Potential Effects of Obesity on Anti-Müllerian Hormone in Polycystic Ovary Syndrome

Abstract

Background: Polycystic ovary syndrome (PCOS) is a common endocrine abnormality with its known effects on reproduction. It is usually associated with infertility. Early detection is crucial the use of Antimullerian hormone (AMH) as indicator of ovarian function could be a reliable indicator.  The association between PCOS and other metabolism-related disorders (e.g., obesity) is not sufficiently studied.  

Aim of the work: we carried out this study aiming to investigate the possible association between AMH, ovarian reserve, AFC with BMI in women with PCOS. Generally, we seek the link between obesity and PCOS. 

Methods: The study included 240 women with confirmed diagnosis of PCOS. They were categorized according to body mass index (BMI) into three groups the first for normal BMI (group A; n=100); the second for overweight women (Group B; n=65) and the third for obese women (group C; n=75). All were clinically (by history and examination) and radiologically (pelvic ultrasound) evaluated and then AMH, beside others were measured in plasma and data was compared between groups.

 Results: Study groups were comparable regarding their age and incidence of hirsutism, ovarian volume. Hirsutism for example reported in 16%, 15.4% and 25.3% of normal weight, overweight and obese groups, respectively. Otherwise, waist circumference, hip circumference and waist/hip ratio were significantly increased progressively with increasing BMI. Acne also increased in C and B than in normal A group (41.3%, 21.5% vs 16.0%, respectively).  By ultrasound, most follicles were peripheral (69.0%, 73.8% and 72.0% in groups A, B and C respectively). Furthermore, AMH and the antral follicular count (AFC) showed progressive increase in B and C groups than normal weight group (5.49±1.20, 18.61±6.40; 8.13±1.88, 23.73±5.94 versus 2.97±0.66 and 14.96±2.88, respectively). Finally, AMH was significantly and proportionately correlated with BMI, waist/hip ratio, ovarian volume and AFC. The correlation with BMI, W/H ratio and AFC was powerful (r > 0.7).  In addition, there was moderate, significant and statistically significant correlation between AFC and each of BMI, W/H ratio and mean ovarian volume. However, the correlation between AFC and age was non-significant.

Conclusion: AMH showed significant increase with obesity, with positive correlation with BMI and ANF. Thus, BMI can play a crucial role in the development of PCOS.