title: May AMH levels distinguish LOCAH from PCOS among hirsute women?
abstract: OBJECTIVE
  To determine whether women with polycystic ovary syndrome (PCOS) would be distinguishable from women with late onset congenital adrenal hyperplasia (LOCAH) on the basis of antimullerian hormone (AMH) levels.
  
  
  METHODS
  PCOS was diagnosed in 170 women; 105 were polycystic ovary morphology (PCOM)+/oligo-anovulation (OA)+/hyperandrogenism (HA)+, 40 PCOM+/OA-/HA+ and 25 PCOM-/OA+/HA+. These three groups were compared with 25 women in whom LOCAH was diagnosed.
  
  
  RESULTS
  The mean serum AMH levels were 8.12±1.85ng/ml in PCOM+/OA+/HA+ group, 5.34±1.82ng/ml in PCOM+/OA-/HA+ group, 3.02±1.76ng/ml in PCOM-/OA+/HA+ group and 4.43±1.29ng/ml in LOCAH group. The mean AMH level in PCOM+/OA+/HA+ group was approximately twofold higher than the mean AMH level measured in LOCAH group (p<0.001). Women with PCOM+/OA-/HA+ had higher serum AMH levels than those with LOCAH, women with LOCAH had higher serum AMH levels than those with PCOM-/OA+/HA+ but these differences were not statistically significant (p>0.05).
  
  
  CONCLUSIONS
  AMH is not suitable for distinguishing LOCAH from all types of hyperandrogenic patterns of PCOS, but is only applicable for a specific subtype, such as PCOS patients with three main diagnostic criteria. Therefore, ACTH stimulation test remains an essential clinical tool to diagnose LOCAH.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey. Electronic address: mahmutoncul@gmail.com.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Oncul
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Sezai
authors.initials: S
authors.lastname: Sahmay
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Tuten
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Abdullah S
authors.initials: AS
authors.lastname: Acikgoz
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Hazel C
authors.initials: HC
authors.lastname: Gurleyen
mesh_terms: D000312:Adrenal Hyperplasia, Congenital / Q000097:blood / Q000175:diagnosis*; D000328:Adult; D000858:Anovulation / Q000097:blood; D054304:Anti-Mullerian Hormone / Q000097:blood*; D005260:Female; D006628:Hirsutism / Q000097:blood*; D006801:Humans; D017588:Hyperandrogenism / Q000097:blood; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000175:diagnosis*; D012189:Retrospective Studies
chemical_list: D054304:Anti-Mullerian Hormone
keywords: Antimullerian hormone; Late onset congenital adrenal hyperplasia; Polycystic ovary syndrome