The Effect of 6 Months of Combined Estrogen and Progestin Pills on Anti-mullerian Hormone in Polycystic Ovary Syndrome Patients

Abstract Introduction: Cyproterone acetate plus ethinylestradiol (CPA/EE) is an oral contraceptive pill that has traditionally remained the first choice for the management of polycystic ovary syndrome (PCOS). Data on the effect of these hormonal pills on anti-mullerian hormone (AMH) levels are contradictory. The present study was carried out to evaluate the effect of CPA/EE administration on serum AMH levels in Indian women suffering from PCOS. Materials and Methods: Fifty-five patients were included in the present, prospective, observational study conducted between August 2020 and October 2021. Women ≥18 years of age who attended outpatient clinics and who were diagnosed with PCOS with a minimum of two of the three Rotterdam criteria were included. Modified Ferriman–Gallwey Score (mFGS) and serum AMH and testosterone levels were recorded at the baseline and 6 months. The women were given a combination of CPA-EE for 6 months. The primary objective was to study the effect of 6 months of CPA-EE on serum AMH levels, whereas the secondary objective was to determine the effect on serum testosterone. Results: The mean mFGS, the median AMH, and mean testosterone were significantly lower after 6 months as compared to the baseline parameters in patients who took CPA-EE for 6 months. The percentage of women who had irregular menstrual cycles, acne, and hair fall was significantly lower after 6 months as compared to the baseline parameters in patients who took CPA-EE. Conclusions: AMH and testosterone serum levels were significantly decreased under treatment with CPA-EE in PCOS patients.