Geburtshilfe Frauenheilkd 2014; 74 - PO_Endo04_02
DOI: 10.1055/s-0034-1388008

Anti-Mullerian-Hormone – an indicator for the severity of polycystic ovarian syndrome?

A Köninger 1, B Schmidt 2, L Koch 1, P Edimiris 1, A Enekwe 1, S Kasimir-Bauer 1, T Strowitzki 3, R Kimmig 1
  • 1Universitätsklinikum Essen, Frauenklinik, Essen, Germany
  • 2Universitätsklinikum Essen, Institut für medizinische Informatik, Biometrie und Epidemiologie, Essen, Germany
  • 3Klinikum der Ruprecht-Karl-Univ. Heidelberg, Abt. Gynäkologische Endokrinologie und Fertilitätsstörungen, Heidelberg, Germany

Purpose: Diagnostic tools of polycystic ovarian syndrome like sonographic aspects, androgens, gonadotrophins and Anti-Mullerian-Hormone (AMH) were evaluated according to their diagnostic potency in detecting different degrees of PCOS severity.

Fig. 1: AMH and severity

Methods: 80 women with PCOS and 48 controls were enrolled prospectively. PCOS patients fulfilling all Rotterdam criteria for PCOS diagnosis were defined as having severe PCOS (n = 59), while patients showing oligo-/amenorrhoea in combination with polycystic ovaries but without hyperandrogenemia were defined as having mild PCOS (n = 21). Diagnostic valu...

Results: The strongest group difference between controls and severe PCOS patients was observed for AMH showing an estimated odds ratio of 2.56 (95%-confidence interval [CI]: 2.00 – 3.27; p < 0.0001). Age-adjusted receiver operating characteristic (ROC) analysis showed that the AUC of 0.88 (95%-CI: 0.80 – 0.95) for AMH and the AUC of 0.94 (95%-CI: 0.88 – 0.98) for AFC did not differ significantly in their discrimination ability between severe PCOS patients and controls. AMH showed higher AUC estimates than androgens, ovarian volume, LH and LH/FSH-ratio.

Conclusions: AMH levels seem to reflect PCOS severity. In cases where vaginal scans are not feasible or in patients without hyperandrogenemia AMH may be used as a reliable surrogate parameter in PCOS diagnosis, superior to androgens and gonadotrophins.