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

Mirte R Caanen1, Remi S Soleman2, Esther A M Kuijper1

  • 1Division of Reproductive Medicine, Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, the Netherlands.

Fertility and Sterility
|March 17, 2015
PubMed
Summary

Hormonal androgenic treatment significantly lowered antimüllerian hormone (AMH) levels in female-to-male individuals. This finding challenges the hypothesis that androgens increase AMH, suggesting AMH levels should be interpreted alongside other reproductive endocrine factors.

Keywords:
Antimüllerian hormoneandrogensfolliculogenesispolycystic ovary syndrometransgender

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Area of Science:

  • Reproductive Endocrinology
  • Endocrinology
  • Gynecology

Background:

  • Polycystic ovary syndrome (PCOS) is associated with elevated antimüllerian hormone (AMH) levels.
  • It is hypothesized that androgens contribute to high AMH by promoting the development of small antral follicles.
  • The precise role of androgens in AMH regulation remains unclear.

Purpose of the Study:

  • To investigate the impact of hormonal androgenic treatment on serum AMH levels in female-to-male (FtM) transsexuals.
  • To explore the relationship between androgens and AMH dynamics in the context of folliculogenesis.

Main Methods:

  • Observational, prospective cohort study conducted at a tertiary academic medical center.
  • Twenty-two healthy FtM individuals undergoing androgenic treatment (testosterone and aromatase inhibitor) with GnRH agonist suppression.
  • Measurement of AMH and other reproductive hormones before and after a 16-week treatment period.

Main Results:

  • Androgenic treatment led to a significant decrease in AMH concentrations (from 4.4 ± 4.4 μg/L to 1.4 ± 2.1 μg/L).
  • A pronounced suppression of AMH secretion was observed over 16 weeks of treatment.
  • Hormone levels measured included AMH, inhibin B, testosterone, androstenedione, DHEAS, E2, SHBG, LH, and FSH.

Conclusions:

  • The study highlights the significant role of androgens in regulating folliculogenesis.
  • Findings challenge the notion that androgens induce elevated AMH levels, a feature often seen in PCOS.
  • AMH levels should be interpreted considering other reproductive endocrine parameters.