title: Antimüllerian hormone levels decrease in female-to-male transsexuals using testosterone as cross-sex therapy.
abstract: OBJECTIVE
  To investigate the effect of hormonal androgenic treatment on antimüllerian hormone (AMH) serum levels in female-to-male (FtM) transsexuals. Polycystic ovary syndrome (PCOS) is associated with elevated AMH levels. Some hypothesize that the high AMH level is a consequence of androgen-induced excessive development of small antral follicles. However, this role of androgens is not yet clear.
  
  
  METHODS
  Observational, prospective, cohort study.
  
  
  METHODS
  Tertiary academic medical center.
  
  
  METHODS
  Twenty-two FtM transsexuals, healthy native females receiving cross-sex hormone therapy/androgenic treatment.
  
  
  METHODS
  Androgenic treatment with testosterone (T) and an aromatase inhibitor while endogenous hormone secretion was suppressed with the use of a GnRH agonist.
  
  
  METHODS
  Hormone concentrations were measured before and after androgenic treatment (administration of T and aromatase inhibitor). Measured hormones: AMH, inhibin B, T, androstenedione, DHEAS, E2, SHBG, LH, and FSH.
  
  
  RESULTS
  AMH concentrations were significantly lower after androgenic treatment (4.4 ± 4.4 μg/L vs. 1.4 ± 2.1 μg/L). Androgenic treatment resulted in a strong suppression of AMH secretion over a relative short period of 16 weeks.
  
  
  CONCLUSIONS
  Our data underscore the likely important role of androgens in the dynamics of folliculogenesis. It challenges the idea that androgens induce high AMH levels, which is gaining more interest nowadays as an important particular PCOS feature. This strong decline furthermore indicates that AMH must be interpreted in the context of other reproductive endocrine conditions.
  
  
  BACKGROUND
  NTR2493.
authors.affiliation: Division of Reproductive Medicine, Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, the Netherlands. Electronic address: m.caanen@vumc.nl.
authors.forename: Mirte R
authors.initials: MR
authors.lastname: Caanen
authors.affiliation: Division of Reproductive Medicine, Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, the Netherlands; Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, the Netherlands; Department of Medical Psychology, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: Remi S
authors.initials: RS
authors.lastname: Soleman
authors.affiliation: Division of Reproductive Medicine, Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: Esther A M
authors.initials: EA
authors.lastname: Kuijper
authors.affiliation: Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, the Netherlands; Department of Medical Psychology, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: Baudewijntje P C
authors.initials: BP
authors.lastname: Kreukels
authors.affiliation: Department of Reproductive Medicine, University Hospital Ghent, Ghent, Belgium.
authors.forename: Chloë
authors.initials: C
authors.lastname: De Roo
authors.affiliation: Department of Reproductive Medicine, University Hospital Ghent, Ghent, Belgium.
authors.forename: Kelly
authors.initials: K
authors.lastname: Tilleman
authors.affiliation: Department of Reproductive Medicine, University Hospital Ghent, Ghent, Belgium.
authors.forename: Petra
authors.initials: P
authors.lastname: De Sutter
authors.affiliation: Division of Reproductive Medicine, Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, the Netherlands; Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: Mick A A
authors.initials: MA
authors.lastname: van Trotsenburg
authors.affiliation: Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Broekmans
authors.affiliation: Division of Reproductive Medicine, Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, the Netherlands; Department of Reproductive Medicine, University Hospital Ghent, Ghent, Belgium.
authors.forename: Cornelis B
authors.initials: CB
authors.lastname: Lambalk
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000728:Androgens / Q000627:therapeutic use*; D054304:Anti-Mullerian Hormone / Q000097:blood*; D047072:Aromatase Inhibitors / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D015536:Down-Regulation; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D008297:Male; D010053:Ovary / Q000187:drug effects / Q000378:metabolism; D011446:Prospective Studies; D057829:Gender-Affirming Procedures / Q000379:methods*; D062606:Tertiary Care Centers; D013739:Testosterone / Q000627:therapeutic use*; D013997:Time Factors; D014189:Transsexualism / Q000097:blood / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000728:Androgens; D047072:Aromatase Inhibitors; D015415:Biomarkers; D007987:Gonadotropin-Releasing Hormone; D013739:Testosterone; D054304:Anti-Mullerian Hormone
keywords: Antimüllerian hormone; androgens; folliculogenesis; polycystic ovary syndrome; transgender