Antimullerian hormone and obesity: insights in oral contraceptive users☆
Received 15 May 2009; received in revised form 24 September 2009; accepted 6 October 2009. published online 16 November 2009.
Abstract
Background
The study was conducted to examine the impact of oral contraceptives (OCs) on serum antimullerian hormone (AMH) levels by obesity status in reproductive-age women.
Study Design
Ovulatory women, ages 18–35 years, of normal (<25 kg/m2; n=10) and obese (>30 kg/m2; n=10) body mass index (BMI) received a low-dose OC (20 mcg ethinyl estradiol/100 mcg levonorgestrel) for two cycles. Serum samples obtained at several time points during active pill use and hormone-free intervals were analyzed for AMH, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol and inhibin B.
Results
AMH levels did not differ by OC cycle day in either BMI group. On average, AMH levels were 34% lower in the obese group (2.9±2.1 vs. 4.4±1.8 ng/mL, p<.05). Modeling to determine differences in AMH throughout the cycle based on obesity status demonstrated significantly lower levels (p<.05), whereas serum AMH, FSH, LH, estradiol and inhibin B levels revealed no correlations when all time points were included.
Conclusions
In reproductive-age women, serum AMH levels do not appear to fluctuate during OC use, but AMH levels are significantly lower in obese women. Lower levels do not appear to be due to differences in gonadotropin levels or ovarian activity.
aDepartment of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC 27599, USA
bDepartment of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA 90033, USA
cDepartment of Obstetrics and Gynecology, Oregon Health Science University (OHSU), Portland, OR 97239, USA
Corresponding author.
☆ Financial support: HD 01243-03 Women's Reproductive Health Research Fellow (NICHD K-12), PHS Grant 5 M01 RR000334, 1 R03 HD 053611-01, UNC WRHR HD 050113-02 and the University of North Carolina: University Research Council Grant.
ABSTRACT