Anti‐Müllerian hormone measurement for the diagnosis of polycystic ovary syndrome

Abstract

Whilst an elevated AMH has poor sensitivity, it is fourfold more likely to be associated with a diagnosis of PCOS, and supplementary to biochemical parameters will make a positive diagnosis of PCOS in 22% of patients when neither serum testosterone nor FAI is elevated.

Simplified 4‐item criteria for polycystic ovary syndrome: A bridge too far?

“…This value is more stringent than the AMH threshold value (33.5 pmol/L or 4.7 ng/mL) determined by meta‐analysis of the extracted data from studies published prior to 2013 . In line with observations from another study, AMH alone, demonstrated poor sensitivity diagnosing about 34% more women as having PCOS compared to Rotterdam 2003. These data are in line with finding observations made by PCOS cases identified by AMH alone had significantly lower prevalence of oligomenorrhoea, lower androgen and metabolic indices, arguing against the adoption of AMH as a single biomarker for PCOS.…”

“…This value is more stringent than the AMH threshold value (33.5 pmol/L or 4.7 ng/mL) determined by meta-analysis of the extracted data from studies published prior to 2013 19. In line with observations from another study,34 AMH alone, demonstrated poor sensitivity diagnosing about 34% more women as having PCOS compared to…”

Development of a novel risk prediction and risk stratification score for polycystic ovary syndrome

“…AMH is produced in the granulosa cells by the preantral and small antral follicles and it appears to inhibit the action of FSH on aromatase, and therefore, it contributes to the development of a single follicle for ovulation. 8 It has also been suggested that serum AMH reflects ovarian size in PCOS patients and can be used as surrogate for transvaginal ultrasound in the diagnosis of PCOS. 22 We have recently shown that those with raised AMH have up to 4fold increased risk of having PCOS.…”

“…The study and study measurements are described in detail in our previous publication. 8 In summary, we measured body mass index (BMI) (kg/m 2 ), waist circumference (cm), hip circumference (cm), AMH (pmol/L), salivary testosterone (pmol/L), total testosterone (nmol/L), salivary androstenedione (pmol/L), serum androstenedione (nmol/L), SHBG (nmol/L), FAI (%), follicle-stimulating hormone (FSH) (IU/L), luteinizing hormone (LH) (IU/L), fasting glucose (mmol/L), 2-hour glucose (mmol/L), insulin (μIU/mL) according to established protocols in women with PCOS and controls. We also ascertained oral contraceptive use and history of menstrual irregularity/amenorrhoea.…”

“…Clinical hyperandrogenaemia, characterized by the presence of hirsutism, is recommended as a substitute of biochemical hyperandrogenaemia in the current guidelines but this can often be unreliable due to wide interobserver variation and ethnic variations. 7 While the focus has been placed upon biochemical and clinical hyperandrogenaemia for the diagnosis of PCOS, recent data by our group 8 and others 9 have shown that elevated levels of antimullerian hormone (AMH), a surrogate measure of follicle count on ultrasound, can be an important supplement to the hormonal parameters used in the diagnosis of PCOS. While PCOS is a diagnosis of exclusion, the diagnosis can often be challenging, given the presentation of this syndrome as a spectrum of clinical features and metabolic abnormalities in the affected patients, rather than the presence of a single unified entity, PCOS.…”