Müllerian Duct Anomalies and Anti-Müllerian Hormone Levels in Women With Polycystic Ovary Syndrome

Min Yang; Fang Zhang; Kaiqi Wu; Dong Yu; Yi Zhang; Yun Liao; Gufeng Xu; Yue Wang

doi:10.7759/cureus.43848

Müllerian Duct Anomalies and Anti-Müllerian Hormone Levels in Women With Polycystic Ovary Syndrome

Cureus. 2023 Aug 21;15(8):e43848. doi: 10.7759/cureus.43848. eCollection 2023 Aug.

Authors

Min Yang¹, Fang Zhang², Kaiqi Wu³, Dong Yu⁴, Yi Zhang², Yun Liao¹, Gufeng Xu¹, Yue Wang¹

Affiliations

¹ Department of Ambulatory Surgery, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, CHN.
² Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, CHN.
³ Department of Clinical Laboratory, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, CHN.
⁴ Department of Sonography, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, CHN.

Abstract

Background: Significant associations between the presence of polycystic ovary syndrome (PCOS) and uterine anomalies have been reported. It is unclear whether high anti-Müllerian hormone (AMH) levels coexist with the development of uterine malformations in women with PCOS. This study sought to investigate the association between Müllerian duct anomalies and anti-Müllerian hormone (AMH) levels in women with PCOS.

Methods: In this retrospective cohort study, the records of 1,391 women with PCOS were analyzed. The cohort was divided into a low-AMH group (n = 700) and a high-AMH group (n = 691), based on an AMH cutoff value of 8.45 ng/ml. Müllerian duct anomalies were classified into four subtypes based on three-dimensional ultrasonography: septate uterus, bicornuate uterus, uterus didelphys, unicornuate uterus, and arcuate uterus. The primary outcome was the overall incidence of Müllerian duct anomalies. The secondary outcome was the prevalence of the abovementioned specific types of Müllerian duct anomalies. The prevalence of Müllerian duct anomalies was analyzed using the chi-squared test or Fisher's exact test.

Results: Among the patients with PCOS, the prevalence of unicornuate uterus anomalies was higher in the high-AMH group than in the low-AMH group (1.0% vs. 0.1%, P = 0.04). No statistically significant difference in the overall incidence of uterine malformations was found between the two AMH groups (4.3% vs. 5.7%, P = 0.22).

Conclusions: Our study confirmed a higher prevalence of unicornuate uterus in PCOS women with high AMH levels. Clinicians might decide to investigate the possibility of a unicornuate uterus in PCOS women with high AMH levels.

Keywords: anti-mullerian hormone; müllerian duct anomalies; polycystic ovary syndrome; unicornuate uterus; uterine malformation.

Grants and funding

This work was supported by the Natural Science Foundation of Zhejiang Province under Grant LGF22H040011, the Health Commission of Zhejiang Province under Grant 2022KY857, and the Zhejiang Provincial Department of Education under Grant Y202146852.