Publication: Accuracy of anti-Müllerian hormone and total follicles count to diagnose polycystic ovary syndrome in reproductive women
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Issued Date
2018-08-01
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ISSN
18756263
10284559
10284559
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2-s2.0-85048946166
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Mahidol University
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SCOPUS
Bibliographic Citation
Taiwanese Journal of Obstetrics and Gynecology. Vol.57, No.4 (2018), 499-506
Suggested Citation
Thanyarat Wongwananuruk, Nalinee Panichyawat, Suchada Indhavivadhana, Manee Rattanachaiyanont, Surasak Angsuwathana, Kitirat Techatraisak, Busadee Pratumvinit, Nutchaya Sa-nga-areekul Accuracy of anti-Müllerian hormone and total follicles count to diagnose polycystic ovary syndrome in reproductive women. Taiwanese Journal of Obstetrics and Gynecology. Vol.57, No.4 (2018), 499-506. doi:10.1016/j.tjog.2018.06.004 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/46438
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Title
Accuracy of anti-Müllerian hormone and total follicles count to diagnose polycystic ovary syndrome in reproductive women
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Abstract
© 2018 Objective: Recently, there was a new recommendation of ultrasonographic criteria to diagnosis polycystic ovary syndrome (PCOS). In addition, serum anti-Müllerian hormone (AMH) was proposed as a surrogate marker for diagnosis of PCOS, but AMH cut-off level for diagnosis of PCOS is unclear. This study aimed to investigate the accuracy of serum AMH and evaluate new ultrasonographic criteria, follicle number per ovary (FNPO) threshold ≥ 25 follicles and ovarian volume (OV) > 10 mL, for diagnosis of PCOS. Materials and methods: A cross-sectional study was conducted. Fifty-five PCOS women and sixty-three normal ovulatory, non-hyperandrogenic women were recruited. Transvaginal or transrectal ultrasonography was performed in all participants to evaluate follicle number and OV. Serum AMH was evaluated in both study groups. Results: The mean age of the participants was 25.1 ± 5.3 years old in PCOS group and 29.7 ± 7.2 years old in control group. Mean AMH, FNPO and OV in PCOS women were significantly higher than those in non-PCOS women. The area under the receiver-operating characteristic (ROC) curve of AMH was 0.903. The threshold of AMH at 4.7 ng/mL offered the best compromise between 80% sensitivity and 77.8% specificity. The appropriated threshold values for FNPO, follicle number per cross-section (FNPS) and OV were 15 follicles, 7 follicles and 6.5 mL, respectively. Serum AMH level was significantly positively correlated with FNPO, FNPS and OV in both PCOS and control groups. In PCOS women, serum AMH showed strongly correlation with FNPO (r = 0.53, p < 0.001) and weakly correlation with total testosterone (r = 0.283, p = 0.036). Conclusion: Serum AMH had a good diagnostic performance for diagnosis of PCOS presenting with oligo/anovulation and hyperandrogenism. AMH threshold at 4.7 ng/mL was the best compromise level for diagnosis of PCOS. FNPO ≥15, FNPS ≥7 and OV ≥ 6.5 mL were reliable threshold for detecting polycystic ovaries in women with frank manifestation of PCOS.