title: Anti-mullerian hormone is higher in seizure-free women with epilepsy compared to those with ongoing seizures.
abstract: To determine if anti-mullerian hormone (AMH), a neuroactive peptide hormone and a measure of ovarian reserve, is different between women with epilepsy (WWE) and healthy controls (HC) seeking pregnancy and to evaluate epilepsy-related factors associated with AMH concentrations.
  
  
  
  Subjects were participants in Women with Epilepsy: Pregnancy Outcomes and Deliveries (WEPOD), a multi-center prospective, observational cohort study evaluating fecundity in WWE compared to HC, ages 18-40 years. WWE were divided into a Sz+ group or a Sz- group, dependent on whether they had seizures within the 9 months prior to enrollment. Serum was collected, and AMH concentrations were measured as an exploratory analysis. Linear and logistic regression models were used to assess associations and control for covariates.
  
  
  
  Serum AMH concentrations were measured in 72 out of 90 enrolled WWE and 97 out of 109 HC; the remaining subjects became pregnant before serum was obtained. Thirty WWE were in the Sz+ group and 40 in the Sz- group (retrospective seizure information was missing for two). All AMH concentrations were within the range, however, the normal inverse correlation between age and AMH was present in the HC and in the Sz- groups, but was lacking in the Sz+ group. Mean AMH concentration was higher in the Sz- group (3982pg/ml (SD+/-2452)) compared to the Sz+ group of WWE (2776pg/ml (SD+/-2308)) and HCs (3241 (SD±2647)). All values were within the expected range for age. In WWE, by linear regression, after controlling for age and BMI, seizure occurrence remained associated with AMH (p=0.025). In the prospective phase of the study, AMH concentrations were also associated with seizure occurrence during the menstrual cycle in which the serum sample was obtained (p=0.012). Antiepileptic drugs and other epilepsy factors were not associated with AMH concentrations. When analyzing the Sz- WWE group and the HC group by linear regression with AMH as the dependent variable, after controlling for age and BMI, the association with AMH was also present (p=0.017). AMH concentrations of the Sz+ group and HCs did not differ.
  
  
  
  In this exploratory analysis, seizure freedom was associated with higher AMH concentrations compared to women with ongoing seizures and to HCs. Future studies should further investigate the mechanism of the association of AMH with seizure occurrence, whether AMH could have a direct seizure-protective neuroactive hormone effect, as well as implications of AMH concentrations as a biomarker for ovarian reserve in women with epilepsy.
authors: Icahn School of Medicine at Mount Sinai, 1428 Madison Ave, New York, NY, 11029, USA. Electronic address: charden@chpnet.org.
authors: Cynthia L
authors: CL
authors: Harden
authors: Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA. Electronic address: ppennell@partners.org.
authors: Page B
authors: PB
authors: Pennell
authors: NYU School of Medicine, 462 1st Avenue, New York, NY, 10016, USA. Electronic address: Jacqueline.French@nyumc.org.
authors: Jacqueline A
authors: JA
authors: French
authors: Columbia University Medical Center, 630 W 168th St, New York, NY, 10032, USA. Electronic address: ard4@cumc.columbia.edu.
authors: Anne
authors: A
authors: Davis
authors: Northwell Health, 611 Northern Boulevard, Great Neck, NY, 11021, USA. Electronic address: clau@northwell.edu.
authors: Connie
authors: C
authors: Lau
authors: Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA. Electronic address: nllewellyn@partners.org.
authors: Nichelle
authors: N
authors: Llewellyn
authors: NYU School of Medicine, 462 1st Avenue, New York, NY, 10016, USA. Electronic address: bennyrkaufman@gmail.com.
authors: Benjamin
authors: B
authors: Kaufman
authors: Icahn School of Medicine at Mount Sinai, 1428 Madison Ave, New York, NY, 11029, USA. Electronic address: emilia.bagiella@mountsinai.org.
authors: Emilia
authors: E
authors: Bagiella
authors: Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA. Electronic address: ariel.kirshenbaum@gmail.com.
authors: Ariel
authors: A
authors: Kirshenbaum
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D000927:Anticonvulsants / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D004827:Epilepsy / Q000097:blood* / Q000188:drug therapy; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D011247:Pregnancy; D011446:Prospective Studies; D012189:Retrospective Studies; D012640:Seizures / Q000097:blood* / Q000188:drug therapy; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D015415:Biomarkers; D054304:Anti-Mullerian Hormone
keywords: AMH; Anti-mullerian hormone; Epilepsy; Ovarian reserve; Seizures