Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC 27599, USA.
Contraception. 2010 Mar;81(3):245-8. doi: 10.1016/j.contraception.2009.10.004. Epub 2009 Nov 14.
The study was conducted to examine the impact of oral contraceptives (OCs) on serum antimullerian hormone (AMH) levels by obesity status in reproductive-age women.
Ovulatory women, ages 18-35 years, of normal (<25 kg/m(2); n=10) and obese (>30 kg/m(2); n=10) body mass index (BMI) received a low-dose OC (20 mcg ethinyl estradiol/100 mcg levonorgestrel) for two cycles. Serum samples obtained at several time points during active pill use and hormone-free intervals were analyzed for AMH, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol and inhibin B.
AMH levels did not differ by OC cycle day in either BMI group. On average, AMH levels were 34% lower in the obese group (2.9+/-2.1 vs. 4.4+/-1.8 ng/mL, p<.05). Modeling to determine differences in AMH throughout the cycle based on obesity status demonstrated significantly lower levels (p<.05), whereas serum AMH, FSH, LH, estradiol and inhibin B levels revealed no correlations when all time points were included.
In reproductive-age women, serum AMH levels do not appear to fluctuate during OC use, but AMH levels are significantly lower in obese women. Lower levels do not appear to be due to differences in gonadotropin levels or ovarian activity.
本研究旨在探讨肥胖状态对生育期妇女口服避孕药(OC)对血清抗苗勒管激素(AMH)水平的影响。
18-35 岁排卵正常(<25 kg/m²;n=10)和肥胖(>30 kg/m²;n=10)的女性接受低剂量 OC(20 mcg 炔雌醇/100 mcg 左炔诺孕酮)治疗两个周期。在服用活性药物和激素间期的几个时间点采集血清样本,分析 AMH、卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇和抑制素 B。
在两个 BMI 组中,AMH 水平在 OC 周期天数上均无差异。肥胖组的 AMH 水平平均低 34%(2.9+/-2.1 vs. 4.4+/-1.8 ng/mL,p<.05)。根据肥胖状态对整个周期 AMH 差异进行建模表明,AMH 水平显著降低(p<.05),而血清 AMH、FSH、LH、雌二醇和抑制素 B 水平在纳入所有时间点时无相关性。
在生育期妇女中,OC 使用期间血清 AMH 水平似乎不波动,但肥胖女性的 AMH 水平显著降低。低水平似乎不是由于促性腺激素水平或卵巢活动的差异所致。