The impact of oral contraceptives and metformin on anti-Müllerian hormone serum levels in women with polycystic ovary syndrome and biochemical hyperandrogenemia.

Abstract

OBJECTIVE:

To assess the impact of metformin and of two different oral contraceptives (OCs) containing cyproterone acetate and drospirenone, on serum anti-Müllerian hormone (AMH) levels, in a cohort of women with polycystic ovary syndrome (PCOS) with hyperandrogenism.

DESIGN:

Prospective randomised study.

SETTING:

Division of Endocrinology and Human Reproduction, Aristotle University of Thessaloniki.

PATIENTS:

Forty-five (45) women with PCOS diagnosed according to the criteria proposed in 1990 by the NIH.

INTERVENTIONS:

Women with PCOS were randomised into three groups, all treated for 6 months: Group A received an OC containing 35 μg ethinylestradiol plus 2 mg cyproterone acetate, Group B received an OC containing 30 μg ethinylestradiol plus 3 mg drospirenone and Group C received metformin 850 mg × 2. Main outcome measure(s). Anti-Müllerian hormone levels were measured by a specific ELISA.

RESULTS:

AMH was significantly decreased under treatment with 35 μg ethinylestradiol plus 2 mg cyproterone acetate (p = 0.002 at 3 months and p < 0.001 at 6 months). Treatment with 30 μg ethinylestradiol plus 3 mg drospirenone, and treatment with metformin 850 mg × 2 did not significantly affect serum AMH levels. AMH was significantly decreased under OCs treatment compared to metformin 850 mg × 2 (p = 0.005).

CONCLUSION(S):

AMH serum levels were significantly decreased under treatment with 35 μg ethinylestradiol plus 2 mg cyproterone acetate, due to decrease in androgens and suppression of gonadotropins.

• Authors: Dimitrios Panidis, Neoklis A Georgopoulos, Athanasia Piouka, Ilias Katsikis, Alexandros D Saltamavros, George Decavalas, Evanthia Diamanti-Kandarakis
• Journal: Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology (Gynecol Endocrinol) Vol. 27 Issue 8 Pg. 587-92 (Aug 2011) ISSN: 1473-0766 [Electronic] England
• PMID: 20836726 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Androgen Antagonists
• Androstenes
• Blood Glucose
• Contraceptives, Oral, Combined
• Drug Combinations
• Hypoglycemic Agents
• drospirenone and ethinyl estradiol combination
• Ethinyl Estradiol
• Cyproterone Acetate
• Anti-Mullerian Hormone
• Metformin

Topics

• Adolescent
• Adult
• Androgen Antagonists (adverse effects, therapeutic use)
• Androstenes (adverse effects, therapeutic use)
• Anti-Mullerian Hormone (blood)
• Blood Glucose (analysis)
• Body Mass Index
• Cohort Studies
• Contraceptives, Oral, Combined (adverse effects, therapeutic use)
• Cyproterone Acetate (adverse effects, therapeutic use)
• Drug Combinations
• Ethinyl Estradiol (adverse effects, therapeutic use)
• Female
• Humans
• Hyperandrogenism (etiology)
• Hypoglycemic Agents (therapeutic use)
• Insulin Resistance
• Metformin (therapeutic use)
• Polycystic Ovary Syndrome (blood, diagnosis, drug therapy, physiopathology)
• Practice Guidelines as Topic
• Young Adult