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The diagnostic performance of antimullerian hormone for polycystic ovarian syndrome and polycystic ovarian morphology

  • Gynecologic Endocrinology and Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

The diagnosis of polycystic ovary syndrome (PCOS) remains a challenge to clinicians due to heterogeneous clinical presentation and diagnostic criteria. This study investigated the utilization of Anti-Müllerian hormone (AMH) alone or replacing polycystic ovarian morphology (PCOM) in the PCOS diagnostic criteria.

Methods

A total of 401 women were categorised as PCOS (n:154), nonPCOS with polycystic ovarian morphology (PCOM) (n:105), and nonPCOS with normal ovarian morphology (NOM) (n:142). First, the diagnostic performance of AMH for PCOS diagnosis in Rotterdam, Androgen Excess Society, and National Institutes of Health (NIH) criteria was analyzed. Second, AMH was used instead of PCOM in Rotterdam criteria and we searched diagnostic performance for PCOS phenotypes.

Results

AMH levels were positively correlated with LH, testosterone, hirsutism score, menstrual cycle length, and antral follicle count (p < 0.05). AMH alone had specificity and sensitivity for PCOS diagnosis were 84.9% and 72.4% in Rotterdam (AUC: 0.866); 84.4% and 72% in Androgen Excess Society (AUC: 0.857); 83.3% and 66.4% in National Institute of Health criteria (AUC: 0.825). AMH alone had satisfactory diagnostic potential for phenotype A, but not other phenotypes. The replacement of PCOM with AMH in Rotterdam criteria had a high diagnostic potential for PCOS (AUC: 0.934, sensitivity:97.4%, specificity: 90.67%). Phenotype A and phenotype D were diagnosed with 100% sensitivity and 94.5% specificity. Phenotype C was recognised with 96.15% sensitivity and 94.5% specificity.

Conclusion

AMH may be used with high diagnostic accuracy instead of PCOM in the Rotterdam PCOS criteria.

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Data availability

The datasets created and/or analyzed during the current study are subject to the permission of the relevant hospital and are therefore not available to the public, but are available from the corresponding author on reasonable request.

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Funding

No funding was received for this study.

Author information

Authors and Affiliations

  1. Obstetrics and Gynecology Department, University of Health Sciences, Hamidiye Medical Faculty, Haydarpaşa Numune Training and Research Hospital, Tıbbiye Cad.No:40, 34668, Istanbul, Turkey

    Fisun Vural

  2. Obstetrics and Gynecology, IVF Center, BV Clinic, Istanbul, Turkey

    Birol Vural

  3. Obstetric and Gynecology, Tuzla State Hospital, Istanbul, Turkey

    Eyupcan Kardaş

  4. Obstetric and Gynecology Department, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey

    Ayşe Deniz Ertürk Coşkun & İrem Yildirim

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Contributions

All authors contributed adequately to this study and approved its submission. FV: study design; concept; supervision of analyses; writing; read and approved the final version of the manuscript. BV: Conceptualization, Methodology, Supervision, critical revision of the manuscript for important intellectual content; read and approved the final version of the manuscript. EK: Data curation, software, read and approved the final version of the manuscript. ADEC: Writing and editing; read and approved the final version of the manuscript. IY: Data curation; read and approved the final version of the manuscript.

Corresponding author

Correspondence to Fisun Vural.

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Conflict of interest

There are no conflicts of interests that are directly or indirectly related to the research including the following: research grants from funding agencies; honoraria for speaking at symposia; financial support for attending symposia; financial support for educational programs; employment or consultation; support from a project sponsor; position on advisory board or board of directors or other types of management relationships; multiple affiliations; financial relationships, for example equity ownership or investment interest; intellectual property rights (e.g., patents, copyrights and royalties from such rights); holdings of spouse and/or children that may have a financial interest in the work.

Ethical approval

This study was conducted in accordance with the Declaration of Helsinki. Informed consent was obtained from all patients. Ethical approval was obtained from the local Ethics Committee (HNEAH-KAEK, 2021/293–3343).

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Vural, F., Vural, B., Kardaş, E. et al. The diagnostic performance of antimullerian hormone for polycystic ovarian syndrome and polycystic ovarian morphology. Arch Gynecol Obstet 307, 1083–1090 (2023). https://doi.org/10.1007/s00404-022-06874-w

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