Diagnostic value of anti-Mullerian hormone in adolescent girls with polycystic ovary syndrome

Abstract

Background. Scientific debate continues on the diagnostic criteria for polycystic ovary syndrome in adolescents (PCOS). In adolescents these criteria cause special diagnostic problems due to the fact that the characteristics of normal puberty often coincide with the signs and symptoms of PCOS. There is a need to develop diagnostic criteria for PCOS in adolescents, which could be used in addition to those proposed. A possible additional diagnostic criterion may be the level of anti-Mullerian hormone (AMH). The purpose of the study is to assess the levels of anti-Mullerian hormone in the blood of adolescent girls with polycystic ovary syndrome. Materials and methods. A clinical-anamnestic and laboratory study of 27 adolescent girls (12–18 years) with PCOS was conducted. The comparison group consisted of 25 girls of the same age without gynecological disorders. Determination of AMG was performed in venous serum (Gen II ELISA, Beckman Coulter). Results. The anamnesis of adolescent girls with PCOS was analyzed: intrauterine hypoxia occurred in almost half of adolescents, pathological course of the postnatal period was observed in 25.9%, infectious index was 4.6, hypertensive-hydrocephalic syndrome was found in 23.8%, minimal cerebral dysfunction 28.5%, autonomic disorders— in 47.6%, most of the surveyed girls had average body weight and height, inverted puberty and disharmonious sexual development. The most common symptoms of PCOS in girls were: hypomenstrual syndrome (86.9%), dermopathy (82.6%) and hirsutism (60.8%). The mean AMG in girls with PCOS and in the comparison group was 3.67±1.0 ng/ml (in girls with PCOS 4.8±0.9 and in girls in the comparison group 3.1±0.7 ng/ml, p<0.05). Adolescent girls with form A PCOS had the highest hormone levels— 6.4 [4.8; 6.9] pg/ml, p<0.01, which may indicate a probable diagnostic value of AMG concentration. Conclusions. Adolescent girls with suspected polycystic ovary syndrome should have a complete set of tests to determine the level of anti-Mullerian hormone as an additional marker, especially in the absence of clinical manifestations of hyperandrogenemia.