Anti-Müllerian hormone in polycystic ovary syndrome and normo-ovulatory women: Correlation with clinical, hormonal and ultrasonographic parameters

Abstract

Abstract Background Although the ultimate pathogenesis of polycystic ovary syndrome (PCOS) remains obscure, the distinctive feature is failure of follicular maturation resulting in anovulation and accumulation of preantral and small antral follicles which contribute significantly to the production of anti-Mullerian hormone (AMH). Objectives To compare serum AMH levels between PCOS and normo-ovulatory women; and to investigate whether AMH correlates to clinical, hormonal and ultrasonographic parameters in both groups. Design Comparative observational cross-sectional study. Setting Department of Obstetrics and Gynecology, Kasr El-Aini Teaching Hospital, Faculty of Medicine, Cairo University. Subjects Thirty-five women with PCOS according to the Rotterdam consensus; and 35 normo-ovulatory-matched controls with male, tubal or unexplained infertility. Methods Serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, androstenedione, estradiol, fasting insulin and AMH were measured in the early follicular phase (day 3–4) of natural cycle or progestin-induced withdrawal bleeding (in PCOS); together with transvaginal sonography for detection of the number of small follicles ( Main outcome measures Correlation between AMH and clinical, hormonal and ultrasonographic parameters in both groups. Results AMH was significantly higher in the PCOS group. In the whole group of patients and in each group separately, AMH was positively correlated to LH, LH/FSH, number of follicles r =0.557; P =0.001 and r =0.451; P =0.007, respectively). Multiple regression analysis demonstrated that testosterone was the only determinant for AMH level ( r =0.485; P Conclusions Hyperandrogenism is associated with increased AMH secretion in PCOS patients, possibly due to increased number of small antral follicles. Assessment of AMH levels before and after the treatment of hyperandrogenism should be recommended in the plan of management of PCOS.