Circulating antimüllerian hormone and steroid hormone levels remain high in pregnant women with polycystic ovary syndrome at term

Abstract

Objective: To investigate plasma antim€ ullerian hormone (AMH) concentration and its relation to steroid hormone levels in pregnant women with polycystic ovary syndrome (PCOS) and controls at term. Design: Case-control study. Setting: University-affiliated hospital. Patient(s): A total of 74 pregnant women at term: 25 women with PCOS (aged 31.6 AE 3.9 years [mean AE standard deviation], body mass index 24.0 AE 3.9 kg/m2, mean gestational length 279 AE 9 days) and 49 controls (aged 31.7 AE 3.3 years, body mass index 24.0 AE 3.3 kg/m2, mean gestational length 281 AE 9 days). Intervention(s): None. Main Outcome Measure(s): Plasma AMH and steroid hormone levels. Result(s): Antim€ ullerian hormone, T, and androstenedione levels were higher in women with PCOS at term compared with controls, whereas estrogen and P levels were similar. The differences were pronounced in women carrying a female fetus. Testosterone and AMH levels correlated positively in both groups, but E 2 levels only in women with PCOS. Conclusion(s): Pregnant women with PCOS present with elevated AMH and androgen levels even at term, suggesting a hormonal imbalance during PCOS pregnancy. Differences were detected especially in pregnancies with a female fetus, raising the question of whether female pregnancies are more susceptible to AMH and steroid hormone actions.

Pregnancy outcome in women with polycystic ovary syndrome in relation to second-trimester testosterone levels

“…Women with PCOS have higher testosterone levels during pregnancy compared with women without PCOS. This finding is in line with previous studies in pregnant women with PCOS, in which high testosterone levels also in late pregnancy have been noted (Glintborg et al, 2018;Detti et al, 2019;Piltonen et al, 2019). In pregnancy, maternal testosterone levels depend mainly on the feto-placental unit.…”

“…We and other investigators have previously demonstrated that women with PCOS have higher AMH levels during pregnancy (Detti et al,. 2019;Piltonen et al, 2019;Valdimarsdottir et al, 2019). As AMH is produced by the antral follicles in the ovary and by the placenta (Novembri et al, 2015), and as AMH is correlated with testosterone levels (Detti et al, 2019;Piltonen et al, 2019;Valdimarsdottir et al, 2019), it may be speculated that the ovaries continue contributing to the overall testosterone synthesis in pregnant women with PCOS.…”

“…Findings on the role of hyperandrogenism for the obstetric complications that women with PCOS may encounter are less conclusive, as these also seem to depend on PCOS phenotype and maternal ethnicity, but only a few high-quality studies have been published (Falbo et al, 2010;Palomba et al, 2010;Bahri Khomami et al, 2018). Women with PCOS have higher total testosterone and free androgen index during pregnancy (Glintborg et al, 2018;Valdimarsdottir et al, 2019), and testosterone levels are positively correlated with AMH levels (Detti et al, 2019;Piltonen et al, 2019;Valdimarsdottir et al, 2019). The specific role of testosterone in the development of obstetric and neonatal complications has been assessed in a relatively limited number of studies, but rarely in PCOS populations.…”

Role of Anti-Müllerian Hormone in the Pathogenesis of Polycystic Ovary Syndrome

“…Recent studies suggest that AMH may be involved in this phenomenon. Circulating AMH levels are higher in pregnant women with PCOS compared to those with normal fertility (66,67) and are correlated with androgen levels (67). These results therefore suggest that AMH at relatively high concentration during pregnancy could itself be the cause of prenatal programming of PCOS.…”

Pcos and Uteri̇ne Abnormality; Possible Connection and Relationship With Maternal Serum Amh Levels

“…It has been shown that patients with HOXA10 mutations had uterine defects ranging from septate uterus to a didelphys uterus indicative of MD fusion defects. (21)(22)(23) In a review, it was clearly shown that intrauterine hyper exposure to testosterone influences the expressing genes. 23There may be other mechanisms that are responsible for increased intrauterine hyper androgens linked with intrauterine AMH function.…”