Role of Anti-Müllerian Hormone in pathophysiology, diagnosis and treatment of Polycystic Ovary Syndrome: a review.

Sophie Catteau-Jonard,Didier Dewailly,Geoffroy Robin,Agathe Dumont

doi:10.1186/s12958-015-0134-9

Abstract

Polycystic ovary syndrome (PCOS) is the most common cause of chronic anovulation and hyperandrogenism in young women. Excessive ovarian production of Anti-Müllerian Hormone, secreted by growing follicles in excess, is now considered as an important feature of PCOS. The aim of this review is first to update the current knowledge about the role of AMH in the pathophysiology of PCOS. Then, this review will discuss the improvement that serum AMH assay brings in the diagnosis of PCOS. Last, this review will explain the utility of serum AMH assay in the management of infertility in women with PCOS and its utility as a marker of treatment efficiency on PCOS symptoms. It must be emphasized however that the lack of an international standard for the serum AMH assay, mainly because of technical issues, makes it difficult to define consensual thresholds, and thus impairs the widespread use of this new ovarian marker. Hopefully, this should soon improve.

Highlights

Polycystic ovary syndrome (PCOS) is the most common cause of chronic anovulation and hyperandrogenism in young women and affects 5 to 10 % of the female population
Serum AMH is synthetized by small antral follicles, which are precisely the ones seen on ultrasound
It is undeniable that serum AMH is a valuable tool for the diagnosis of PCOS

Summary

Introduction

Polycystic ovary syndrome (PCOS) is the most common cause of chronic anovulation and hyperandrogenism in young women and affects 5 to 10 % of the female population. Since 2003, the Rotterdam Consensus defines PCOS and considers the antral follicle count (AFC) on ultrasound as one of the diagnostic criteria. With the improvement in ultrasonographic technology, the number of follicles seen on ultrasound increases almost daily but remains dependent on the specific equipment. Serum AMH is synthetized by small antral follicles, which are precisely the ones seen on ultrasound. Serum AMH could be used as a surrogate for the AFC in the diagnosis of PCOS. Serum AMH has demonstrated its utility in the treatment of infertility. The absence of an international standard for serum AMH assay and the inability to define thresholds makes application of serum AMH more difficult. The purpose of this review is to explain the relationship between

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Conclusion