THE ROLE OF ANTI-MÜLLERIAN HORMONE IN THE DIAGNOSIS OF POLYCYSTIC OVARY SYNDROME

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SAT 532-553-Hyperandrogenic Disorders
Basic/Clinical
Saturday, June 15, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SAT-533
Sharon Lie Fong*1, Izaak Schipper2, Olivier Valkenburg2, Frank H. de Jong3 and Jenny A. Visser3
1Erasmuc MC Univ Med Ctr, Rotterdam, Netherlands, 2Erasmus MC University Medical Centre, Rotterdam, Netherlands, 3Erasmus MC, Rotterdam, Netherlands
The majority of women presenting with anovulatory dysfunction have normal gonadotropin and normal estradiol levels. Furthermore, most of these women also suffer from polycystic ovary syndrome (PCOS). According to the Rotterdam consensus criteria, this syndrome includes oligo-ovulation or anovulation, hyperandrogenism, and the presence of polycystic ovarian morphology (PCOM). Serum anti-Müllerian hormone (AMH) levels correlate well with the number of pre-antral and small antral follicles. Indeed, many studies have shown elevated AMH levels in women with PCOS. Therefore, it is hypothesized that AMH can predict the presence of PCOM.

Serum AMH levels were measured in 1.465 patients with normogonadotropic, normoestrogenic anovulation, and compared with AMH levels in 468 age-matched healthy controls. 1.289 (88.0%) Patients had PCOS according to the Rotterdam consensus criteria.

Serum AMH levels in the total cohort of patients were significantly higher than in controls (P < 0.001), although in 80% of anovulatory women AMH levels were within the normal range. Patients had two- to three-fold more follicles than controls (P < 0.001). In agreement, 83.0% of the anovulatory women had PCOM. Serum AMH and AFC were positively correlated (r = + 0.62; P < 0.001). Receiver operating characteristic (ROC) curve analysis was performed to test the diagnostic accuracy of AMH for the presence of PCOM. The area under the curve was 89.8 % (confidence interval 87.9 – 91.7 %). In this ROC analysis, only a selection of control subjects was included, i.e. those with normal ovarian morphology. Consequently, the selected control subjects did not represent the age range of the total patient cohort.  

In conclusion, the majority of our large cohort of normogonadotropic anovulatory patients had serum AMH levels within the normal range. In addition, our data suggest that the threshold level to discriminate PCOM from normal ovarian morphology, is age-dependent and that the threshold for PCOM might need to be adjusted. Consequently, the criteria for PCOS according to the Rotterdam criteria might need refinement.

Nothing to Disclose: SL, IS, OV, FHD, JAV

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm