Abstract: P-295

Effect of GNRH Agonist Downregulation on Serum AMH Levels: A Prospective Cohort Study with Repeated Measurements.

Presenter: Panagiotis Drakopoulos


Abstract


OBJECTIVE: To investigate whether anti-Müllerian hormone (AMH) levels are affected by the administration of 14 days of pituitary downregulation with a GnRH-agonist (0.1mg/0.1mL daily injections of triptorelin)
DESIGN: Prospective cohort study in a Centre for Reproductive Medicine, in a tertiary University Hospital view more

OBJECTIVE: To investigate whether anti-Müllerian hormone (AMH) levels are affected by the administration of 14 days of pituitary downregulation with a GnRH-agonist (0.1mg/0.1mL daily injections of triptorelin)
DESIGN: Prospective cohort study in a Centre for Reproductive Medicine, in a tertiary University Hospital
MATERIALS AND METHODS: 52 women aged between 18 and 43 years, who were considered normal ovarian responders and planned to undergo ovarian stimulation for IVF/ICSI in a GnRH-agonist protocol, were recruited between July 2015 and March 2016. Participants had three visits. Visit 1 was on the day of GnRH-agonist treatment initiation (menstrual cycle day 21±3); visit 2 and 3 were at 7 and 14 days after visit 1, respectively. Blood samples were collected at all visits for evaluation of serum AMH, FSH, LH, E2, and Progesterone. Samples at visit 1 were taken before start of treatment. Samples were split in four aliquots, measured in random order
RESULTS: Serum AMH levels significantly changed during GnRH-agonist treatment following a V-shape from baseline to day 7 and day 14. Compared with baseline AMH (mean 1.65ng/mL, 95% CI: 0.06-3.2ng/mL), serum AMH decreased by a mean of 0.27ng/mL (95% CI: 0.13-0.4ng/mL) on day 7, and increased by a mean of 0.29ng/mL (95% CI: 0.17-0.45ng/mL) on day 14. Replicate testing of serum AMH in four aliquots of the same sample showed excellent precision in all patient samples collected at baseline (CV 1.3%), day 7 (CV 1.2%) and day 14 (CV 1.4%). The serum levels of LH, E2, and Progesterone decreased significantly on day 14, compared with baseline. FSH serum levels were not affected
CONCLUSIONS: GnRH-agonist downregulation has a clinically significant effect on serum AMH levels. This effect is dependent on the duration of GnRH-agonist treatment.Therefore, the serum AMH level should be measured before start of GnRH-agonist downregulation, and not during GnRH-agonist downregulation

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