Diagnosis of Polycystic Ovary Syndrome: AMH in combination with clinical symptoms

Abstract

Purpose We assessed the utility of using anti-Müllerian hormone (AMH) and clinical features of polycystic ovary syndrome (PCOS), polycystic ovarian morphology (PCOM), oligo/amenorrhea (OA), and hyperandrogenism (HA) for diagnosing PCOS, and compared their diagnostic accuracy with those of classical diagnostic systems. Methods A total of 606 females were admitted to a university hospital with menstrual irregularities or symptoms of hyperandrogenism were enrolled in this cross-sectional study. Fasting blood samples were collected. Pelvic and/or abdominal ultrasonography and clinical examination were performed. Patients were evaluated for the presence of PCOS according to conventional diagnostic criteria. The diagnostic performance of using serum AMH levels alone and in various combinations with the clinical features of PCOM, OA, and HA were investigated. Results For the diagnosis of PCOS, the combination of OA and/or HA with AMH showed 83 % sensitivity and 100 % specificity according to the Rotterdam criteria; 83 % sensitivity and 89 % specificity according to the National Institutes of Health (NIH) criteria; and 82 % sensitivity and 93.5 % specificity according to the Androgen Excess Society (AES) criteria. Conclusions The serum AMH level is a useful diagnostic marker for PCOS and is correlated with conventional diagnostic criteria. The combination of AMH level with OA and/ or HA markedly increased the clinical scope for PCOS diagnosis and can be introduced as a possible objective criterion for the diagnosis of this disease.

Age related endocrine patterns observed in polycystic ovary syndrome patients vs. ovulatory controls: descriptive data from a university based infertility center

“…(3.8 ng/mL) and Wiweko and cols. (4.45 ng/mL) (4,5). In contrast with results published by Kriseman and cols.…”

“…Accordingly, several threshold AMH values for PCOS (based on measurements among varied age and ethnic groups) have been proposed. Of note, serum AMH has been considered as a substitute for antral follicle count as articulated by the Rotterdam diagnostic criteria for PCOS (4)(5)(6)(7)(8)(9)(10)(11)(12) although this has not been widely used perhaps due to the lack of a universally standardized AMH serum assay (13).…”

Hormon anty-müllerowski i zespół policystycznych jajników

“…[52]. Additionally, it has been shown that for the diagnosis of PCOS the combination of OM and/or HA with AMH shows 83% sensitivity and 100% specificity according to the Rotterdam criteria [53]. Due to the fact that published studies use different assays, the values of serum AMH obtained in one assay may not be directly translated to the other.…”

“…uważają, że przy stężeniu AMH w surowicy krwi > 35 pmol/l lub liczbie pęcherzyków jajnika przekraczającej 19, częstość występowania PCOS była niższa odpowiednio 8,5% i 6,3% w porównaniu z częstością 16,6% przy kryteriach rotterdamskich [52]. Warto zwrócić uwagę, że współwystępowanie OM i/lub HA z podwyższonym stężeniem AMH pozwala na diagnozę PCOS z czułością 83% i specyficznością 100%, według kryteriów rotterdamskich [53]. Do oznaczenia stężenia AMH w surowicy wykorzystywane były różne metody, co sprawia, że uzyskane wyniki nie zawsze mogą być ze sobą porównywane.…”

Maximizing the clinical utility of antimüllerian hormone testing in women's health

“…Numerous studies demonstrate that PCOS is significantly associated with elevated serum AMH both with the NIH criteria [43 ▪ ,44 ▪ ] and with the Rotterdam criteria [44 ▪ ,45 ▪▪ ,46 ▪▪ ,47–49]. One study demonstrated that in women presenting for fertility evaluation with serum AMH elevated, high, and very high, the frequency of PCOS diagnosis was 51.6% ( n  = 84), 97% ( n  = 30), and 100% ( n  = 20), respectively [50 ▪ ].…”