AMH as part of the diagnostic PCOS workup in large epidemiological studies.

OBJECTIVES Previous studies have shown good correlation between polycystic ovarian morphology (PCOM) and serum Anti-Müllerian hormone (AMH) levels. We evaluated the utility of AMH as a surrogate for PCOM as a part of the PCOS diagnosis by describing how the use of different AMH cut-off values would change the prevalence of PCOS. METHODS A general population-based birth cohort study. AMH concentrations were measured from serum samples taken at age 31 years (n=2917) using the electrochemiluminescence immunoassay (Elecsys®). AMH data were combined with data on oligo-amenorrhea and hyperandrogenism to identify women with PCOS. RESULTS The addition of AMH as a surrogate marker for PCOM increased the number of women fulfilling at least two PCOS features in accordance with the Rotterdam criteria. The prevalence of PCOS was 5.9% when using the AMH cut-off based on the 97.5% quartile (10.35 ng/ml), and 13.6% when using the recently proposed cut-off of 3.2 ng/ml. When using the latter cut-off value, the distribution of PCOS phenotypes A, B, C and D were 23.9%, 4.7%, 36.6% and 34.8%, respectively. Compared with the controls, all PCOS groups with different AMH concentration cut-offs showed significantly elevated T, FAI, LH, LH/FSH -ratio, BMI, waist circumference and HOMA-IR values, as well as significantly decreased SHBG values. CONCLUSIONS AMH could be useful surrogate for PCOM in large data sets, where transvaginal ultrasound is not feasible, to aid the capturing of women with typical PCOS characteristics. AMH measurement from archived samples enables retrospective PCOS diagnosis when combined with oligo-amenorrhea or hyperandrogenism.

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