AMH secretion seems not to be influenced by acute GnRH-analogue administration in PCOS patients
Roberto Mioni1, Rosa Ritunnano1, Chiara Cosma2, Laura Zuliani1, Letizia Glinski1, Sara Azzolini1, Luigi Bleve1, Marnie Granzotto1, Piero Maffei1, Diego Faggian2, Nicola Sicolo1 & Roberto Vettor1
Background: Hyperandrogenism and disrupted folliculogenesis are prominent features of polycystic ovary syndrome (PCOS) and are causatively linked to ovarian dysfunction. In PCOS, increased anti-Müllerian hormone (AMH) serum levels have been observed and related to the severity of the phenotype. However, the regulation of AMH in PCOS remains poorly understood. Therefore, we compared AMH secretory pattern after acute exposure to a GnRH-analogue in women affected by PCOS or by other causes of anovulation and hyperandrogenism, such as functional hypothalamic amenorrhea (FHA) and extra-ovarian hyperandrogenaemia (non-PCOSH).
Patients and methods: Of 26 PCOS (23.9±4.8 years), 9 FHA (26.6±2.6 years) and 8 non-PCOSH (21.2±4.5 years) women were studied. Testing was performed at 47 day/cycle, after Liddle test. AMH, LH, FSH, DHEA-S, 17-OHP, A, T, DHT, E2, Inh-B were evaluated at 0-h, and over a 20 and 24-h period after a s.c. injection of Triptorelin (0.1 mg).
Results: Our results are summarized in Table:
|*P<0.05 versus PCOS baseline; †P<0.05 versus FHA baseline; ‡P<0.05 versus PCOS peak; §NS versus baseline values.|
Conclusions: AMH serum levels were increased in PCOS and FHA patients when compared with non-PCOSH subjects, suggesting that extra-ovarian androgens may not be directly involved in the complex AMH regulation network. In contrast with conventional markers of early follicular growth, such as inhibin-B and E2, AMH secretion appears to be independent of gonadotropin acute stimulation in vivo both in PCOS and non-PCOS patients.