The value of anti-Müllerian hormone in the diagnosis of polycystic ovary syndrome
Objective. To estimate the value of anti-Müllerian hormone (AMH) for the diagnosis of polycystic ovary syndrome (PCOS) and the possible characteristics of its secretion in various phenotypes of the syndrome.Naidukova A.A., Kaprina E.K., Ivanets T.Yu., Chernukha G.E.
Subjects and methods. The investigation enrolled 502 reproductive-aged women, including 250 patients aged 25.4±4.2 years (body mass index (BMI), 24.2±5.6 kg/m2) with PCOS and 252 women (aged 25,2±3,8 years; BMI, 24.2±5.6 kg/m2) without reproductive dysfunction. Four phenotypes of the syndrome were identified using the Rotterdam criteria. Phenotypes A, B, C, and D were detected in 58, 10.4, 6.4, and 25.2% of the women, respectively. The investigators made complex clinical and laboratory examinations, including small pelvic ultrasound and a study of the androgen profile, AMH, luteinizing hormone, follicle-stimulating hormone, prolactin, and thyroid-stimulating hormone.
Results. The mean serum AMH level in the healthy women and women with PCOS was 3.3±1.9 and 15.8±10.2 ng/ml,
respectively (p < 0.05). The highest AMH level (17.9±11.6 ng/ml) was found in the women with phenotype A as compared with other phenotypes of the syndrome (p < 0.05). ROC analysis revealed that the threshold level of AMH for the diagnosis of PCOS was 5.2 ng/ml (an AUC of 0.97, a sensitivity of 95%, a specificity of 92%, and a confidence interval (CI)) of 95%).
Conclusion. The AMH level exceeding 5.2 ng/ml can be considered as a threshold in the diagnosis of PCOS regardless of the phenotype of the syndrome. The elevated serum level of AMH is a more specific and sensitive diagnostic criterion for PCOS than enlarged ovaries.
Keywords
polycystic ovary syndrome
phenotypes
anti-Müllerian hormone
threshold level
Supplementary Materials
- Picture 1. ROC-analyses, AMH level and ovarian volume significance estimation in PCOS diagnosis.
- Table 1. Comparative evaluation of AMH level and ovarian volume diagnostic significance.
- Table 2. AMH levels in PCOS and control group in different age periods.
- Picture 2. ROC-analyses, AMH and ovarian volume significance estimation in different PCOS phenotypes: а) phenotype А; b) phenotype В; c) phenotype D.
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Received 26.08.2016
Accepted 02.09.2016
About the Authors
Naydukova Alina A., post-graduate, department of gynecological endocrinology, Research Center of Obstetrics, Gynecology and Perinatology.117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79166750097. E-mail: aleeshka@mail.ru
Kaprina Elena K., post-graduate department of gynecological endocrinology, Research Center of Obstetrics, Gynecology and Perinatology.
117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79161294118
Ivanets Tatiana Yu., PhD, Head of Research and diagnostic laboratory, Research Center of Obstetrics, Gynecology and Perinatology Ministry of Health of Rossiа.
117997, Russia, Moscow, Ac. Oparina str. 4. E-mail: t_ivanetz@oparina4.ru
Chernukha Galina E., a doctor of medical sciences, professor, head of department of Gynecological Endocrinology, Research Center of Obstetrics,
Gynecology and Perinatology. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79859996000. E-mail: G_chernukha@oparina4.ru
For citations: Naidukova A.A., Kaprina E.K., Ivanets T.Yu., Chernukha G.E. The value of anti-Müllerian hormone in the diagnosis of polycystic ovary syndrome.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (1): 46-52. (in Russian)
http://dx.doi.org/10.18565/aig.2017.1.46-52
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