OBJECTIVES To evaluate the prognostic value of anti-Mullerian hormone (AMH) levels in estimating the ovarian density of primordial and primary follicles, which can be assumed to reflect the real ovarian reserve. STUDY DESIGN A total of 537 women, average age 30.4 years (range 8.0-43.7 years), underwent ovarian tissue cryopreservation prior to gonadotoxic therapies due to malignant diseases which do not affect ovarian reserve parameters. Standardized ovarian biopsies were obtained, and follicular density was analysed. The prognostic accuracy of serum AMH in estimating ovarian follicle density was evaluated. MAIN OUTCOME MEASURES Histologically determined follicle density, AMH serum concentration and their correlation. RESULTS In children, follicle density was high but AMH concentration was low. AMH concentration was predicted to be maximum at the age of 15.5 years. In women aged over 15.5 years, the relationship between AMH concentration and follicle density was evaluated. Crude analysis revealed that serum AMH levels and follicular density were moderately correlated (r = 0.34, p < 0.001). From the adjusted regression model the predicted value of follicle density of women aged 20, 30 and 40 years as well as the associated 50 % and 95 % prediction intervals (50 % PI and 95 % PI, respectively) were calculated. For example, for women aged 40 years with a serum AMH level of 1 ng/ml, a follicle density of 2.3/mm3 (50 %PI: [1.1, 4.6]; 95 %PI: [0.3, 18]) was predicted. These large prediction intervals demonstrate the low predictive value of serum AMH for the ovarian follicle density. CONCLUSIONS Serum AMH levels have limited prognostic value for the follicle density and therefore for the real ovarian reserve.

中文翻译：

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血清抗苗勒管激素 (AMH) 浓度对原始和初级卵泡密度的预后价值有限，质疑它作为卵巢储备的准确参数

目的 评估抗苗勒管激素 (AMH) 水平在估计原始和初级卵泡的卵巢密度方面的预后价值，可以假设它反映了真实的卵巢储备。研究设计共有 537 名女性，平均年龄 30.4 岁（范围 8.0-43.7 岁），由于不影响卵巢储备参数的恶性疾病在性腺毒性治疗前接受了卵巢组织冷冻保存。获得标准化的卵巢活检，并分析卵泡密度。评估了血清 AMH 在估计卵巢卵泡密度方面的预后准确性。主要观察指标 组织学测定的卵泡密度、AMH 血清浓度及其相关性。结果儿童卵泡密度高，AMH浓度低。预计 AMH 浓度在 15.5 岁时达到最大值。在 15.5 岁以上的女性中，评估了 AMH 浓度与卵泡密度之间的关系。粗略分析显示，血清 AMH 水平和卵泡密度呈中度相关（r = 0.34，p < 0.001）。根据调整后的回归模型，计算了 20、30 和 40 岁女性的卵泡密度预测值以及相关的 50% 和 95% 预测区间（分别为 50% PI 和 95% PI）。例如，对于血清 AMH 水平为 1 ng/ml 的 40 岁女性，预测的卵泡密度为 2.3/mm3（50%PI：[1.1, 4.6]；95%PI：[0.3, 18]）。这些大的预测区​​间表明血清 AMH 对卵巢卵泡密度的预测价值很低。