In-vitro AMH production of ovarian tissue samples in culture correlates with their primordial follicle pool

Objective: We aimed to investigate if there is a correlation between in-vitro AMH production and primordial follicle reserve of the ovarian cortical samples in culture. Methods: Seven patients undergoing laparoscopic excision of ovarian dermoid cysts were included in the study. 0.5 x 0.5 cm of ovarian cortical samples embedded within the cyst wall were removed and cultured for one day. Then, the cultured cortical pieces were fixed, paraffin-embedded and serially sectioned for histormorphometric analysis. AMH and estradiol (E-2) production of the samples after one-day culture period were measured in the spent culture media. Primordial follicle density was expressed as the number of primordial follicles per mm(2). Pearson correlation and linear regression analyses were applied. Results: The mean age of the patients was 29.2 +/- 6.8 (ranging from 18 to 36). There was a negative correlation between age and PF density (r=-0.92, %95CI: -0.99 to -0.76, p <0.001). In-vitro AMH level of the cortical samples was significantly associated with age (R-2 = 0.67, p = 0.023), primordial follicle density (R-2 = 0.71, p = 0.015). There was a borderline significance between in-vitro levels of AMH and E-2 level (R-2 = 0.55, p = 0.058). A similar comparison could not be made for secondary follicles (preantral and small antral follicles) because of their rarity in the histological sections analyzed. Conclusions: This histomorphometric study provides evidence that in-vitro AMH production of the ovarian cortical samples reflects primordial follicle pool of the samples. (C) 2020 Elsevier B.V. All rights reserved.