Diagnosis of Polycystic Ovary Syndrome: AMH in combination with clinical symptoms
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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.
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.
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.
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.
KeywordsAMH PCOS Hyperandrogenism Oligo/amenorrhea Rotterdam criteria Androgen Excess Society NIH
We would like to thank Scott Mathyk, Begum Aydogan MD, Metehan Imamoglu MD, Yasemin Kurban, Kiymet Guler for their sincere support and technical assistance.
Conflict of interest
The authors declare no conflict of interest.
- 13.Pigny P, Merlen E, Robert Y, Cortet-Rudelli C, Decanter C, Jonard S, et al. Elevated serum level of anti-Müllerian hormone in patients with polycystic ovary syndrome: relationship to the ovarian follicle excess and to the follicular arrest. J Clin Endocrinol Metab. 2003;88:5957–62.PubMedCrossRefGoogle Scholar
- 17.Dewailly D, Pigny P, Soudan B, Catteau-Jonard S, Decanter C, Poncelet E, et al. Reconciling the definitions of polycystic ovary syndrome: the ovarian follicle number and serum anti-Müllerian hormone concentrations aggregate with the markers of hyperandrogenism. J Clin Endocrinol Metab. 2010;95:4399–405.PubMedCrossRefGoogle Scholar
- 19.Wang JG, Nakhuda GS, Guarnaccia MM, Sauer MV, Lobo RA. Müllerian inhibiting substance and disrupted folliculogenesis in polycystic ovary syndrome. Am J Obstet Gynecol. 2007;196:77 e1–5.Google Scholar
- 23.Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81:19–25Google Scholar
- 25.Zawadski JK, Dunaif A. Diagnostic criteria for polycystic ovary syndrome: towards a rational approach. In: Dunaif A, Givens JR, Haseltine F, Merriam GR, editors. Polycystic ovary syndrome. Boston: Blackwell Scientific; 1992. p. 377.Google Scholar