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Serum anti-Müllerian hormone levels in women are unstable in the postpartum period but return to normal within 5 months: a longitudinal study

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Abstract

Purpose

Anti-Müllerian hormone (AMH) levels fall during pregnancy but the amount of time required for AMH levels to return to normal has not been accurately determined. We have previously shown that AMH levels have yet to return to normal in some women at 3-months postpartum. In this study, AMH levels were examined at 1- and 5-months postpartum to examine whether AMH levels had returned to normal within this interval.

Methods

Longitudinal study involving 38 pregnant women, with serum samples taken in the first trimester, third trimester, 1-month postpartum, 5-months postpartum and 4–6 years postpartum. Participants were recruited from a tertiary maternity clinic (single centre). All women in the study were intending to breastfeed exclusively for at least 5 months, with all 38 participants achieving this at 1-month postpartum and 36/38 after 5 months.

Results

Serum AMH concentrations had not returned to expected non-pregnant levels by 1-month postpartum. At 5-months postpartum, mean AMH concentrations were similar to expected non-pregnant levels but the rank order of AMH concentrations was still dissimilar to the non-pregnant state.

Conclusions

The regulation of AMH secretion appears to be distinctly different in non-pregnant, pregnant and postpartum populations. This may affect the conclusions that can be drawn from AMH measurements in women during pregnancy and the postpartum period.

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Acknowledgements

The authors acknowledge Mrs Gaye Ellis for her contribution to participant recruitment. The authors would like to thank Drs Ian McLennan and Wayne Gillet for advice on experimental design and Mr Andrew Gray for assistance in statistical analysis. Mrs Nicola J. Batchelor is thanked for provision of technical assistance.

Funding

Supported by grants from the Health Research Council of New Zealand [grant # 14–441] and the Healthcare Otago Charitable Trust. M.W.P. is supported by a Sir Charles Hercus Health Research Fellowship from the Health Research Council of New Zealand [grant # 18–027].

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Authors and Affiliations

  1. Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand

    Michael W. Pankhurst

  2. Department of Reproductive Medicine, University Medical Center Utrecht, Utrecht, The Netherlands

    Annelien C. de Kat & Frank J. M. Broekmans

  3. Department of Women’s and Children’s Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand

    Shirley Jones & Benjamin. J. Wheeler

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  1. Michael W. Pankhurst
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Correspondence to Michael W. Pankhurst.

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Conflict of interest

M.W.P., A.C.K., S.J. and B.J.W. have nothing to disclose. F.J.M.B. discloses personal fees as a member of the external advisory boards for Ferring BV, Merck Serono and Gedeon Richter and personal fees from educational activities for Ferring BV during the conduct of the study.

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This project was approved by the University of Otago Human Ethics Committee (Health) and was conducted in accordance with the Code of Ethics of the World Medical Association (Declaration of Helsinki).

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All participants provided written informed consent prior to participation in the original study and again during the re-recruitment phase.

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Pankhurst, M.W., de Kat, A.C., Jones, S. et al. Serum anti-Müllerian hormone levels in women are unstable in the postpartum period but return to normal within 5 months: a longitudinal study. Endocrine 71, 225–232 (2021). https://doi.org/10.1007/s12020-020-02491-2

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  • DOI: https://doi.org/10.1007/s12020-020-02491-2

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