Objective: This study explores the role of anti-Mullerian hormone (AMH) and LH/ FSH ratio in diagnosis of polycystic ovary syndrome (PCOS). Methods: In this multicentre cross-sectional descriptive study, a total of 863 infertile women between 18 and 45 years were evaluated at three infertility centres in Vietnam and were recruited from June 2016 to June 2017. The patients were classified into two groups: Group I included 441 patients with PCOS (based on Rotterdam criteria consensus) and Group II included 422 non-PCOS women. Diagnosis of PCOS was established based on Rotterdam 2003 consensus, and exclusion criteria were ovarian disease (ovary cyst/tumour), history of ovarian surgery and ovarian failure. Results: At an optimum cut-off level of 32.79 pmol/L, AMH showed sensitivity and specificity of 78.50% and 75.83%, respectively, with the AUC 0.852 (95% CI: 0.826-0.875). The LH/FSH ratio had a similar AUC at the optimum cut-off of 1.33 (AUC = 0.867, 95% CI 0.842-0.889), which demonstrated a similar diagnosis value to AMH (P = 0.340). By using multiple logistic regression analysis, 1 ng/mL increase in AMH levels was associated with an increased risk of PCOS (OR = 1.63, 95% CI:1.506-1.764; P < 0.001). Similarly, one unit increase in LH/FSH ratio was associated with 14.433 times increased (95% CI: 9.302-22.395; P < 0.001) risk of PCOS. There were no significant differences between values of AMH and LH/FSH ratio in PCOS diagnosis, as the difference between the two AUCs was 0.013, 95% CI: −0.024 to 0.028 and P = 0.897. Conclusion:The value of serum AMH concentration has been found not significantly superior to LH/FSH ratio in PCOS diagnosis. Although these biomarkers separately are not adequate for PCOS diagnosis based on their own value, the combination of different endocrine factors including AMH, LH and LH/FSH ratio together with BMI and other anthropometric and clinical characteristics may offer extra value to establish the diagnosis of PCOS. K E Y W O R D Santi-Mullerian hormone, diagnostic value, LH/FSH ratio, polycystic ovary syndrome ACK N OWLED G EM ENTSWe thank the staff of the Hue Center for Reproductive Endocrinology and Infertility, Hue University Hospital for their excellent support.

BackgroundPolycystic ovarian syndrome (PCOS) is one of the most common endocrinopathies among reproductive-age women. Its metabolic features often overlap with those associated with metabolic syndrome (MS) and insulin resistance syndrome (IRS). The objective of this study was to determine the prevalence and predictors of MS and IRS in infertile Vietnamese women with PCOS.MethodsA cross-sectional study was conducted at a tertiary fertility centre at Hue University Hospital from June 2016 to November 2017. A total of 441 infertile women diagnosed with PCOS based on the revised 2003 Rotterdam consensus criteria were enrolled. MS and IRS were defined based on the National Heart, Lung, and Blood Institute/American Heart Association Adult Treatment Panel III 2005 and American College of Endocrinology IRS 2003 criteria, respectively. Complete clinical and biochemical measurements of 318 women were available for analysis. Independent predictors of MS and IRS were identified using multivariate logistic regression.ResultsThe overall prevalence of MS and IRS in women with PCOS was 10.4% and 27.0%, respectively. We identified older age (>30 years) and obesity as independent predictors of MS and IRS. Elevated anti-Müllerian hormone levels increased the risk of IRS, but not that of MS.ConclusionMS and IRS are prevalent disorders among infertile Vietnamese women with PCOS. PCOS is not solely a reproductive problem. Screening and early intervention for MS and/or IRS based on anthropometric, metabolic, and reproductive hormone risk factors should be an integral part of fertility care.

Aim: This study aimed to evaluate the unique phenotype of the Vietnamese polycystic ovarian syndrome (PCOS) population. Methods: In this multicenter cross-sectional descriptive study, a total of 901 reproductive-age women were recruited at three medical centers in Vietnam from June 2016 to May 2018. Group I included 479 patients with PCOS (Rotterdam 2003 consensus) and Group II included 422 non-PCOS women, consisted of women with regular menstrual cycle, collected at the same time of PCOS recruitment, without ovarian disease or ovarian failure. Main outcome measures were anthropomorphic, serum hormone, ultrasound and physical characteristics of PCOS. Results: The Vietnamese PCOS population was lean, but with a higher weight and body mass index compared to controls. About 34.4% of PCOS subjects had hirsutism, primarily confined to the leg, arm and pubis. The PCOS population had higher serum luteinizing hormone (LH), LH : follicle stimulating hormone ratio, anti-Mullerian hormone and testosterone. The PCOS population had double the ovarian volume compared to controls. PCOS subjects had no increase in metabolic disease history and had on average optimal serum markers for low metabolic disease risk. Group D (O + polycystic ovary morphology [PCOM]) was the most prevalent phenotype noted in our Vietnamese PCOS cohort (67.6%). Modified Ferriman-Gallwey, levels of LH, testosterone and anti-Mullerian hormone were highest in Group A (O + H + PCOM) and lowest in Group D (O + PCOM). Conclusion: The Vietnamese PCOS population is characterized by a lean body type, nonfacial hirsutism, anovulatory, enlarged ovaries and typical PCOS serum hormone markers, low risk factors for metabolic syndrome. Nonclassical phenotypes for PCOS were more frequent than the classic phenotype.

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Introduction: Polycystic ovary syndrome (STD) is a common endocrine and metabolic disorder that affects significantly the general health of 6-18% of women. Data on metabolic disorders in PCOS is so far still limited and lack of uniformity in terms of race, geographic location, human-origin, age, sample size or lifestyle. Methodology: A cross-sectional description of 759 cases of reproductive-age women who were diagnosed with PCOS by Rotterdam criteria (391) and non-PCOS (368) visited 3 ART centers in central Vietnam including Hue University Hospital, Hue Central Hospital and Danang Hospital for Women and Children, from June 2016 to June 2017. Inclusion criteria to the control group consisted of infertile women without PCOS, regular menstrual cycle, no ovarian disease (ovary cyst/tumor or endometriosis), without history of ovarian surgery or determined ovarian failure. Clinical characteristics and basic hormonal profile, AMH, lipidemia variables, fasting blood glucose and glucose tolerance testing were performed to evaluate endocrine and metabolic status. Input and process data using SPSS 19.0 software. Results: The PCOS group had a 1.2-fold increase in overweight BMI (RR=1.20 with 95%CI: 1.02-1.42). The mean of waist circumference and waist / hip ratio was higher than that of control group. Lipidemia dysfunction was observed in 176 cases of PCOS (45%), of which total cholesterol abnormalities accounted for 21.0%, triglycerides 21.5%, LDL-C 25.6% and decreased HDL in 7.9%. Glycemia disturbances occurred in 119 cases (accounting for 30.4%) with abnormal blood glucose 16.4% and abnormal glucose tolerance test after 2 hours was 25.0%. Considering the metabolic factors, 68.8% of PCOS cases have at least one disorder. There is a correlation between metabolic disorders and clinical and endocrine factors: increased WHR with age, body mass index, AMH and prolactin; Total cholesterol associated with BMI and prolactin; Triglycerides related to age; HDL-C decrease is associated with BMI, LH and FSH; Hyperglycemia is associated with BMI. Conclusions: Endocrine disorders and especially metabolic syndrome are common in the infertile patients with PCOS in Central Vietnam. Appropriate screening strategy, early detection and timely intervention are needed to prevent systemic complications related to metabolic disorders. Key words: polycystic ovary syndrome, endocrine disorders, metabolic disorders