title: The role of AMH in the pathophysiology of polycystic ovarian syndrome.
abstract: Polycystic ovarian syndrome (PCOS) affects 5 - 10% of reproductive age women, but its pathogenesis is still poorly understood. The aim of this review is to collate evidence and summarize our current knowledge of the role of anti-Müllerian hormone (AMH) in PCOS pathogenesis. AMH is increased and correlated with the various reproductive and metabolic/endocrine alterations in PCOS. AMH plays an inhibitory role in follicular development and recruitment, contributing to follicular arrest. AMH inhibitory action on FSH-induced aromatase production likely contributes to hyperandrogenism in PCOS, which further enhances insulin resistance in these women. Elevated serum AMH concentrations are predictive of poor response to various treatments of PCOS including weight loss, ovulation induction and laparoscopic ovarian drilling, while improvement in various clinical parameters following treatment is associated with serum AMH decline, further supporting an important role for AMH in the pathophysiology of this syndrome. This review emphasizes the need for understanding the exact mechanism of action of AMH in the pathophysiology of PCOS. This may lead to the development of new treatment modalities targeting AMH to treat PCOS, as well as help clinicians in prognostication and better tailoring existing treatments for this disease.
authors.affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York.
authors.forename: Deepika
authors.initials: D
authors.lastname: Garg
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut. Electronic address: reshef.tal@yale.edu.
authors.forename: Reshef
authors.initials: R
authors.lastname: Tal
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D054304:Anti-Mullerian Hormone / Q000097:blood*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007333:Insulin Resistance; D010535:Laparoscopy; D057230:Limit of Detection; D007986:Luteinizing Hormone / Q000097:blood; D008875:Middle Aged; D006080:Ovarian Follicle / Q000502:physiology; D010060:Ovulation; D010062:Ovulation Induction; D018384:Oxidative Stress; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000503:physiopathology; D055815:Young Adult
chemical_list: D054304:Anti-Mullerian Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone
keywords: AMH; PCOS; hyperandrogenism; insulin resistance; ovulatory dysfunction; pathophysiology