Value of Serum Level Anti-Mülerian Hormone in the Diagnosis of Polycystic Ovary Syndrome in Women of Reproductive Age,
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- Category: Vol. 84, December 2016
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Value of Serum Level Anti-Mülerian Hormone in the Diagnosis of Polycystic Ovary Syndrome in Women of Reproductive Age, ASHRAF M. KANSOUH, MOHAMED A. EL-NAGGAR and AHMED E. EL-SHEIK and SAMAR E. GHANEM
Abstract
Background: Polycystic Ovary Syndrome (PCOS) is one of the most frequent endocrine disorders in women of repro-ductive age, characterized by the association of polycystic ovaries, hyperandrogenism and chronic anovulation. Excessive ovarian production of Anti-Mülerian Hormone (AMH), se-creted by the excess of growing follicles, is now considered an important feature of PCOS, with an increasing number of evidence in the last decade on the role of AMH in the patho-genesis of the syndrome.
Objective: This study was conducted to evaluate the role of measuring early follicular phase serum AMH in the diagnosis of polycystic ovary syndrome in women of reproductive age as well as the association of AMH with other components of the syndrome.
Methods: A cross-sectional study of clinical, hormonal and biochemical markers in 50 patients with PCOS diagnosed according to Rotterdam criteria and 50 controls was conducted. The patients subjected to this study were selected from women attending the Department of Obstetrics and Gynecology in Shibeen El-Kom and Benha Teaching Hospitals, December 2014 and December 2015.
All women included in the study were between the ages of 18 to 40 years, suffered from infertility for more than 2 years and did not had diabetes mellitus, liver or renal diseases or known cause of hyperandrogenism other than PCOS. Smokers and alcohol abusers were excluded from the study. Also we excluded any woman who was receiving any hormonal treatment or metformin.
Results: There was a statistically significant difference of AMH values between the groups, positive significant correlation of AMH values PMI, AFN, ovarian volume, as well as a significant correlation with serum level of LH and total serum testosterone levels and negative significant corre-lation with the levels of follicle stimulating hormone were observed. Measurement of serum AMH levels as a diagnostic modality of PCOS showed high sensitivity and specificity. Optimal specificity and sensitivity were achieved at thecutoff level of 2.98ng/ml offering sensitivity of 96% and specif-icity of 74% with a accuracy 85%.
Conclusion: We may recommend using serum anti-Mullerian hormone as one of the diagnostic criteria of poly-cystic ovary syndrome.
Conclusion: As a diagnostic marker, AMH measurement has been found to offer a relatively high specificity and sensitivity for PCOS. Given its strong implication in the pathophysiology of PCOS, AMH measurement would theo-retically be more accurate than ultrasound, as it also reflects the excess of small antral follicles non-visible on ultrasound.