Bariatric Surgery Reduces Serum Anti-mullerian Hormone Levels in Obese Women With and Without Polycystic Ovarian Syndrome.

Abstract

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.

One-year impact of bariatric surgery on serum anti-Mullerian-hormone levels in severely obese women

“…Similarly, Bhandari et al reported a 36% decrease in AMH concentration in women without PCOS at 6 months post-BS [10]. In a recent study including 18 patients without PCOS and that underwent BS, Chiofalo et al reported significant variation in AMH at 1 year post-surgery [26]. In accordance with these studies, we found a 38% decrease in AMH concentration at 1 year post-BS in non-PCOS patients.…”

“…In accordance with these results, we found no correlation in our study between these parameters. Similarly, we did not find any correlation between changes in BMI or EWL and changes in AMH, despite an average decrease of 14 points in BMI at 12 months [10,26].…”

“…Our study has several limitations, such as its retrospective design and the small population size. We assumed that PCOS patients were a specific population with a high risk of impairment to ovarian quality and function; recent studies have focused on this particular population [10,26]. However, exclusion of PCOS patients did not significantly change our results.…”

Review: Sex-Specific Aspects in the Bariatric Treatment of Severely Obese Women

“…In women without a history of infertility, the AMH level is used to assess the ovarian reserve, or the number of functional oocytes; a high level can be associated with cycle irregularities. Therefore, AMH is increased in patients who suffer from polycystic ovary syndrome (PCOS) and is positively associated with serum levels of testosterone, androstendione, and dehydroepiandrosterone sulfate (DHEAS) [43][44][45][46]. In several pilot surveys, a decrease in AMH concentration after bariatric surgery independent of the surgical procedure was found.…”

“…In several pilot surveys, a decrease in AMH concentration after bariatric surgery independent of the surgical procedure was found. This drop persisted with the exclusion of PCOS patients [43,44,47,48]. The limitations of the current state of research as well as the complex interaction of fertility-promoting and fertility-inhibiting hormonal changes after bariatric surgery must be considered in this context, too.…”