{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T03:46:10Z","timestamp":1778643970117,"version":"3.51.4"},"reference-count":31,"publisher":"The Endocrine Society","issue":"5","license":[{"start":{"date-parts":[[2020,3,14]],"date-time":"2020-03-14T00:00:00Z","timestamp":1584144000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Different phenotypical features of women with hypothalamic hypogonadism (HH), also known as World Health Organization-1 anovulation, including ovarian morphology, have been scarcely described in large cohorts. Some studies have reported increased levels of anti-M\u00fcllerian hormone (AMH) in women with HH.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To assess whether women with HH, compared with healthy controls, have increased serum levels of AMH and what proportion of these women erroneously meet the Rotterdam Criteria for Polycystic Ovarian Syndrome (PCOS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design, Setting and Participants<\/jats:title>\n                  <jats:p>Retrospective cohort study in a Dutch academic medical center including 83 women with neither anovulation nor menstrual cycle disorders (healthy controls), 159 women with HH and 3640 women with PCOS. Age matching was used between the HH and PCOS group (1:2 ratio) to create a second group consisting of 318 age-matched women with PCOS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Intervention<\/jats:title>\n                  <jats:p>None.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measures<\/jats:title>\n                  <jats:p>AMH levels and ovarian morphology.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Median AMH serum levels for the HH group were 3.8 (&amp;lt;0.1\u201319.8), compared with 7.5 (&amp;lt;0.1\u201381.0) in the PCOS group and 1.9 (&amp;lt;0.1\u201321.5) in the control group (P\u2005&amp;lt;\u20050.001). In the HH group, 58 (36%) erroneously met the Rotterdam Criteria for PCOS (meeting 2 of 3 criteria).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>AMH levels are increased in women with HH. We hypothesize that this increase, although there was no increase in follicle count, may be explained by the presence of a relatively large pool of antral follicles smaller than 2 mm in diameter, that are undetectable by transvaginal ultrasound. This study highlights the importance of measuring gonadotropins and estradiol before diagnosing a patient with PCOS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgaa116","type":"journal-article","created":{"date-parts":[[2020,3,14]],"date-time":"2020-03-14T07:17:30Z","timestamp":1584170250000},"page":"e2008-e2014","source":"Crossref","is-referenced-by-count":24,"title":["Anti-M\u00fcllerian Hormone and Ovarian Morphology in Women With Hypothalamic Hypogonadism"],"prefix":"10.1210","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3056-1581","authenticated-orcid":false,"given":"Amoon","family":"Alemyar","sequence":"first","affiliation":[{"name":"Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus University Medical Centre, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0497-3814","authenticated-orcid":false,"given":"Anne-Lotte L F","family":"van der Kooi","sequence":"first","affiliation":[{"name":"Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus University Medical Centre, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5444-9845","authenticated-orcid":false,"given":"Joop S E","family":"Laven","sequence":"first","affiliation":[{"name":"Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus University Medical Centre, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2020,3,14]]},"reference":[{"issue":"7414","key":"2020051909382922500_CIT0001","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1136\/bmj.327.7414.546","article-title":"Anovulation","volume":"327","author":"Hamilton-Fairley","year":"2003","journal-title":"BMJ."},{"issue":"6","key":"2020051909382922500_CIT0002","first-page":"1549","article-title":"The ESHRE Capri Workshop Group","volume":"10","author":"Anovulatory infertility","year":"1995","journal-title":"Hum Reprod"},{"key":"2020051909382922500_CIT0003","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.ejogrb.2015.01.007","article-title":"The role of anti-M\u00fcllerian hormone in the classification of anovulatory infertility","volume":"186","author":"Lie Fong","year":"2015","journal-title":"Eur J Obstet Gynecol Reprod Biol."},{"issue":"1","key":"2020051909382922500_CIT0004","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1080\/09513590701807381","article-title":"Functional hypothalamic amenorrhea: current view on neuroendocrine aberrations","volume":"24","author":"Meczekalski","year":"2008","journal-title":"Gynecol Endocrinol."