The Impact of Depot GnRH Agonist on AMH Levels in Healthy Reproductive-Aged Women
Context:GnRH agonists (GnRHa) are being used experimentally in an attempt to preserve fertility in young female cancer patients undergoing chemotherapy. Anti-Müllerian hormone (AMH) produced by ovarian granulosa cells may serve as a marker of ovarian reserve, but it is not clear whether this marker...
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| Published in | The journal of clinical endocrinology and metabolism Vol. 98; no. 12; pp. E1961 - E1966 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
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United States
Oxford University Press
01.12.2013
Copyright by The Endocrine Society Endocrine Society |
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| Abstract | Context:GnRH agonists (GnRHa) are being used experimentally in an attempt to preserve fertility in young female cancer patients undergoing chemotherapy. Anti-Müllerian hormone (AMH) produced by ovarian granulosa cells may serve as a marker of ovarian reserve, but it is not clear whether this marker is useful during GnRHa treatment.Objective:The purpose of this study was to determine the effect of a depot GnRHa on AMH levels.Design:Depot leuprolide (3.75 mg) was administered in the midluteal phase (MLP) in healthy women. Assessments of AMH, FSH, LH, estradiol, and progesterone were performed in the early follicular phase (EFP) and MLP before GnRHa treatment and approximately 7, 14, and 30 days after GnRHa administration.Setting:The study was conducted in a university research center.Patients:Participants were 33 healthy, premenopausal women aged 18 to 45 years old with regular menses.Results:EFP and MLP AMH levels were similar before GnRHa administration. Relative to MLP AMH levels, AMH decreased 7 days after GnRHa administration by a median of 24% (P < .001) and then increased above pretreatment levels 14 and 30 days after GnRHa by 13% and 32%, respectively (P < .001). Changes in AMH levels did not correlate with changes in gonadotropins, estradiol, or progesterone.Conclusions:Significant changes in AMH levels occur in the first 4 weeks after depot leuprolide administration, suggesting that AMH may not be a reliable marker of ovarian reserve during this interval. Changes in AMH occurred independent of gonadotropin levels, supporting a direct effect of GnRHa on granulosa cell expression of AMH or an indirect effect of GnRHa on the development and/or dynamics of the follicle pool. |
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| AbstractList | GnRH agonists (GnRHa) are being used experimentally in an attempt to preserve fertility in young female cancer patients undergoing chemotherapy. Anti-Müllerian hormone (AMH) produced by ovarian granulosa cells may serve as a marker of ovarian reserve, but it is not clear whether this marker is useful during GnRHa treatment.
The purpose of this study was to determine the effect of a depot GnRHa on AMH levels.
Depot leuprolide (3.75 mg) was administered in the midluteal phase (MLP) in healthy women. Assessments of AMH, FSH, LH, estradiol, and progesterone were performed in the early follicular phase (EFP) and MLP before GnRHa treatment and approximately 7, 14, and 30 days after GnRHa administration.
The study was conducted in a university research center.
Participants were 33 healthy, premenopausal women aged 18 to 45 years old with regular menses.
EFP and MLP AMH levels were similar before GnRHa administration. Relative to MLP AMH levels, AMH decreased 7 days after GnRHa administration by a median of 24% (P < .001) and then increased above pretreatment levels 14 and 30 days after GnRHa by 13% and 32%, respectively (P < .001). Changes in AMH levels did not correlate with changes in gonadotropins, estradiol, or progesterone.
