P503 - LBA_ECE_1463 - Anti-Müllerian hormone as a marker of gonadotropic–androgenic interaction during female development

Abstract

The interpretation of anti-Müllerian hormone (AMH) in paediatric and adolescent populations remains uncertain, as its clinical use is largely extrapolated from adult ovarian reserve models. This study aimed to define age-dependent endocrine correlates of AMH across female development, with particular focus on pubertal maturation. A retrospective cross-sectional study included 238 females from late infancy to early adulthood undergoing routine endocrine assessment. Participants were stratified by developmental stage. Associations between AMH and gonadotropins (LH, FSH, LH/FSH ratio), androgens, estradiol and selected endocrine parameters were analysed using Spearman correlation. In adolescents, receiver operating characteristic (ROC) analysis was performed using an AMH threshold of 30 pmol/L. AMH demonstrated stage-dependent associations with hormonal parameters. In early life, AMH was inversely correlated with FSH, most strongly in toddlerhood (ρ = −0.70, P = .0001) and early childhood (ρ = −0.30, P = .04), consistent with preserved ovarian–pituitary feedback. During adolescence, the association profile shifted, with positive correlations between AMH and LH (ρ = 0.30, P = .03) and androstenedione (ρ = 0.50, P = .02). Adolescents with AMH ≥30 pmol/L showed a higher LH/FSH ratio (P = .004) and increased androstenedione levels (P = .01), alongside lower total testosterone (P = .009). ROC analysis demonstrated the highest discriminatory performance for androstenedione (AUC = 0.78, P < .01), followed by LH/FSH ratio and total testosterone (both AUC = 0.70, P < .05). AMH reflects distinct, age-dependent endocrine patterns in females. In adolescence, elevated AMH is associated with LH-dominant gonadotropic activity and increased androgen production, particularly androstenedione, supporting its interpretation as a marker of functional endocrine phenotype rather than ovarian reserve alone.