Serum anti-müllerian hormone as a surrogate for antral follicle count for definition of the polycystic ovary syndrome

Despite its frequency, the polycystic ovary syndrome (PCOS) is still a difficult diagnosis in endocrinology, gynecology, and reproductive medicine. To help solve this issue, the Rotterdam consensus conference proposed to include the ultrasonographic follicle count as a new diagnostic criterion, in a...

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Bibliographic Details
Published in:The journal of clinical endocrinology and metabolism 2006-03, Vol.91 (3), p.941-945
Main Authors: PIGNY, P, JONARD, S, ROBERT, Y, DEWAILLY, D
Format: Article
Language:English
Subjects:
Adolescent
Adult
Androgens - blood
Anti-Mullerian Hormone
Biological and medical sciences
Biomarkers - blood
Endocrinopathies
Female
Follicle Stimulating Hormone - blood
Fundamental and applied biological sciences. Psychology
Glycoproteins - blood
Humans
Luteinizing Hormone - blood
Medical sciences
Ovarian Follicle - pathology
Polycystic Ovary Syndrome - blood
Polycystic Ovary Syndrome - diagnosis
Reference Values
Regression Analysis
ROC Curve
Sensitivity and Specificity
Testicular Hormones - blood
Vertebrates: endocrinology
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Summary:Despite its frequency, the polycystic ovary syndrome (PCOS) is still a difficult diagnosis in endocrinology, gynecology, and reproductive medicine. To help solve this issue, the Rotterdam consensus conference proposed to include the ultrasonographic follicle count as a new diagnostic criterion, in addition to hyperandrogenism and oligo-anovulation. Unfortunately, its assessment does not offer sufficient reliability worldwide. The aim of our study was to check whether anti-Müllerian hormone (AMH) measurement in the serum could be a surrogate for antral follicle count in the diagnostic criteria of PCOS. Serum AMH was measured with a second-generation immunoassay in a cohort of 73 PCOS patients and 96 controls, and its diagnostic power was evaluated by receiver operating characteristic curves. PCOS was diagnosed according to the Rotterdam definition. Serum AMH levels were 3-fold higher in PCOS patients than in controls (81.6 vs. 33.5 pmol/liter; P < 0.001) and were significantly related to the follicle number in the two groups. The area under the receiver operating characteristic curve for the AMH assay was 0.851, indicating a good diagnostic potency. Setting the threshold at 60 pmol/liter offered the best compromise between specificity (92%) and sensitivity (67%). The serum AMH level is an accurate marker of the ovarian early antral follicle number and offers a good diagnostic potency. In situations where accurate ultrasonographic data are not available, AMH could thus be used instead of the follicle count as a diagnostic criterion and incorporated as such in the Rotterdam definition of PCOS.
ISSN:0021-972X
1945-7197
DOI:10.1210/jc.2005-2076