Anti-Müllerian hormone measurement for the diagnosis of polycystic ovary syndrome

Abstract

Objective

Anti-Müllerian hormone (AMH) is derived from the small antral follicles and an elevated level has been suggested to add value to the Rotterdam criteria for the diagnosis of PCOS in cases of diagnostic uncertainty. Therefore, the role of AMH in the classical phenotype of PCOS was defined within a Caucasian population.

Design

This was a cross sectional study.

Patients

65 women without PCOS and 110 women with PCOS fulfilling all 3 diagnostic Rotterdam criteria.

Measurements

The main outcomes were the utility of serum AMH for the diagnosis of PCOS and its relationship to the metabolic parameters.

Results

AMH was increased in PCOS compared to controls (p<0.001) Areas under the receiver operator curve showed AMH to be predictive of PCOS (0.76) using a cut off AMH of 46pmol/l, derived from the 95^th percentile of the controls gave a 41% sensitivity and 86% specificity; an AMH cut off of 35pmol/l gave a 55% sensitivity and 79% specificity. Age and BMI adjusted multiple logistic regression showed that AMH was more predictive of PCOS independently of either serum testosterone (T) (OR = 4.04; 95% CI 1.42-11.11; p=0.007) or free androgen index (FAI) (OR = 3.90; 95% CI 1.40-10.83; p=0.009).

Conclusion

Whilst an elevated AMH has poor sensitivity, it is four fold more likely to be associated with a diagnosis of PCOS, and supplementary to biochemical parameters will make a positive diagnosis of PCOS in 22% of patients when neither serum testosterone or FAI are elevated.

This article is protected by copyright. All rights reserved.

http://ift.tt/2iZJ1gQ