Müllerian-inhibiting substance reflects ovarian findings in women with polycystic ovary syndrome better than does inhibin B.
OBJECTIVE
To investigate Müllerian-inhibiting substance (MIS) levels in women with polycystic ovary syndrome (PCOS), as well as relationships to ovarian morphology, levels of inhibin B, and other reproductive hormones.


METHODS
Prospective clinical study.


METHODS
Academic endocrinology centers in Palermo, Italy and New York.


METHODS
Forty-six women with PCOS, recruited on the basis of the classic criteria of chronic anovulation and hyperandrogenism, and 25 age-matched ovulatory controls.


METHODS
Fasting blood was obtained in all subjects in the early follicular phase (days 5-6) after spontaneous or induced menses (in PCOS), and transvaginal ultrasounds were performed.


METHODS
Assessment of values for luteinizing hormone (LH), testosterone (T), androstenedione (A), estradiol (E2), inhibin B, MIS, fasting insulin, and the calculated quantitative sensitivity check index (QUICKI), as well as assessments of ovarian volume and blood flow.


RESULTS
Women with PCOS had higher LH, T, and A; higher insulin and lower QUICKI; and higher ovarian volume and lower pulsatility index. Inhibin B concentrations were statistically significantly higher in PCOS patients (70 +/- 8.0 vs. 40 +/- 3.4 pg/mL), as was MIS (6.7 +/- 0.9 vs. 4.6 +/- 0.5 ng/mL). Inhibin B had a statistically significant direct correlation with levels of MIS (r = 0.351). However, MIS, but not inhibin B, had a statistically significant positive correlation with ovarian size (r = 0.350); the reproductive hormones LH, T, A, and E2; and insulin (r = 0.249), independent of body mass index. Women with PCOS with the highest levels of MIS had higher ovarian volumes and values of LH, T, A, and insulin.


CONCLUSIONS
Measurements of MIS reflect ovarian findings in PCOS better than levels of inhibin B and are more frequently elevated. However, MIS lacks sensitivity for use as a diagnostic tool in PCOS.
Chu
Micheline C
MC
Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.
Carmina
Enrico
E
Wang
Jeff
J
Lobo
Rogerio A
RA
D000858:Anovulation / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology; D054304:Anti-Mullerian Hormone; D015415:Biomarkers / Q000097:blood*; D005260:Female; D005498:Follicular Phase; D006023:Glycoproteins / Q000097:blood*; D006801:Humans; D007265:Inhibins / Q000097:blood*; D007328:Insulin / Q000097:blood; D009765:Obesity / Q000097:blood / Q000473:pathology; D010053:Ovary / Q000000981:diagnostic imaging / Q000473:pathology; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000000981:diagnostic imaging / Q000473:pathology*; D011446:Prospective Studies; D013735:Testicular Hormones / Q000097:blood*; D014463:Ultrasonography
D015415:Biomarkers; D006023:Glycoproteins; D007328:Insulin; D013735:Testicular Hormones; C422364:inhibin B; D007265:Inhibins; D054304:Anti-Mullerian Hormone