The effect of weight loss by bariatric surgery on the level of anti-mullerian hormone for obese female patients

Background-Aim: Obesity is a serious health problem and the incidence of this condition is increasing day by day. Because of the comorbid diseases related with obesity, the obese patients use one of the following methods to lose weight; diet, exercises or medical treatments. A surgical procedure is recommended to the patients when they were unable to lose weight with these kinds of methods. Infertility is one of the most prominent comorbidity for the obese patients. Anti-Mullerian Hormone (AMH) is one of the most reliable markers that indicate the ovarian reserve and using in assisted reproductive technology. The aim of this study was to investigate the effect of weight loss by bariatric surgery on the level of AMH in morbidly obese female patients. Material-Method: This prospective study including 70 female, obese and fertile patients in the age range of 18-40 years. The level of AMH at admission and 6 months after surgery were compared. All patients were evaluated in terms of the following parameters both pre-op and post-op 6 months; lipid metabolism, body mass index, parathormone (PTH), thyroid-stimulating hormone (TSH), cortisol, uric acid, folate and vitamin B12. Younger than 18 years and older than 40 years patients were excluded from the study. Results: The mean levels of the pre-op and post-op AMH were 130.13 pg/ml (13.21-378.13) and 609.19 pg/ml (174.49-1244.02), respectively. The post-op AMH levels were significantly higher than the pre-op levels (p<0.001). There were significant differences in the levels of glucose, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride, total cholesterol, hemoglobin A1c (HbA1c), homeostasis model assessment-estimated insulin resistance (HOMA-IR), insulin between pre-op and post-op 6 month. Conclusion: Our study suggests that the significantly increased levels of AMH may contribute to the fertilization potential in morbidly obese women losing weight after the bariatric surgery. Consequently, the bariatric surgery for weight loss is becoming one of the most available options for the obese female patients who were planning pregnancy and unable to weight lose with diet, exercise or medical treatment. Key Words: AMH, obesity, infertility, bariatric surgery, ovarian reserve