Androgens and antimüllerian hormone in mothers with polycystic ovary syndrome and their newborns

Capsule:
In mothers with polycystic ovary syndrome, metformin had no impact on antim€ullerian hormone or androgen levels but increased the free testosterone index in the umbilical vein of boys.

Authors:
Eszter Vanky, M.D., Ph.D. and Sven Magnus Carlsen, M.D., Ph.D.
Volume 97, Issue 2 , Pages 509-515.e1, February 2012

Objective:
To explore the possible effect of metformin on maternal and fetal androgens and antimüllerian hormone (AMH) levels at birth and to study the predictors of maternal and fetal AMH levels.

Design:
Substudy of a randomized controlled trial (the PregMet study).

Setting:
University hospital.

Patient(s):
Women with polycystic ovary syndrome (PCOS) and their newborns (n = 132).

Intervention(s):
Metformin, 2,000 mg/daily, or placebo from the first trimester until delivery.

Main Outcome Measure(s):
Androgens and AMH levels in maternal venous serum and in umbilical vein and artery serum.

Result(s):
Except for the increased free testosterone index (FTI) in the umbilical artery in boys, metformin did not influence maternal or fetal androgens, or AMH levels. The maternal body mass index (BMI) was a negative and FTI a strong positive predictor of maternal AMH levels. Maternal androgens and AMH levels did not correlate to fetal gender. In girls, gestational age, birth weight, or maternal androgens did not correlate to the AMH levels. In boys, birth weight was negatively correlated to the AMH levels.

Conclusion(s):
Except for FTI, which was higher in boys, metformin had no impact on maternal or fetal androgen levels or the level of AMH. Fetal AMH, as a surrogate marker for ovarian development, was unaffected by maternal androgens. Birth weight and gestational age had no impact on AMH levels in girls; in boys, AMH probably reflects the physiologic variations due to birth weight.

Clinical trial registration number:
NCT00159536 (www.clinicaltrials.gov).

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