title: Bariatric Surgery Reduces Serum Anti-mullerian Hormone Levels in Obese Women With and Without Polycystic Ovarian Syndrome.
abstract: Obesity in fertile women has negative effect on fertility. Anti-mullerian hormone (AMH) represents a good index of fertility, and it is considered a marker of ovarian reserve and of polycystic ovarian syndrome (PCOS) gravity. Previous studies evaluated the relationship between obesity and AMH with contradictory results. The aim of the study was to investigate the relationship between obesity and AMH and the changes of AMH in obese women in reproductive age submitted to bariatric surgery.
  
  
  
  Fifty-five obese patients between 18 and 39 years with (29 patients) and without PCOS (26 patients) were compared with a control group of normal weight women with (24 patients) and without PCOS (19 patients). Fourteen obese women with PCOS and 18 without PCOS underwent to bariatric surgery. Serum AMH, testosterone, androstenedione, and DHEAS were performed in all patients before and 1 year after surgical intervention.
  
  
  
  AMH was significantly higher in the PCOS groups (p < 0.001), both in obese (5.84 ± 3.94 ng/ml) and non-obese women (7.35 ± 4.39 ng/ml). AMH was positively related to testosterone (p < 0.0001), androstenedione (p = 0.0005), and DHEAS (p = 0.003). After bariatric surgery, AMH levels were reduced in the both PCOS (p = 0.02) and non-PCOS group (p = 0.04).
  
  
  
  AMH levels are elevated in PCOS patients regardless of the body weight. Bariatric surgery is effective in the normalization of AMH levels (a possible indirect marker of better fertility) only in obese patients with PCOS.
authors.affiliation: Department of Medical, Surgical and Neurological Sciences, University of Siena, Viale M. Bracci 16, 53100, Siena, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Chiofalo
authors.affiliation: Department of Medical, Surgical and Neurological Sciences, University of Siena, Viale M. Bracci 16, 53100, Siena, Italy. c.ciuoli@ao-siena.toscana.it.
authors.forename: Cristina
authors.initials: C
authors.lastname: Ciuoli
authors.affiliation: Department of Medical, Surgical and Neurological Sciences, University of Siena, Viale M. Bracci 16, 53100, Siena, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Formichi
authors.affiliation: Department of Medical, Surgical and Neurological Sciences, University of Siena, Viale M. Bracci 16, 53100, Siena, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Selmi
authors.affiliation: Department of Medical, Surgical and Neurological Sciences, University of Siena, Viale M. Bracci 16, 53100, Siena, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Forleo
authors.affiliation: Department of Medical, Surgical and Neurological Sciences, University of Siena, Viale M. Bracci 16, 53100, Siena, Italy.
authors.forename: Ornella
authors.initials: O
authors.lastname: Neri
authors.affiliation: Department of Surgical Sciences, Bariatric Surgery Unit, University of Siena, Viale M. Bracci 16, 53100, Siena, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Vuolo
authors.affiliation: Department of Medical, Surgical and Neurological Sciences, University of Siena, Viale M. Bracci 16, 53100, Siena, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Paffetti
authors.affiliation: Department of Medical, Surgical and Neurological Sciences, University of Siena, Viale M. Bracci 16, 53100, Siena, Italy.
authors.forename: Furio
authors.initials: F
authors.lastname: Pacini
mesh_terms: D000293:Adolescent; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D050110:Bariatric Surgery; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D009767:Obesity, Morbid / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000601:surgery; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications / Q000453:epidemiology; D055815:Young Adult
chemical_list: D054304:Anti-Mullerian Hormone
keywords: Anti-mullerian hormone; Bariatric surgery; Obesity; Polycystic ovarian syndrome