Comparison of sitagliptin and metformin on the anti-mullerian hormone level in infertile women with polycystic ovarian syndrome in IVF cycle

Background: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy among adult women in the developed world. PCOS is not a specific endocrine pathology with a solitary cause, but a syndrome with different signs and symptoms. Anti-mullerian hormone (AMH) acts as a regulator of folliculogenesis. The level of serum AMH in PCOS were evaluated about two or three-fold. Serum AMH was recently proposed as diagnostic marker of POCS. Metformin is the most common antihyperglycemic agent, recently introduced for treatment of women with PCOS. Some studies have attempted to investigate the AMH serum level during treatment with metformin in patients with PCOS. Some clinical trials of PCOS have shown effects of Sitagliptin in women with PCOS.Objective: The aim of this study was to compare effects of Sitagliptin and Metformin on AMH levels in PCOS patients suffering from infertility.Materials and Methods: In this clinical trial, 60 infertile women, aged 23-38 yr, diagnosed with PCOS according to the Rotterdam 2003 criteria and candidate for IVF. Patients divided into 3 groups for receiving Sitagliptin, Metformin and placebo every day for 8 weeks (n=20 each group). The serum AMH and BMI level were recorded before start of stimulation and after 8 weeks of treatment. We used SPSS version 19 for data analysis.Results: The level of AMH in sitagliptin group and metformin groups was significantly lower than the placebo group. AMH level in the sitagliptin group was significantly lower than the metformin group.Conclusion: In this clinical practice, reducing serum AMH levels of women with infertility and PCOS treated with Sitagliptin and metformin can show better results in IVF cycle. The AMH levels on Sitagliptin group was observed in patients with PCOS comparable to metformin group.

Keywords:

Polycystic ovarian syndrome , Anti-mullerian hormone , Metformin , Sitagliptin