The AMH level peaked at or before ovulation in most women, trended down with natural pregnancies, and consistently increased or decreased in women with a viable pregnancy after therapy. Nonviable pregnancies showed erratic AMH patterns. Factors responsible for these different responses in pregnancy remain to be identified.

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Aim: To assess if testosterone therapy, with suppression of LH and FSH altered AMH levels in men. Study background:AMH is an important male hormone and is increasingly measured by laboratories for men and women's health assessments. This prospective study was conducted in community medical centres to assess the effects of testosterone on AMH levels in men.Methods: Men (n=15) with androgen deficiency symptoms, who were prescribed a trial of testosterone therapy by their own practitioner for at least 6 months, consented to participate in a study measuring AMH pre-therapy and post-therapy. Testosterone therapy was given to achieve LH and FSH suppression. Measurement of testosterone, LH, FSH and AMH at baseline and post testosterone therapy on at least 2 occasions including at 6 months was completed in all men. Men with abnormal baseline biochemistry (elevated LH or testosterone below age appropriate ranges) were excluded (n=5) from further study. Results:In the study group baseline LH was normal (<8 U/L) and baseline testosterone was 7-23 (mean 12 nmol/L) and within age specific intervals. Mean baseline AMH was 36 pmol/L (range 19-89) and within age related intervals. A significant rise (p=0.001) of at least 1.5-fold in testosterone occurred post treatment (range 1.5-7.5-fold increase) with suppression of LH to <1 U/L with therapy. AMH showed variable changes after testosterone. There was no significant trend in AMH either rising or falling compared to baseline and levels were not associated with testosterone (p=0.197) nor affected by the suppression of FSH or LH (p=0.683, 0.271 respectively). Conclusions:No significant pattern of change occurs in AMH in adult men at 6 months undergoing exogenous testosterone therapy. Laboratories do not need to adjust AMH reference intervals for effects of testosterone therapy in men with normal baseline LH and testosterone prior to therapy.

Objective: The aim of this study was to characterize changes in free triiodothyronine (fT3), free thyroxine (fT4) and thyroid-stimulating hormone (TSH) during the follicular and luteal phase and during subsequent early pregnancy in individual women.Method: TPOAb negative women with a viable pregnancy (n=49) had fT3, fT4 and TSH measured longitudinally in serum samples at baseline/non-pregnant (gestation week 0), ovulation (gestation week 2), mid-luteal phase (gestation week 3) and twice weekly from gestation weeks 4 to 6.5. Patient groups received in their conception cycle either no medication (n=13), low ovarian stimulation, (n=17) or controlled ovarian hyperstimulation (COH) for IVF treatment (n=19).Results: Women receiving COH had a transient drop in TSH at the time of ovulation followed by a peak at midluteal (p=0.024). Levels of fT3 and fT4 at each gestation week were not significantly different between the treatment groups, whereas TSH levels were significantly higher at all gestation weeks (p=0.036) in the COH group compared to the natural and low stimulation groups. There were significant changes in thyroid function once pregnancy was established (gestation week 4) through to gestation week 6.5, with a gradual decrease in serum fT3 (r=-0.104, p=0.030) and TSH (r=-0.123 p=0.031), whilst fT4 levels remained constant. 3 women (6.1%) had TSH levels >4.0 mU/L during their pregnancy although these were isolated measurements. Conclusion:Thyroid hormones in individual women did not remain constant but showed discrete changes. TSH was significantly lower at time of ovulation in women who received high doses of ovarian stimulation medication for IVF, and was higher throughout pregnancy than for the other groups. Serum fT3 and TSH decreased significantly during early pregnancy irrespective of medication given in the conception cycle.