Antimullerian hormone levels decrease in female-to-male transsexuals using testosterone as cross-sex therapy

被引:64
作者
Caanen, Mirte R. [1 ]
Soleman, Remi S. [1 ,2 ,3 ]
Kuijper, Esther A. M. [1 ]
Kreukels, Baudewijntje P. C. [2 ,3 ]
De Roo, Chloe [4 ]
Tilleman, Kelly [4 ]
De Sutter, Petra [4 ]
van Trotsenburg, Mick A. A. [1 ,2 ]
Broekmans, Frank J. [5 ]
Lambalk, Cornelis B. [1 ,4 ]
机构
[1] Vrije Univ Amsterdam, Med Ctr, Dept Obstet & Gynaecol, Div Reprod Med, NL-1007 MB Amsterdam, Netherlands
[2] Vrije Univ Amsterdam, Med Ctr, Ctr Expertise Gender Dysphoria, NL-1007 MB Amsterdam, Netherlands
[3] Vrije Univ Amsterdam, Med Ctr, Dept Med Psychol, NL-1007 MB Amsterdam, Netherlands
[4] Univ Hosp Ghent, Dept Reprod Med, Ghent, Belgium
[5] Univ Med Ctr Utrecht, Dept Reprod Med Gynecol, Utrecht, Netherlands
关键词
Antimullerian hormone; androgens; polycystic ovary syndrome; transgender; folliculogenesis; ANTI-MULLERIAN HORMONE; POLYCYSTIC-OVARY-SYNDROME; ELEVATED SERUM-LEVEL; AROMATASE INHIBITOR; REPRODUCTIVE AGE; MLLERIAN HORMONE; FOLLICLE EXCESS; DOWN-REGULATION; SYNDROME PCOS; ANDROGEN;
D O I
10.1016/j.fertnstert.2015.02.003
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To investigate the effect of hormonal androgenic treatment on antimullerian hormone (AMH) serum levels in female-to-male (FtM) transsexuals. Polycystic ovary syndrome (PCOS) is associated with elevated AMH levels. Some hypothesize that the high AMH level is a consequence of androgen-induced excessive development of small antral follicles. However, this role of androgens is not yet clear. Design: Observational, prospective, cohort study. Setting: Tertiary academic medical center. Patient(s): Twenty-two FtM transsexuals, healthy native females receiving cross-sex hormone therapy/androgenic treatment. Intervention(s): Androgenic treatment with testosterone (T) and an aromatase inhibitor while endogenous hormone secretion was suppressed with the use of a GnRH agonist. Main Outcome Measure(s): Hormone concentrations were measured before and after androgenic treatment (administration of T and aromatase inhibitor). Measured hormones: AMH, inhibin B, T, androstenedione, DHEAS, E-2, SHBG, LH, and FSH. Result(s): AMH concentrations were significantly lower after androgenic treatment (4.4 +/- 4.4 mg/L vs. 1.4 +/- 2.1 mg/L). Androgenic treatment resulted in a strong suppression of AMH secretion over a relative short period of 16 weeks. Conclusion(s): Our data underscore the likely important role of androgens in the dynamics of folliculogenesis. It challenges the idea that androgens induce high AMH levels, which is gaining more interest nowadays as an important particular PCOS feature. This strong decline furthermore indicates that AMH must be interpreted in the context of other reproductive endocrine conditions. Clinical Trial Registration Number: NTR2493. (C) 2015 by American Society for Reproductive Medicine.
引用
收藏
页码:1340 / 1345
页数:6
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