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


METHODS
Prospective randomised study.


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


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


METHODS
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).


CONCLUSIONS
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.
Panidis
Dimitrios
D
Division of Endocrinology and Human Reproduction, Second Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Thessaloniki, Greece. panidisd@med.auth.gr
Georgopoulos
Neoklis A
NA
Piouka
Athanasia
A
Katsikis
Ilias
I
Saltamavros
Alexandros D
AD
Decavalas
George
G
Diamanti-Kandarakis
Evanthia
E
D000293:Adolescent; D000328:Adult; D000726:Androgen Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D000736:Androstenes / Q000009:adverse effects / Q000627:therapeutic use; D054304:Anti-Mullerian Hormone / Q000097:blood*; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D015331:Cohort Studies; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects / Q000627:therapeutic use*; D017373:Cyproterone Acetate / Q000009:adverse effects / Q000627:therapeutic use; D004338:Drug Combinations; D004997:Ethinyl Estradiol / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000209:etiology*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007333:Insulin Resistance; D008687:Metformin / Q000627:therapeutic use*; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D017410:Practice Guidelines as Topic; D055815:Young Adult
D000726:Androgen Antagonists; D000736:Androstenes; D001786:Blood Glucose; D003277:Contraceptives, Oral, Combined; D004338:Drug Combinations; D007004:Hypoglycemic Agents; C534342:drospirenone and ethinyl estradiol combination; D004997:Ethinyl Estradiol; D017373:Cyproterone Acetate; D054304:Anti-Mullerian Hormone; D008687:Metformin