},{"issue":"6","key":"2020051909382922500_CIT0005","first-page":"2049","article-title":"Severity of osteopenia in estrogen-deficient women with anorexia nervosa and hypothalamic amenorrhea","volume":"84","author":"Grinspoon","year":"1999","journal-title":"J Clin Endocrinol Metab."},{"issue":"4","key":"2020051909382922500_CIT0006","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1007\/s00198-007-0518-6","article-title":"Strategies to reverse bone loss in women with functional hypothalamic amenorrhea: a systematic review of the literature","volume":"19","author":"Vescovi","year":"2008","journal-title":"Osteoporos Int."},{"issue":"11","key":"2020051909382922500_CIT0007","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1007\/s40618-014-0169-3","article-title":"Functional hypothalamic amenorrhea and its influence on women\u2019s health","volume":"37","author":"Meczekalski","year":"2014","journal-title":"J Endocrinol Invest."},{"issue":"3","key":"2020051909382922500_CIT0008","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/S0735-1097(02)02763-8","article-title":"Hypoestrogenemia of hypothalamic origin and coronary artery disease in premenopausal women: a report from the NHLBI-sponsored WISE study","volume":"41","author":"Bairey Merz","year":"2003","journal-title":"J Am Coll Cardiol."},{"issue":"12","key":"2020051909382922500_CIT0009","doi-asserted-by":"crossref","first-page":"5957","DOI":"10.1210\/jc.2003-030727","article-title":"Elevated serum level of anti-mullerian hormone in patients with polycystic ovary syndrome: relationship to the ovarian follicle excess and to the follicular arrest","volume":"88","author":"Pigny","year":"2003","journal-title":"J Clin Endocrinol Metab."},{"issue":"4","key":"2020051909382922500_CIT0010","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1093\/humupd\/dmn015","article-title":"Follicle dynamics and anovulation in polycystic ovary syndrome","volume":"14","author":"Franks","year":"2008","journal-title":"Hum Reprod Update."},{"issue":"1","key":"2020051909382922500_CIT0011","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1210\/jc.2003-030932","article-title":"Anti-M\u00fcllerian hormone serum concentrations in normoovulatory and anovulatory women of reproductive age","volume":"89","author":"Laven","year":"2004","journal-title":"J Clin Endocrinol Metab."},{"issue":"7","key":"2020051909382922500_CIT0012","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/j.tem.2019.04.006","article-title":"Anti-m\u00fcllerian hormone in PCOS: a review informing international guidelines","volume":"30","author":"Teede","year":"2019","journal-title":"Trends Endocrinol Metab."},{"issue":"5","key":"2020051909382922500_CIT0013","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1016\/j.fertnstert.2011.08.015","article-title":"Anti-M\u00fcllerian hormone reduces follicle sensitivity to follicle-stimulating hormone in human granulosa cells","volume":"96","author":"Pellatt","year":"2011","journal-title":"Fertil Steril."},{"issue":"1","key":"2020051909382922500_CIT0014","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.fertnstert.2011.10.031","article-title":"A characterization of the relationship of ovarian reserve markers with age","volume":"97","author":"Rosen","year":"2012","journal-title":"Fertil Steril."},{"issue":"2","key":"2020051909382922500_CIT0015","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/S0015-0282(01)02993-4","article-title":"Antim\u00fcllerian hormone serum levels: a putative marker for ovarian aging","volume":"77","author":"de Vet","year":"2002","journal-title":"Fertil Steril."},{"issue":"4","key":"2020051909382922500_CIT0016","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1080\/09513590.2017.1395842","article-title":"Features of polycystic ovary syndrome (PCOS) in women with functional hypothalamic amenorrhea (FHA) may be reversible with recovery of menstrual function","volume":"34","author":"Carmina","year":"2018","journal-title":"Gynecol Endocrinol."},{"issue":"1","key":"2020051909382922500_CIT0017","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1093\/humrep\/deh098","article-title":"Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS)","volume":"19","author":"Rotterdam ESHRE\/ASRM-Sponsored PCOS Consensus Workshop Group","year":"2004","journal-title":"Hum Reprod"},{"issue":"3","key":"2020051909382922500_CIT0018","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/j.fertnstert.2018.05.004","article-title":"Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome","volume":"110","author":"Teede","year":"2018","journal-title":"Fertil Steril."},{"key":"2020051909382922500_CIT0019","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1210\/jcem-21-11-1440","article-title":"Clinical assessment of body hair growth in women","volume":"21","author":"Ferriman","year":"1961","journal-title":"J Clin Endocrinol Metab."