Anti-Mullerian hormone in the diagnosis of polycystic ovary syndrome: can morphologic description be replaced?

作者：Eilertsen Tina B^*; Vanky Eszter; Carlsen Sven M

来源：Human Reproduction, 2012, 27(8): 2494-2502.

DOI：10.1093/humrep/des213

• AMH
• PCOS
• AFC
• hirsutism
• cut-off
• sensitivity
• specificity

Can anti-Mllerian hormone (AMH) level replace the morphologic description in the diagnosis of polycystic ovary syndrome (PCOS) and what is the relationship between AMH and different diagnostic criteria of PCOS? %26lt;br%26gt;AMH may be a good substitute for polycystic ovarian morphology (PCOM) in diagnosing PCOS. %26lt;br%26gt;AMH has been suggested as an alternative to antral follicle count (AFC) in diagnosing PCOS. Cut-off values for AMH studied so far show an acceptable specificity but a rather poor sensitivity, leaving up to one-third of PCOS women undiagnosed. %26lt;br%26gt;We used data from a cross-sectional, casecontrol study on women with prior preterm birth and their controls, i.e. women with prior full-term birth. Among 262 women, 56 met the Rotterdam criteria (PCOS-R) and 44 the Androgen Excess-PCOS Society (PCOS-AES) criteria of PCOS. %26lt;br%26gt;Fasting blood samples were collected, a transvaginal ultrasound investigation and a clinical examination were performed. PCOS-R and PCOS-AES were re-diagnosed by replacing PCOM with AMH. Main outcome measures were the prevalence of PCOS, PCOM, hirsutism, oligoamenorrhoea and serum levels of AMH and androgens. %26lt;br%26gt;When replacing PCOM with AMH, the specificity and sensitivity for identifying PCOS were 97.1 and 94.6 according to the PCOS-R criteria and 97.2 and 95.5 according to the PCOS-AES criteria, respectively, at an AMH cut-off value of 20 pmol/l. %26lt;br%26gt;The results need to be confirmed when international standards and methods for AMH measurements are established. %26lt;br%26gt;AMH may be a good substitute for PCOM in diagnosing PCOS. %26lt;br%26gt;This study was financed by the Cooperative of Central Norway Regional Health Authority and Norwegian University of Science and Technology. The authors have no interests to disclose. %26lt;br%26gt;This study is registered at as NCT01355536.

• 出版日期2012-8