Biologic markers of ovarian reserve and reproductive aging: application in a cohort study of HIV infection in women

Objective: To compare Mullerian inhibiting substance (MIS) levels in serum obtained during the early follicular phase to those obtained randomly during the menstrual cycle. To determine whether HIV infection influences early follicular MIS levels, an early marker of ovarian aging. Design: A cross-sectional study. Setting: Women's Interagency HIV Study, a multicenter prospective study. Patient(s): Serum samples obtained from 263 (187 HIV infected and 76 uninfected) participants of the Women's Interagency HIV Study who reported menstrual bleeding during the preceding 6 months and who were not taking exogenous hormones. Intervention(s): Early follicular (cycle days 2-5) MIS samples were compared with serum samples that had been obtained without regard to menstrual cycle phase. Comparison samples were obtained within 6 weeks before or within 3 to 6 months after the early follicular samples. Early follicular FSH, E-2, inhibin B, and MIS levels were also compared between the HIV infected and uninfected women. Main Outcome Measure(s): Correlation between early follicular MIS and prior and subsequent samples. Comparison of serum markers of ovarian reserve between HIV positive and negative women. Result(s): The MIS values from early follicular and other random cycle phases were highly correlated with each other (r > 0.93). In multivariate analysis, increased age and FSH level and lower inhibin B levels were associated with lower MIS level; MIS values did not vary by HIV serostatus. Conclusion(s): Without regard to cycle phase, MIS was similar during early follicular phase and highly correlated with early follicular FSH and inhibin Bin women with and without HIV. Measurement of serum MIS offers a simplified method of determining ovarian reserve using specimens obtained without menstrual phase timing. Furthermore, using biologic measures of reproductive aging, we found no evidence that HIV infection influences ovarian aging. (Fertil Steril((R)) 2007;88:1645-52. (c) 2007 by American Society for Reproductive Medicine.).