},{"issue":"7","key":"2020051909382922500_CIT0020","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1016\/0002-9378(81)90746-8","article-title":"Hirsutism: implications, etiology, and management","volume":"140","author":"Hatch","year":"1981","journal-title":"Am J Obstet Gynecol."},{"issue":"12","key":"2020051909382922500_CIT0021","doi-asserted-by":"crossref","first-page":"4650","DOI":"10.1210\/jc.2012-1440","article-title":"Serum anti-m\u00fcllerian hormone levels in healthy females: a nomogram ranging from infancy to adulthood","volume":"97","author":"Lie Fong","year":"2012","journal-title":"J Clin Endocrinol Metab."},{"issue":"2","key":"2020051909382922500_CIT0022","first-page":"540","article-title":"Detection of minimal levels of serum anti-M\u00fcllerian hormone during follow-up of patients with ovarian granulosa cell tumor by means of a highly sensitive enzyme-linked immunosorbent assay","volume":"85","author":"Long","year":"2000","journal-title":"J Clin Endocrinol Metab."},{"issue":"5","key":"2020051909382922500_CIT0023","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.1016\/j.fertnstert.2014.08.001","article-title":"Cardiovascular and metabolic profiles amongst different polycystic ovary syndrome phenotypes: who is really at risk?","volume":"102","author":"Daan","year":"2014","journal-title":"Fertil Steril."},{"issue":"6","key":"2020051909382922500_CIT0024","doi-asserted-by":"crossref","first-page":"714.e1","DOI":"10.1016\/j.ajog.2015.12.055","article-title":"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","volume":"214","author":"Carmina","year":"2016","journal-title":"Am J Obstet Gynecol."},{"issue":"1","key":"2020051909382922500_CIT0025","doi-asserted-by":"crossref","first-page":"34","DOI":"10.3109\/09513590.2011.579664","article-title":"Serum anti-M\u00fcllerian hormone, inhibin B, and total inhibin levels in women with hypothalamic amenorrhea and anorexia nervosa","volume":"28","author":"Luisi","year":"2012","journal-title":"Gynecol Endocrinol."},{"issue":"2","key":"2020051909382922500_CIT0026","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1093\/molehr\/gah015","article-title":"Anti-M\u00fcllerian hormone expression pattern in the human ovary: potential implications for initial and cyclic follicle recruitment","volume":"10","author":"Weenen","year":"2004","journal-title":"Mol Hum Reprod."},{"issue":"5","key":"2020051909382922500_CIT0027","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1530\/REP-09-0415","article-title":"Anti-M\u00fcllerian hormone and polycystic ovary syndrome: a mountain too high?","volume":"139","author":"Pellatt","year":"2010","journal-title":"Reproduction."},{"issue":"1","key":"2020051909382922500_CIT0028","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1093\/humrep\/deh560","article-title":"The ovarian markers of the FSH insufficiency in functional hypothalamic amenorrhoea","volume":"20","author":"Jonard","year":"2005","journal-title":"Hum Reprod."},{"issue":"4","key":"2020051909382922500_CIT0029","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1016\/j.fertnstert.2006.11.004","article-title":"Predictors of recovery of ovarian function during weight gain in anorexia nervosa","volume":"87","author":"van Elburg","year":"2007","journal-title":"Fertil Steril"},{"issue":"4","key":"2020051909382922500_CIT0030","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1210\/jc.2006-2501","article-title":"Androgens in women with anorexia nervosa and normal-weight women with hypothalamic amenorrhea","volume":"92","author":"Miller","year":"2007","journal-title":"J Clin Endocrinol Metab."},{"issue":"5","key":"2020051909382922500_CIT0031","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1111\/ajo.12647","article-title":"Elevated anti-Mullerian hormone in lean women may not indicate polycystic ovarian syndrome","volume":"57","author":"Bradbury","year":"2017","journal-title":"Aust N Z J Obstet Gynaecol."}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgaa116\/32905031\/dgaa116.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/105\/5\/e2008\/33232795\/dgaa116.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/105\/5\/e2008\/33232795\/dgaa116.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T14:53:05Z","timestamp":1589899985000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/105\/5\/e2008\/5805240"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,14]]},"references-count":31,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2020,5,1]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgaa116","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,5]]},"published":{"date-parts":[[2020,3,14]]}}}