Impact of Cyproterone Acetate and Ethinylestradiol on Clomiphene-Resistant PCOS Patients with High Serum AMH Levels

The study conducted by Banu et al. in 2021 examined the effects of metformin and oral contraceptives containing cyproterone acetate and ethinyl estradiol on serum anti-Mullerian hormone (AMH) levels in 60 patients with clomiphene-resistant polycystic ovary syndrome (PCOS) and high serum AMH levels. The patients were divided into two groups: Group A (30 patients) received 2mg cyproterone acetate and 35 mcg of ethinylestradiol for 6 months, and Group B (30 patients) received metformin for the same period. The results showed that AMH levels significantly decreased under treatment with 35mg ethinylestradiol plus 2mg cyproterone acetate (p < 0.001 at 6 months), while treatment with metformin did not significantly affect serum AMH levels. The study concluded that AMH serum levels were significantly decreased due to a decrease in androgens and suppression of gonadotropins (LH) under treatment with 35mg ethinylestradiol plus 2mg cyproterone acetate.