Significant changes in AMH levels occur in the first 4 weeks after depot leuprolide administration, suggesting that AMH may not be a reliable marker of ovarian reserve during this interval. Changes in AMH occurred independent of gonadotropin levels, supporting a direct effect of GnRHa on granulosa cell expression of AMH or an indirect effect of GnRHa on the development and/or dynamics of the follicle pool. GnRH agonists (GnRHa) are being used experimentally in an attempt to preserve fertility in young female cancer patients undergoing chemotherapy. Anti-Müllerian hormone (AMH) produced by ovarian granulosa cells may serve as a marker of ovarian reserve, but it is not clear whether this marker is useful during GnRHa treatment.CONTEXTGnRH agonists (GnRHa) are being used experimentally in an attempt to preserve fertility in young female cancer patients undergoing chemotherapy. Anti-Müllerian hormone (AMH) produced by ovarian granulosa cells may serve as a marker of ovarian reserve, but it is not clear whether this marker is useful during GnRHa treatment.The purpose of this study was to determine the effect of a depot GnRHa on AMH levels.OBJECTIVEThe purpose of this study was to determine the effect of a depot GnRHa on AMH levels.Depot leuprolide (3.75 mg) was administered in the midluteal phase (MLP) in healthy women. Assessments of AMH, FSH, LH, estradiol, and progesterone were performed in the early follicular phase (EFP) and MLP before GnRHa treatment and approximately 7, 14, and 30 days after GnRHa administration.DESIGNDepot leuprolide (3.75 mg) was administered in the midluteal phase (MLP) in healthy women. Assessments of AMH, FSH, LH, estradiol, and progesterone were performed in the early follicular phase (EFP) and MLP before GnRHa treatment and approximately 7, 14, and 30 days after GnRHa administration.The study was conducted in a university research center.SETTINGThe study was conducted in a university research center.Participants were 33 healthy, premenopausal women aged 18 to 45 years old with regular menses.PATIENTSParticipants were 33 healthy, premenopausal women aged 18 to 45 years old with regular menses.EFP and MLP AMH levels were similar before GnRHa administration. Relative to MLP AMH levels, AMH decreased 7 days after GnRHa administration by a median of 24% (P < .001) and then increased above pretreatment levels 14 and 30 days after GnRHa by 13% and 32%, respectively (P < .001). Changes in AMH levels did not correlate with changes in gonadotropins, estradiol, or progesterone.RESULTSEFP and MLP AMH levels were similar before GnRHa administration. Relative to MLP AMH levels, AMH decreased 7 days after GnRHa administration by a median of 24% (P < .001) and then increased above pretreatment levels 14 and 30 days after GnRHa by 13% and 32%, respectively (P < .001). Changes in AMH levels did not correlate with changes in gonadotropins, estradiol, or progesterone.Significant changes in AMH levels occur in the first 4 weeks after depot leuprolide administration, suggesting that AMH may not be a reliable marker of ovarian reserve during this interval. Changes in AMH occurred independent of gonadotropin levels, supporting a direct effect of GnRHa on granulosa cell expression of AMH or an indirect effect of GnRHa on the development and/or dynamics of the follicle pool.CONCLUSIONSSignificant changes in AMH levels occur in the first 4 weeks after depot leuprolide administration, suggesting that AMH may not be a reliable marker of ovarian reserve during this interval. Changes in AMH occurred independent of gonadotropin levels, supporting a direct effect of GnRHa on granulosa cell expression of AMH or an indirect effect of GnRHa on the development and/or dynamics of the follicle pool. Context:GnRH agonists (GnRHa) are being used experimentally in an attempt to preserve fertility in young female cancer patients undergoing chemotherapy. Anti-Müllerian hormone (AMH) produced by ovarian granulosa cells may serve as a marker of ovarian reserve, but it is not clear whether this marker is useful during GnRHa treatment.Objective:The purpose of this study was to determine the effect of a depot GnRHa on AMH levels.Design:Depot leuprolide (3.75 mg) was administered in the midluteal phase (MLP) in healthy women. Assessments of AMH, FSH, LH, estradiol, and progesterone were performed in the early follicular phase (EFP) and MLP before GnRHa treatment and approximately 7, 14, and 30 days after GnRHa administration.Setting:The study was conducted in a university research center.Patients:Participants were 33 healthy, premenopausal women aged 18 to 45 years old with regular menses.Results:EFP and MLP AMH levels were similar before GnRHa administration. Relative to MLP AMH levels, AMH decreased 7 days after GnRHa administration by a median of 24% (P < .001) and then increased above pretreatment levels 14 and 30 days after GnRHa by 13% and 32%, respectively (P < .001). Changes in AMH levels did not correlate with changes in gonadotropins, estradiol, or progesterone.Conclusions:Significant changes in AMH levels occur in the first 4 weeks after depot leuprolide administration, suggesting that AMH may not be a reliable marker of ovarian reserve during this interval. Changes in AMH occurred independent of gonadotropin levels, supporting a direct effect of GnRHa on granulosa cell expression of AMH or an indirect effect of GnRHa on the development and/or