Serum antimullerian hormone in response to dietary management and/or physical exercise in overweight/obese women with polycystic ovary syndrome: secondary analysis of a randomized controlled trial

Objective: To investigate whether randomized diet and/or physical exercise influence serum levels of antimullerian hormone (AMH) in obese women with polycystic ovary syndrome (PCOS). Design: Randomized, 4-month trial with three interventions. Setting: Women's health clinical research unit at a university hospital. Patient(s): Fifty-seven overweight/obese women with PCOS. Intervention(s): Diet, physical exercise, or both, using programs individually adapted and supervised by a dietician and/or a physiotherapist. Main Outcome Measure(s): Serum AMH levels before and after the interventions and correlations to reproductive function, body composition, and endocrine and metabolic variables. Result(s): After intervention, serum levels of AMH were significantly decreased only in the diet group, and the levels were significantly lower than in the exercise group. The strongest predictor of decreased AMH was a decrease in free T, whereas weight loss had no significant influence. Normalized levels of AMH were associated with improvements in menstrual cyclicity and hyperandrogenism but not in metabolic variables. Conclusion(s): This randomized study supports that diet reduces serum AMH in association with decreased androgen levels in obese women with PCOS. Increased serum AMH may be used as a marker of ovulatory dysfunction and hyperandrogenism but not as a marker of insulin resistance.