Abstract
To compare serum anti-Müllerian hormone (AMH) and other endocrine parameters between patients diagnosed with polycystic ovary syndrome (PCOS) and age-matched ovulatory women. AMH, DHEAS, FSH, LH, PRL, TSH and total testosterone (TT) were prospectively measured in oligo-ovulatory PCOS patients (n = 595) and in ovulatory non-PCOS women (n = 157) referred to a tertiary infertility center. Mean BMI was similar across the two study populations and there were no smokers in the sample. Patients in both groups were further classified into three categories by age: < 25 yrs, 25-34 yrs, and ≥ 35 yrs. Selected clinical and demographic characteristics were tabulated for each group. Serum AMH was significantly higher among PCOS patients compared to non-PCOS controls in the non-stratified sample (7.54 ± 5.8 vs. 2.49 ± 2.0 ng/mL, respectively; p < 0.0001), while serum FSH, DHEAS, TSH and prolactin were similar for both groups (p > 0.05). As expected, mean (total) testosterone levels were notably different between PCOS vs. non-PCOS controls (0.84 ± 0.76 vs. 0.43 ± 0.38 ng/mL, respectively; p < 0.001), and mean AMH level was significantly lower in the oldest age category (> 35 yrs) compared to both younger control groups (p < 0.0001). Both DHEAS and total testosterone decreased with age among PCOS patients, although mean serum DHEAS for women age > 35 yrs was significantly lower than DHEAS measured in younger women with PCOS (p < 0.02). For PCOS patients, AMH remained relatively stable irrespective of age. Although AMH can serve as a satisfactory marker of ovarian reserve, for PCOS patients the expected decline in AMH associated with reproductive aging appears attenuated despite ovarian senescence. In contrast, mean DHEAS levels were markedly lower among older PCOS women (> 35 yrs) compared to younger PCOS patients.
Highlights
S ince the introduction of anti-Müllerian hormone (AMH) as a method of estimating ovarian reserve, its measurement in the setting of the advanced reproductive technologies has received considerable attention
Mean ± SD age for polycystic ovary syndrome (PCOS) patients was significantly lower than for control patients during the study period (26.9 ± 4.6 vs. 29.9 ± 5.9 yrs; p = 0.12), mean BMI was similar in the two groups (p > 0.05)
For study subjects in the non-PCOS group, BMI > 25 was associated with significantly higher serum total testosterone (0.49 ± 0.46 vs. 0.34 ± 0.22 ng/mL; p = 0.039). This association was not observed for serum DHEAS or AMH in our study population. This investigation aimed to provide additional data on PCOS and contribute an improved understanding to the process of how serum AMH changes with increasing age in PCOS
Summary
S ince the introduction of anti-Müllerian hormone (AMH) as a method of estimating ovarian reserve, its measurement in the setting of the advanced reproductive technologies has received considerable attention. As a proxy marker for ovarian granulosa cell activity (or antral follicle count), serum AMH has proven useful in prediction of poor responders and ovarian hyperstimulation syndrome (OHSS) in IVF cycles [1,2]. Serum AMH has been considered as a substitute for antral follicle count as articulated by the Rotterdam diagnostic criteria for PCOS [4,5,6,7,8,9,10,11,12] this has not been widely used perhaps due to the lack of a universally standardized AMH serum assay [13]
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