dynamics of the follicle pool. CONTEXT:GnRH agonists (GnRHa) are being used experimentally in an attempt to preserve fertility in young female cancer patients undergoing chemotherapy. Anti-Müllerian hormone (AMH) produced by ovarian granulosa cells may serve as a marker of ovarian reserve, but it is not clear whether this marker is useful during GnRHa treatment. OBJECTIVE:The purpose of this study was to determine the effect of a depot GnRHa on AMH levels. DESIGN:Depot leuprolide (3.75 mg) was administered in the midluteal phase (MLP) in healthy women. Assessments of AMH, FSH, LH, estradiol, and progesterone were performed in the early follicular phase (EFP) and MLP before GnRHa treatment and approximately 7, 14, and 30 days after GnRHa administration. SETTING:The study was conducted in a university research center. PATIENTS:Participants were 33 healthy, premenopausal women aged 18 to 45 years old with regular menses. RESULTS:EFP and MLP AMH levels were similar before GnRHa administration. Relative to MLP AMH levels, AMH decreased 7 days after GnRHa administration by a median of 24% (P < .001) and then increased above pretreatment levels 14 and 30 days after GnRHa by 13% and 32%, respectively (P < .001). Changes in AMH levels did not correlate with changes in gonadotropins, estradiol, or progesterone. CONCLUSIONS:Significant changes in AMH levels occur in the first 4 weeks after depot leuprolide administration, suggesting that AMH may not be a reliable marker of ovarian reserve during this interval. Changes in AMH occurred independent of gonadotropin levels, supporting a direct effect of GnRHa on granulosa cell expression of AMH or an indirect effect of GnRHa on the development and/or dynamics of the follicle pool. |
| Author | Chang, R. Jeffrey Su, H. Irene Hall, Janet E. Sluss, Patrick M. Maas, Kevin Joffe, Hadine |
| AuthorAffiliation | Moores Cancer Center (H.I.S., K.M., R.J.C.), University of California, San Diego, San Diego, California 92093; and Department of Psychiatry (P.M.S., H.J., J.E.H.), Massachusetts General Hospital, Boston, Massachusetts General Hospital, Boston, Massachusetts 02114 |
| AuthorAffiliation_xml | – name: Moores Cancer Center (H.I.S., K.M., R.J.C.), University of California, San Diego, San Diego, California 92093; and Department of Psychiatry (P.M.S., H.J., J.E.H.), Massachusetts General Hospital, Boston, Massachusetts General Hospital, Boston, Massachusetts 02114 |
| Author_xml | – sequence: 1 givenname: H. Irene surname: Su fullname: Su, H. Irene organization: 1Moores Cancer Center (H.I.S., K.M., R.J.C.), University of California, San Diego, San Diego, California 92093 – sequence: 2 givenname: Kevin surname: Maas fullname: Maas, Kevin organization: 1Moores Cancer Center (H.I.S., K.M., R.J.C.), University of California, San Diego, San Diego, California 92093 – sequence: 3 givenname: Patrick M. surname: Sluss fullname: Sluss, Patrick M. organization: 2Department of Psychiatry (P.M.S., H.J., J.E.H.), Massachusetts General Hospital, Boston, Massachusetts General Hospital, Boston, Massachusetts 02114 – sequence: 4 givenname: R. Jeffrey surname: Chang fullname: Chang, R. Jeffrey organization: 1Moores Cancer Center (H.I.S., K.M., R.J.C.), University of California, San Diego, San Diego, California 92093 – sequence: 5 givenname: Janet E. surname: Hall fullname: Hall, Janet E. organization: 2Department of Psychiatry (P.M.S., H.J., J.E.H.), Massachusetts General Hospital, Boston, Massachusetts General Hospital, Boston, Massachusetts 02114 – sequence: 6 givenname: Hadine surname: Joffe fullname: Joffe, Hadine email: hjoffe@partners.org organization: 2Department of Psychiatry (P.M.S., H.J., J.E.H.), Massachusetts General Hospital, Boston, Massachusetts General Hospital, Boston, Massachusetts 02114 |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/24081742$$D View this record in MEDLINE/PubMed |
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| Snippet | Context:GnRH agonists (GnRHa) are being used experimentally in an attempt to preserve fertility in young female cancer patients undergoing chemotherapy.... CONTEXT:GnRH agonists (GnRHa) are being used experimentally in an attempt to preserve fertility in young female cancer patients undergoing chemotherapy.... GnRH agonists (GnRHa) are being used experimentally in an attempt to preserve fertility in young female cancer patients undergoing chemotherapy. Anti-Müllerian... |
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| SubjectTerms | 17β-Estradiol Adolescent Adult Agonists Anti-Mullerian Hormone - blood Anti-Mullerian Hormone - secretion Biomarkers - blood Chemotherapy Cohort Studies Delayed-Action Preparations Female Fertility Fertility Agents, Female - administration & dosage Fertility Agents, Female - pharmacology Fertility Preservation Follicle-stimulating hormone Gonadotropin-releasing hormone Gonadotropin-Releasing Hormone - agonists Gonadotropins Granulosa cells Granulosa Cells - drug effects Granulosa Cells - secretion Humans JCEM Online: Brief Reports Leuprolide - administration & dosage Leuprolide - pharmacology Luteinizing hormone Menstrual Cycle - blood Menstrual Cycle - drug effects Middle Aged Ovaries Ovary - drug effects Ovary - secretion Pituitary (anterior) Progesterone Young Adult |
| Title | The Impact of Depot GnRH Agonist on AMH Levels in Healthy Reproductive-Aged Women |
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