Anti-Mullerian hormone in the diagnosis of polycystic ovary syndrome: can morphologic description be replaced?
OBJECTIVE
Can anti-Müllerian hormone (AMH) level replace the morphologic description in the diagnosis of polycystic ovary syndrome (PCOS) and what is the relationship between AMH and different diagnostic criteria of PCOS?


CONCLUSIONS
AMH may be a good substitute for polycystic ovarian morphology (PCOM) in diagnosing PCOS.


BACKGROUND
AMH has been suggested as an alternative to antral follicle count (AFC) in diagnosing PCOS. Cut-off values for AMH studied so far show an acceptable specificity but a rather poor sensitivity, leaving up to one-third of PCOS women undiagnosed.


METHODS
We used data from a cross-sectional, case-control study on women with prior preterm birth and their controls, i.e. women with prior full-term birth. Among 262 women, 56 met the Rotterdam criteria (PCOS-R) and 44 the Androgen Excess-PCOS Society (PCOS-AES) criteria of PCOS.


METHODS
Fasting blood samples were collected, a transvaginal ultrasound investigation and a clinical examination were performed. PCOS-R and PCOS-AES were re-diagnosed by replacing PCOM with AMH. Main outcome measures were the prevalence of PCOS, PCOM, hirsutism, oligoamenorrhoea and serum levels of AMH and androgens.


RESULTS
When replacing PCOM with AMH, the specificity and sensitivity for identifying PCOS were 97.1 and 94.6% according to the PCOS-R criteria and 97.2 and 95.5% according to the PCOS-AES criteria, respectively, at an AMH cut-off value of 20 pmol/l.


CONCLUSIONS
The results need to be confirmed when international standards and methods for AMH measurements are established.


CONCLUSIONS
AMH may be a good substitute for PCOM in diagnosing PCOS.


BACKGROUND
This study was financed by the Cooperative of Central Norway Regional Health Authority and Norwegian University of Science and Technology. The authors have no interests to disclose.


BACKGROUND
This study is registered at www.clinicaltrials.gov as NCT01355536.
Department of Obstetrics and Gynaecology, Hospital of Namsos, Nord-Troendelag Hospital Trust, Namsos, Norway. tina.eilertsen@hnt.no
Tina B
TB
Eilertsen
Eszter
E
Vanky
Sven M
SM
Carlsen
D000328:Adult; D054304:Anti-Mullerian Hormone / Q000378:metabolism*; D016022:Case-Control Studies; D003270:Contraceptive Agents / Q000494:pharmacology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006080:Ovarian Follicle / Q000473:pathology; D010053:Ovary / Q000473:pathology; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000175:diagnosis*; D015995:Prevalence; D012372:ROC Curve; D012680:Sensitivity and Specificity
D003270:Contraceptive Agents; D054304:Anti-Mullerian Hormone