The relationship between anti-Mullerian hormone, androgen and insulin resistance on the number of antral follicles in women with polycystic ovary syndrome.
BACKGROUND
Anti-Müllerian hormone (AMH) is a biomarker that predicts the number of antral follicles and is involved in follicle arrest for women with polycystic ovary syndrome (PCOS). We investigated the association between the characteristic hyperandrogenemia, insulin resistance (IR), AMH, and the morphology and size of ovaries for women with PCOS.


METHODS
A total of 99 Taiwanese women with PCOS who were willing to undergo vaginal ultrasonography were enrolled in this cross-sectional study.


RESULTS
The number of antral follicles and the ovarian volume showed a significant correlation with AMH, total testosterone and the free androgen index, but not with age, body mass index (BMI) or the homeostasis model assessment of insulin resistance (HOMA-IR). AMH had a significant negative association with both BMI and HOMA-IR. Multiple stepwise regression analysis demonstrated that AMH, BMI and total testosterone were independently related to the number of antral follicles. AMH and total testosterone were the main determinants for ovarian volume in a stepwise regression model.


CONCLUSIONS
Our results suggest that not only the AMH level, but also obesity, IR and elevated androgen levels may relate to the development of the large size of antral follicle pool and ovarian volume in women with PCOS. Obesity and IR may enhance the follicular excess through the dysregulation of AMH or through the pathway of hyperandrogenemia. These findings might partly explain why adequate body weight management and improvement in IR can improve the ovulatory function for women with PCOS.
Chen
Mei-Jou
MJ
Department of Obstetrics and Gynecology, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei 100, Taiwan.
Yang
Wei-Shiung
WS
Chen
Chi-Ling
CL
Wu
Ming-Yih
MY
Yang
Yu-Shih
YS
Ho
Hong-Nerng
HN
D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D017588:Hyperandrogenism; D007333:Insulin Resistance; D009765:Obesity; D009929:Organ Size; D006080:Ovarian Follicle; D010053:Ovary / Q000000981:diagnostic imaging / Q000473:pathology*; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013624:Taiwan; D013739:Testosterone / Q000097:blood; D014463:Ultrasonography
D013739:Testosterone; D054304:Anti-Mullerian Hormone