The role of anti-Mullerian hormone and other correlates in patients with polycystic ovary syndrome

Gynecol Endocrinol. 2023 Aug 9;39(1):2247098. doi: 10.1080/09513590.2023.2247098.

Abstract

Background: Anti-Müllerian hormone (AMH) has recently emerged as a promising biomarker for the detection of polycystic ovarian morphology. In polycystic ovary syndrome (PCOS), an elevated level of AMH has been suggested to add value to the Rotterdam criteria in cases of diagnostic uncertainty. In this study, we evaluated the correlation between AMH and PCOS, and the potential role of AMH in PCOS diagnosis.

Methods: A case-control study was performed on a total of 200 females, 100 of which were diagnosed with PCOS as per Rotterdam revised criteria (2003) and 100 as the control (non-PCOS group). Patient medical records were therefore retrieved for clinical, biochemical and ultrasound markers for PCOS diagnosis. Sensitivity, specificity, area under receiver operating characteristic (AUROC) curve, and multivariate linear regression models were applied to analyze our data.

Results: Mean serum levels of LH and AMH, and LH/FSH ratio were significantly different between compared groups. In the PCOS group, the mean serum AMH level was 6.78 ng/mL and LH/FSH ratio was 1.53 while those of controls were 2.73 ng/mL and 0.53, respectively (p < .001). The most suitable compromise between 81% specificity and 79% sensitivity was obtained with a cutoff value of 3.75 ng/mL (26.78 pmol/L) serum AMH concentration for PCOS prediction, with an AUROC curve of 0.9691.

Conclusion: Serum AMH cutoff level of 3.75 ng/mL was identified as a convenient gauge for the prediction of PCOS and an adjuvant to the Rotterdam criteria.

Keywords: Polycystic ovary syndrome (PCOS); anti-Müllerian hormone (AMH); hyperandrogenism; menstrual irregularities; oligo/amenorrhea; rotterdam criteria.

MeSH terms

  • Adult
  • Anti-Mullerian Hormone* / blood
  • Case-Control Studies
  • Female
  • Follicle Stimulating Hormone / blood
  • Humans
  • Luteinizing Hormone / blood
  • Menstruation Disturbances / pathology
  • Polycystic Ovary Syndrome* / blood
  • Polycystic Ovary Syndrome* / diagnosis
  • Polycystic Ovary Syndrome* / pathology
  • Prolactin / blood
  • Sensitivity and Specificity
  • Vitamin D / blood

Substances

  • Anti-Mullerian Hormone
  • Follicle Stimulating Hormone
  • Luteinizing Hormone
  • Prolactin
  • Vitamin D