Anti-Mullerian Hormone Levels Increase After Bariatric Surgery in Obese Female Patients With and Without Polycystic Ovary Syndrome

Abstract

This study was aimed to investigate the effect of weight loss by bariatric surgery on the level of anti-Mullerian hormone (AMH) in morbidly obese female patients with or without polycystic ovary syndrome (PCOS). This prospective study includes 70 females, obese, and fertile patients of reproductive age. All patients were evaluated to determine the changes in weight, body mass index (BMI), serum AMH, and other biochemical parameters at the end of six months. The mean levels of the preop and postop AMH were 1.66±0.87 ng/ml and 5.99±1.39 ng/ml in the PCOS group; 1.35±0.76 ng/ml and 6.23±1.47 ng/ml in the non-PCOS group, respectively. The postop AMH levels were significantly higher than the preop levels for both groups (p<0.001). There were significant differences in the level of glucose, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride, total cholesterol, hemoglobin A1c, HOMA-IR, insulin between preop and postop 6th month. A negative correlation was found between postop AMH and body weight in all patients (r=–0.337, p=0.031). Postop AMH levels were negatively correlated with postop BMI levels in the non-PCOS patient group (r=–0.408, p=0.043). No significant difference was observed between the PCOS and non-PCOS groups in terms of all the parameters examined. In conclusion, our study suggests that the significantly increased AMH levels by losing weight with bariatric surgery in patients with morbid obesity with and without PCOS may indicate the improvement of fertilization potential. It could be considered when evaluating fertility in patients with morbid obesity.

Impact of bariatric surgery on anthropometric, metabolic, and reproductive outcomes in polycystic ovary syndrome: a systematic review and meta‐analysis

“…We found no significant differences in the change in meta- Three cohort studies assessed AMH after bariatric surgery in women with and without PCOS. 19,20,22 The women with PCOS had higher AMH levels at baseline compared with women without PCOS (MD 2.23 ng/mL, 95% CI 0.83, 4.84). A meta-analysis found no difference in postoperative AMH between the two groups.…”

“…The remaining seven cohort studies [16][17][18][19][20][21][22] and the one cross-sectional study 23 compared outcomes following bariatric surgery between women with and without PCOS. All studies were published between 2016 and 2022.…”

“…The number of women with PCOS included in each study ranged from 6 to 83 with the mean age ranging from 24 to 37 years. The Rotterdam criteria were used to diagnose PCOS in nine studies, [14][15][16][17][19][20][21][22][23] and the original NIH criteria were used in one study. 18…”

“…A meta-analysis was performed for the seven cohort studies that compared anthropometric outcomes between women with and without PCOS following bariatric surgery [15][16][17][18][19][20][21] (Tables 2 and 3). At baseline, anthropometric measures of body weight and BMI were similar between groups.…”

The Relationship Between Insulin Resistance and Obesity and Serum Anti-Mullerian Hormone Level in Chinese Women with Polycystic Ovary Syndrome: A Retrospective, Single-Center Cohort Study

“…73 Increased leptin production associated with obesity directly inhibits AMH production. 74 It has also been suggested that reduced AMH levels in obese women may be due to the blood-thinning effect of increased body size. 62 Piouka et al demonstrated that the serum AMH levels of overweight and obese women with PCOS were significantly lower than those of lean women with PCOS.…”