P = 0.08) was also shown in the anovulatory group. A positive correlation between INSL3 levels and androgens such as androstenedione (r = 0.38; P = 0.02), testosterone (r = 0.44; P = 0.004) and FAI (r = 0.42; P = 0.006) and a negative borderline significant correlation (r = −0.30; P = 0.055) between AMH and P were shown in all subjects.ConclusionHealthy eumenorrheic late adolescent females with sporadic anovulation display higher AMH and INSL-3 blood concentrations in association with higher androgen levels compared with age- and BMI-matched subjects with ovulatory cycle, suggesting evidence of an earlier ovarian dysfunction.