title: 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.
  
  
  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.
authors.affiliation: Division of Endocrinology and Human Reproduction, Second Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Thessaloniki, Greece. panidisd@med.auth.gr
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Panidis
authors.forename: Neoklis A
authors.initials: NA
authors.lastname: Georgopoulos
authors.forename: Athanasia
authors.initials: A
authors.lastname: Piouka
authors.forename: Ilias
authors.initials: I
authors.lastname: Katsikis
authors.forename: Alexandros D
authors.initials: AD
authors.lastname: Saltamavros
authors.forename: George
authors.initials: G
authors.lastname: Decavalas
authors.forename: Evanthia
authors.initials: E
authors.lastname: Diamanti-Kandarakis
mesh_terms: 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
chemical_list: 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