One-year impact of bariatric surgery on serum anti-Mullerian-hormone levels in severely obese women

Clara Vincentelli (1, 2) , Marie M. Maraninchi (3, 1) , Rene Valero (4, 1) , Sophie Béliard (2, 1) , Flavia Maurice (1, 2) , Olivier Emungania , Bruno Berthet (5) , Elise Lombard , Anne Dutour (3, 1) , Benedicte Gaborit (6, 3, 1) , Blandine Courbiere (7, 8)

1 C2VN - Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
2 LA CONCEPTION - Hôpital de la Conception [CHU - APHM]
3 NORT - Nutrition, obésité et risque thrombotique
4 Service d'endocrinologie, diabète, maladies métaboliques [Hôpital de la Conception - APHM]
5 Department of Nutrition, Metabolic Diseases, Endocrinology, CHU La Conception
6 APHM - Assistance Publique - Hôpitaux de Marseille
7 Service de Gynécologie et Obstétrique [Marseille]
8 IMBE - Institut méditerranéen de biodiversité et d'écologie marine et continentale

INTRODUCTION: Although bariatric surgery seems to increase spontaneous fertility by improving ovulatory function in young women, its impact on ovarian reserve remains largely unknown. OBJECTIVE: To evaluate changes in serum anti-Mullerian hormone (AMH) levels in reproductive-age severely obese women after bariatric surgery (BS). METHODS: AMH levels were measured retrospectively in 39 women (mean age 34.6 ± 1.1 years, range 18-45) that underwent a sleeve gastrectomy or Roux-en-Y gastric bypass (RYGB) at baseline, and 6 and 12 months after BS. Metabolic and micronutrient status, including fasting plasma insulin and glucose, HOMA-IR, leptin, adiponectin, calcium, albumin, transthyretin, ferritin, vitamins (B9, B12, B1, A, E, D), zinc, and selenium, were assessed in all patients before and 1 year after BS. RESULTS: Of the patients, 79% had class-3 obesity. At 6 and 12 months, mean total weight losses (TWL) were 26 and 30%; mean excess weight losses (EWL) were 61.7 and 70.2%. Compared to baseline, AMH levels significantly decreased by 18% at 6 months, and 32% at 12 months post-operatively (p = 0.010 and p = 0.001, respectively). There was no correlation between AMH variation and changes in metabolic parameters or micronutrient levels. Remarkably, changes in AMH levels did not differ between sleeve and RYGB patients and were not correlated with EWL. CONCLUSION: This pilot study shows a drastic reduction in AMH levels at 1 year after BS in reproductive-age severely obese women, which was not related to weight loss: this suggests a negative impact of BS on ovarian reserve, at least in the short term.

Mots clés: Anti-Mullerian hormone; Fertility; Obesity; Ovarian reserve; Bariatric surgery

Domaines: Sciences du Vivant [q-bio]; Médecine humaine et pathologie; Endocrinologie et métabolisme; Biologie de la reproduction; Reproduction sexuée

Clara Vincentelli, Marie M. Maraninchi, Rene Valero, Sophie Béliard, Flavia Maurice, et al.. One-year impact of bariatric surgery on serum anti-Mullerian-hormone levels in severely obese women. Journal of Assisted Reproduction and Genetics, 2018, 35 (7), pp.1317 - 1324. ⟨10.1007/s10815-018-1196-3⟩. ⟨hal-01793400⟩