Abstract
Anti-Müllerian hormone (AMH) is largely expressed throughout folliculogenesis and
its levels may represent both the quantity and quality of ovarian follicle pool. We
conducted this study to evaluate the levels of AMH in women with polycystic ovarian
syndrome (PCOS) before and after metformin therapy. 22 consecutive patients with PCOS
and 20 healthy age-matched controls were investigated. The patients received 2 550 mg/day
metformin for 6 months. Serum levels of AMH, sex hormones, insulin, blood glucose,
and lipids were measured before and after metformin therapy. The basal AMH levels
in patients with PCOS (42.34±6.42 pmol/l) were significantly elevated in comparison
with the controls (21.58±3.41 pmol/l), p=0.008. 17 patients completed 6 months therapy
with metformin. Of them, 13 responded clinically by restoration of regular menstrual
cycles. The AMH levels of these 13 women decreased from 45.67±9.30 pmol/l to 38.25±6.89 pmol/l
(16.27%). In the other 4 patients who did not show satisfactory clinical response
to metformin, AMH levels increased from 31.30±16.52 to 80.77±12.73 (p=0.021). The
patients who responded to metformin were significantly overweight, had higher BMI,
waist circumference, body fat, and blood pressure as compared to nonresponders. AMH
levels are significantly elevated in women with PCOS and they may serve as a marker
for evaluation of treatment efficacy with metformin. Furthermore, obese PCOS patients
are more likely to respond to metformin therapy with maximal doses as compared to
the ones with low body mass index.
Key words
anti-Müllerian hormone - polycystic ovary syndrome - hyperandrogenism - hyperinsulinism
- testosterone
