Wafa, Y., Hammour, M., Hamoda, D., Abd-elaziz, A. (2018). Anti-Mullerian Hormone: An Indicator for the Severity of Polycystic Ovarian Syndrome. The Egyptian Journal of Hospital Medicine, 70(8), 1278-1288. doi: 10.12816/0044636
Yehia Abd-Elsalam Wafa; Mohamed El-Sayed Hammour; Dalia Abdallah Hamoda; Ahmed Fathy Abd-elaziz. "Anti-Mullerian Hormone: An Indicator for the Severity of Polycystic Ovarian Syndrome". The Egyptian Journal of Hospital Medicine, 70, 8, 2018, 1278-1288. doi: 10.12816/0044636
Wafa, Y., Hammour, M., Hamoda, D., Abd-elaziz, A. (2018). 'Anti-Mullerian Hormone: An Indicator for the Severity of Polycystic Ovarian Syndrome', The Egyptian Journal of Hospital Medicine, 70(8), pp. 1278-1288. doi: 10.12816/0044636
Wafa, Y., Hammour, M., Hamoda, D., Abd-elaziz, A. Anti-Mullerian Hormone: An Indicator for the Severity of Polycystic Ovarian Syndrome. The Egyptian Journal of Hospital Medicine, 2018; 70(8): 1278-1288. doi: 10.12816/0044636
Anti-Mullerian Hormone: An Indicator for the Severity of Polycystic Ovarian Syndrome
1Departments of Obstetrics & Gynecology, Faculty of Medicine, Al Azhar University
2Clinical Pathology, Faculty of Medicine, Al Azhar University
Abstract
Background: Polycystic ovarian syndrome (PCOS) is a common endocrinopathy that accompanied with long term complications. Purpose Features of PCOS including sonographic aspects, androgens, luteinizing hormone (LH) and lutenizing and follicular stimulating hormones ratio LH/FSH ratio as well as Anti-Mullerian Hormone (AMH) were evaluated according to their diagnostic potency in detecting different degrees of PCOS severity. Objective: The aim of this study to assess the possible role of AMH as the diagnostic marker for different degrees of PCOS. Materials and Methods: In this cross-sectional study, a total of 150 women aged 18–46 years Patients were consecutively included as they presented in our clinic. 50 patients were diagnosed with sever PCOS (based on Rotterdam criteria consensus), 50 patients were diagnosed with mild PCOS, and 50 women served as controls. In day 2-4 of cycle, transvaginal sonography was performed and serum hormonal level of AMH, LH, FSH, testosterone. PCOS patients fulfilling all Rotterdam criteria were defined as having severe PCOS (n = 50), while patients showing oligo-/amenorrhoea and polycystic ovaries but without hyperandrogenemia were defined as having mild PCOS (n =50). And control group (n= 50). All patients were treated at the University Hospital of El-Hussein, Al-azhar university and at Ain Shams General Hospital Cairo Egypt. Results: The strongest group difference between controls and severe PCOS patients was observed for AMH showing an age-adjusted odds ratio of 2.56 [95 % confidence interval (CI) 2.00–3.27; p < 0.0001]. Age-adjusted receiver operating characteristic analysis showed that the area under the curve (AUC) of 0.88 (95 % CI: 0.80–0.95) for AMH and 0.94 (95 % CI 0.88–0.98) for antral follicle count did not differ significantly in their ability to discriminate between severe PCOS patients and controls. AMH showed higher AUC estimates than androgens, ovarian volume, LH and LH/FSH ratio and an AUC of 0.80 (95 % CI: 0.65–0.91) for detecting mild PCOS. Conclusions: this study comparing the diagnostic potency of AMH, sonographic aspects, androgens and LH/FSH ratio according to different PCOS subgroups while accounting for the age-dependency of AMH. In cases where vaginal scans are not feasible or in patients without hyperandrogenemia AMH may be used as a surrogate parameter in PCOS diagnosis, superior to androgens and gonadotropins.
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