Anti-Müllerian hormone, testosterone and free androgen index following the dose-adjusted unilateral diathermy in women with polycystic ovary syndrome.
OBJECTIVE
The aim of this study was to investigate changes of anti-Müllerian hormone, testosterone and free androgen index after two diathermy methods. We have also aimed at evaluating prognostic value of these parameters for an ovulatory response.


STUDY DESIGN
This prospective, comparative study included ninety-six women with polycystic ovary syndrome unresponsive to clomiphene citrate. Patients were assigned to two groups; the first group underwent unilateral laparoscopic ovarian drilling with thermal doses adjusted to ovarian volume: median of 720J (IQR), while the second group underwent bilateral drilling with fixed doses of 1200J. Anti-Müllerian hormone (AMH), testosterone (T), free androgen index (FAI)and luteinizing hormone (LH) were measured at baseline, at 1st and 6th month of follow up.


RESULTS
AMH, T and LH levels significantly decreased (P<0.001, P≤0.024, P<0.001) after diathermy in both responders and nonresponders from either treatment group. On contrary, FAI levels (P<0.001) significantly changed only in responders, irrespective of the treatment. In 1st and 6th month of follow up median levels of AMH, T and FAI among responders from different treatment groups were equivalent, whereas the responders in bilateral group had higher LH levels in the 1st month of follow up (P=0.003). Nonresponders differed between treatment groups only in AMH level which was decreased in unilateral group throughout the follow up (P≤0.021). The baseline value of T (semi-standardized coefficient, β=-0.28) and value of T in the 1st month (β=-0.72) after the diathermy were significant and consistent indicator of the response to therapy within 6months and the ovulation response in the 1st month.


CONCLUSIONS
The value of T is the strongest and consistent indicator of ovulatory response after diathermy.


CLINICAL TRIAL REGISTRATION
www.ClinicalTrials.gov , NCT01833949.
['Sunj|M|M|', 'Canic|T|T|', 'Jeroncic|A|A|', 'Karelovic|D|D|', 'Tandara|M|M|', 'Juric|S|S|', 'Palada|I|I|']
D000328:Adult D000728:Androgens D054304:Anti-Mullerian Hormone D003972:Diathermy D005260:Female D006801:Humans D010535:Laparoscopy D011085:Polycystic Ovary Syndrome D013739:Testosterone D016896:Treatment Outcome
Anti-Müllerian hormone Androgens Polycystic ovary syndrome Dose-adjusted diathermy Unilateral laparoscopic drilling