This work aimed to explore the expression pattern of circulating miR-199a-3p, miR-21-5p and miR-let7i-3p in infertile women with dysregulated AMH levels. Quantitative real-time PCR was used to measure miR-199a-3p, miR-21-5p, and miR-let7i-3p expression levels in 60 plasma samples of infertile women with low or high AMH levels. Bioinformatic analyses for microRNAs predicting target genes and molecular pathways were performed according to gene ontology (GO) analysis and KEGG pathways. Only miR-199a-3p and miR-21-5p were significantly over and under-expressed, respectively, in the plasma samples of all infertile women with low or high AMH levels versus controls (p-value = 0.01). Furthermore, the diagnostic value miR-199a-3p yielded a receiver operating characteristic (ROC) curve with area under the curve (AUC) of 0.82 with a 95% CI [0.72-0.92] and an AUC of 0.81, for miR-21-5p, 95% CI [0.69-0.92]. The combined ROC curve of miR-21 and miR-199a provided an optimal combination with AUC = 0.98, 95% CI [0.96-1], and, a cut-off point (0.42) which provided 98% sensitivity and 87% specificity. In conclusion, circulating miR-199a-3p and miR-21-5p vary significantly whenever AMH levels of infertile women are disturbed and could potentially serve as non-invasive biomarkers in distinguishing infertile from fertile women.
Keywords: AMH; biomarkers; female infertility; miR-199a; miR-21.