Serum levels of antimüllerian hormone in early maturing girls before, during, and after suppression with GnRH agonist

Abstract

Objective: To evaluate whether serum antimüllerian hormone (AMH) levels are affected in early maturing girls, and whether pituitary suppression by long-acting GnRH agonist (GnRH-a) affects AMH.

Design: Secondary analyses of a prospective clinical study.

Setting: Tertiary pediatric center.

Patient(s): Fifteen girls followed during GnRH-a treatment. Evaluations before, 3 and 12 months after initiation, as well as 6 months after discontinuation of treatment. To evaluate whether AMH levels were affected in early maturing girls, baseline levels were compared with levels in healthy girls (matched for age, n = 129; matched for pubertal Tanner stage, n = 119).

Intervention(s): Patients were treated with SC injections of leuprolide acetate (LA; Procren 3.75 mg every 28th day).

Main outcome measure(s): Basal serum levels of AMH, E(2), inhibin B, FSH, and LH, as well as GnRH-stimulated levels of FSH and LH.

Result(s): At baseline, the median (range) of AMH levels in the patients was 20.3 pmol/L (2.0-30.0 pmol/L). After 3 months of GnRH-a treatment, AMH declined to 10.4 pmol/L (range, <2.0-27.0 pmol/L). The AMH suppression was maintained after 12 months of treatment (14.4 pmol/L [range, <2.0-29.6 pmol/L]). Six months after discontinuation of GnRH-a treatment, AMH levels were similar to pretreatment levels (18.8 pmol/L (range, 5.8-46.9 pmol/L)). Before treatment, AMH levels in early maturing girls did not differ significantly from AMH levels in healthy age-matched girls (median, 20 vs. 23 pmol/L) or Tanner-matched girls (median, 20 vs. 19 pmol/L).

Conclusion(s): The partial suppression of AMH by GnRH-a treatment is consistent with previous studies suggesting partial gonadotropin-dependence of AMH.

Trial registration: ClinicalTrials.gov NCT01411527.