Anti-Müllerian hormone, testosterone and free androgen index following the dose-adjusted unilateral diathermy in women with polycystic ovary syndrome

M Sunj; T Canic; A Jeroncic; D Karelovic; M Tandara; S Juric; I Palada

doi:10.1016/j.ejogrb.2014.05.011

Anti-Müllerian hormone, testosterone and free androgen index following the dose-adjusted unilateral diathermy in women with polycystic ovary syndrome

Eur J Obstet Gynecol Reprod Biol. 2014 Aug:179:163-9. doi: 10.1016/j.ejogrb.2014.05.011. Epub 2014 Jun 2.

Authors

M Sunj¹, T Canic², A Jeroncic³, D Karelovic⁴, M Tandara¹, S Juric³, I Palada¹

Affiliations

¹ Department of Obstetrics and Gynecology, University of Split, Split University Medical Centre, Split, Croatia.
² Department of Obstetrics and Gynecology, University of Zagreb, Zagreb University Medical Centre, Zagreb, Croatia.
³ Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia.
⁴ Department of Obstetrics and Gynecology, University of Split, Split University Medical Centre, Split, Croatia. Electronic address: deni.karelovic@kbsplit.hr.

PMID: 24965999
DOI: 10.1016/j.ejogrb.2014.05.011

Abstract

Objective: The aim of this study was to investigate changes of anti-Müllerian hormone, testosterone and free androgen index after two diathermy methods. We have also aimed at evaluating prognostic value of these parameters for an ovulatory response.

Study design: This prospective, comparative study included ninety-six women with polycystic ovary syndrome unresponsive to clomiphene citrate. Patients were assigned to two groups; the first group underwent unilateral laparoscopic ovarian drilling with thermal doses adjusted to ovarian volume: median of 720J (IQR), while the second group underwent bilateral drilling with fixed doses of 1200J. Anti-Müllerian hormone (AMH), testosterone (T), free androgen index (FAI)and luteinizing hormone (LH) were measured at baseline, at 1st and 6th month of follow up.

Results: AMH, T and LH levels significantly decreased (P<0.001, P≤0.024, P<0.001) after diathermy in both responders and nonresponders from either treatment group. On contrary, FAI levels (P<0.001) significantly changed only in responders, irrespective of the treatment. In 1st and 6th month of follow up median levels of AMH, T and FAI among responders from different treatment groups were equivalent, whereas the responders in bilateral group had higher LH levels in the 1st month of follow up (P=0.003). Nonresponders differed between treatment groups only in AMH level which was decreased in unilateral group throughout the follow up (P≤0.021). The baseline value of T (semi-standardized coefficient, β=-0.28) and value of T in the 1st month (β=-0.72) after the diathermy were significant and consistent indicator of the response to therapy within 6months and the ovulation response in the 1st month.

Conclusions: The value of T is the strongest and consistent indicator of ovulatory response after diathermy.

Clinical trial registration: www.ClinicalTrials.gov , NCT01833949.

Keywords: Androgens; Anti-Müllerian hormone; Dose-adjusted diathermy; Polycystic ovary syndrome; Unilateral laparoscopic drilling.

Publication types

Clinical Trial
Comparative Study

MeSH terms

Adult
Androgens / blood*
Anti-Mullerian Hormone / blood*
Diathermy / methods*
Female
Humans
Laparoscopy / methods
Polycystic Ovary Syndrome / blood*
Polycystic Ovary Syndrome / surgery*
Testosterone / blood*
Treatment Outcome

Substances

Androgens
Testosterone
Anti-Mullerian Hormone

Associated data

ClinicalTrials.gov/NCT01833949