Serum anti-Mullerian hormone as a surrogate for antral follicle count for definition of the polycystic ovary syndrome.
BACKGROUND
Despite its frequency, the polycystic ovary syndrome (PCOS) is still a difficult diagnosis in endocrinology, gynecology, and reproductive medicine. To help solve this issue, the Rotterdam consensus conference proposed to include the ultrasonographic follicle count as a new diagnostic criterion, in addition to hyperandrogenism and oligo-anovulation. Unfortunately, its assessment does not offer sufficient reliability worldwide.


OBJECTIVE
The aim of our study was to check whether anti-Müllerian hormone (AMH) measurement in the serum could be a surrogate for antral follicle count in the diagnostic criteria of PCOS.


METHODS
Serum AMH was measured with a second-generation immunoassay in a cohort of 73 PCOS patients and 96 controls, and its diagnostic power was evaluated by receiver operating characteristic curves. PCOS was diagnosed according to the Rotterdam definition.


RESULTS
Serum AMH levels were 3-fold higher in PCOS patients than in controls (81.6 vs. 33.5 pmol/liter; P < 0.001) and were significantly related to the follicle number in the two groups. The area under the receiver operating characteristic curve for the AMH assay was 0.851, indicating a good diagnostic potency. Setting the threshold at 60 pmol/liter offered the best compromise between specificity (92%) and sensitivity (67%).


CONCLUSIONS
The serum AMH level is an accurate marker of the ovarian early antral follicle number and offers a good diagnostic potency. In situations where accurate ultrasonographic data are not available, AMH could thus be used instead of the follicle count as a diagnostic criterion and incorporated as such in the Rotterdam definition of PCOS.
Pigny
P
P
Laboratoire de Biochimie et Hormonologie, Parc Eurasanté, Centre Hospitalier Régional Universitaire, 59037 Lille cedex, France. p-pigny@chru-lille.fr
Jonard
S
S
Robert
Y
Y
Dewailly
D
D
D000293:Adolescent; D000328:Adult; D000728:Androgens / Q000097:blood; D054304:Anti-Mullerian Hormone; D015415:Biomarkers / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006023:Glycoproteins / Q000097:blood*; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D006080:Ovarian Follicle / Q000473:pathology*; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000175:diagnosis*; D012372:ROC Curve; D012016:Reference Values; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D013735:Testicular Hormones / Q000097:blood*
D000728:Androgens; D015415:Biomarkers; D006023:Glycoproteins; D013735:Testicular Hormones; D054304:Anti-Mullerian Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone