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Role of AMH as Diagnostic Tool for Polycystic Ovarian Syndrome

Abstract

Background

To evaluate role of AMH as a diagnostic tool for PCOS.

Methods

This was a prospective case–control study on women attending Gynae OPD of Dr RML Hospital, New Delhi, from 1 November 2015 to 31 March 2017. Study comprised of 45 women with PCOS, diagnosed using Rotterdam criteria and 45 women as controls. Clinical history included oligomenorrhea, hirsutism, examination included BMI, Ferriman–Gallwey score, investigations included blood for FSH, LH, estradiol, TSH, prolactin, total testosterone, AMH level and pelvic USG which was done for all women.

Results

Both PCOS cases and control were matched for age and BMI. Median AMH levels of 4.32 ng/ml in PCOS cases was almost twice that of 2.32 ng/ml in controls (p = 0.001). Maximum diagnostic potential of AMH alone for PCOS was at a cut-off of 3.44 ng/ml with sensitivity of 77.78% and specificity of 68.89%. AMH was used as an adjunct to existing Rotterdam criteria as the fourth parameter OA+HA+PCOM+AMH (any three out of four) yielded sensitivity of 80%. However, when PCOM in Rotterdam criteria was replaced by AMH, OA+HA+AMH (any two out of three) or OA/HA+AMH resulted in sensitivity of 86.67 and 71.11%, respectively.

Conclusion

AMH levels were significantly higher in PCOS than in controls. AMH as an independent marker could not effectively diagnose PCOS. However, AMH levels as an adjunct to existing Rotterdam criteria for diagnosis of PCOS had good diagnostic potential.

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Acknowledgement

We thank all the patients who consented to participate in this study.

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Authors and Affiliations

Authors

Corresponding author

Correspondence to Upma Saxena.

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Conflict of interest

All the authors declare that they have no relevant conflict of interest.

Ethical Approval

The study was approved by Medical Ethical committee of PGIMER & DR RML Hospital, New Delhi.

Informed Consent

Informed consent was taken from all the patients who agreed to participate in the study.

Additional information

Upma Saxena, Professor and Senior Gynaecologist in the Department of Obstetrics and Gynaecology, PGIMER and Dr RML Hospital, New Delhi; Manisha Ramani, postgraduate student in the Department of Obstetrics and Gynaecology, PGIMER and Dr RML Hospital, New Delhi; Pushpa Singh, Professor and Consultant in the Department of Obstetrics and Gynaecology, PGIMER and Dr RML Hospital, New Delhi.

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Saxena, U., Ramani, M. & Singh, P. Role of AMH as Diagnostic Tool for Polycystic Ovarian Syndrome. J Obstet Gynecol India 68, 117–122 (2018). https://doi.org/10.1007/s13224-017-1066-4

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  • DOI: https://doi.org/10.1007/s13224-017-1066-4

Keywords

  • PCOS
  • AMH
  • Rotterdam criteria
  • Hyperandrogenism (HA)
  • Oligomenorrhea (OA)
  • Polycystic ovarian morphology (PCOM)