Antimüllerian hormone levels are independently related to ovarian hyperandrogenism and polycystic ovaries

• Published in: Fertility and sterility Vol. 98; no. 1; pp. 242 - 249.e4
• Main Authors: Rosenfield, Robert L., Wroblewski, Kristen, Padmanabhan, Vasantha, Littlejohn, Elizabeth, Mortensen, Monica, Ehrmann, David A.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.07.2012; Elsevier
• Subjects: 17-hydroxyprogesterone; Adolescent; Adult; Age Factors; agonists; animal ovaries; anovulation; Anti-Mullerian Hormone - blood; Antimüllerian hormone; Biological and medical sciences; Case-Control Studies; Cohort Studies; dexamethasone; dexamethasone suppression test; Female; Female genital diseases; functional ovarian hyperandrogenism; GnRH agonist test; gonadotropin-releasing hormone; Gynecology. Andrology. Obstetrics; Humans; hyperandrogenism; Hyperandrogenism - blood; Hyperandrogenism - pathology; Internal Medicine; Medical sciences; Metabolic diseases; Non tumoral diseases; Obesity; Obstetrics and Gynecology; oocytes; Organ Size; Osmolar Concentration; Ovarian Diseases - blood; Ovarian Diseases - pathology; ovarian reserve; Ovary - pathology; polycystic ovary; Polycystic Ovary Syndrome - blood; Polycystic Ovary Syndrome - pathology; testosterone; ultrasonography; volunteers; women; Young Adult; functional ovarian hyperandrogenism; Antimüllerian hormone; dexamethasone suppression test; GnRH agonist test; ovarian reserve; obesity; polycystic ovary; Reserve; Obesity; Agonist; Gynecology; Nutrition disorder; Gonadotropin RH; Female sterility; Exploration; Polycystic ovary; Obstetrics; Female genital diseases; Dexamethasone test; Ovarian diseases; Cyst; Hyperandrogenism; Benign neoplasm; Nutritional status
• ISSN: 0015-0282; 1556-5653; 1556-5653
• DOI: 10.1016/j.fertnstert.2012.03.059

To determine the relationship of antimüllerian hormone (AMH) levels to polycystic ovaries and ovarian androgenic function. Prospective case-control study. General clinical research center. Eumenorrheic asymptomatic volunteers without (V-NO; n = 19; reference population) or with (V-PCO; n = 28) a polycystic ovary and hyperandrogenemic anovulatory subjects grouped according to ovarian function into typical PCOS (PCOS-T; n = 37) and atypical PCOS (PCOS-A; n = 18). Pelvic ultrasonography, short dexamethasone androgen-suppression test (SDAST), and GnRH agonist (GnRHag) test. Baseline AMH levels were related to polycystic ovary status, testosterone response to SDAST, and 17-hydroxyprogesterone response to GnRHag test. AMH levels correlated with SDAST and GnRHag test outcomes. AMH was elevated (>6.2 ng/mL) in 32% of V-PCO versus 5% V-NO. The 21% of V-PCO who met Rotterdam PCOS criteria all had functional ovarian hyperandrogenism, but AMH levels were similar to nonhyperandrogenic V-PCO. AMH >10.7 ng/mL discriminated V-PCO from PCOS with 96% specificity and 41% sensitivity for PCOS-T, and insignificantly for PCOS-A. AMH levels are independently related to ovarian androgenic function and polycystic ovaries. Very high AMH levels are specific but insensitive for PCOS. In the absence of hyperandrogenism, moderate AMH elevation in women with normal-variant polycystic ovaries seems to indicate an enlarged oocyte pool.