Diagnostic utility of serum anti-Mullerian hormone levels in south Indian women with polycystic ovarian syndrome

Abstract

Introduction and Aim: Polycystic ovarian syndrome (PCOS) is a prevalent endocrinopathy among women of reproductive age group, conventionally diagnosed using multiple clinical and biochemical tests. We aimed to evaluate the diagnostic utility of serum anti-Müllerian hormone (AMH) levels in PCOS. Materials and Methods: The case control study involved 60 women of 18-40 years age, further grouped using Rotterdam criteria as cases with PCOS (n = 30) and controls without PCOS (n = 30). Study variables were compared between the groups using independent t-test. Correlation analyses were performed to predict the relationship of AMH with other PCOS determinants. Simple logistic regression and ROC analyses were used to determine the diagnostic utility of AMH. Results: PCOS cases had increased levels of serum LH, testosterone, AMH, BMI, total antral follicular count (AFC), ovarian volume (OV) (p < 0.05*) than controls. Of all, serum AMH had the strongest association with PCOS (OR > 1, p < 0.05*) and showed considerable positive correlations with LH:FSH ratio, testosterone, AFC (r = 0.7768, p < 0.05*), OV (r = 0.7981, p < 0.05*). ROC analysis of AMH was significant (AUC = 0.966, p < 0.05*) with high sensitivity, specificity for cut points between 5.595 ng/mL and 5.90 ng/mL. Conclusion: Elevated serum AMH levels were strongly associated with PCOS and correlated with its routine clinical determinants. Serum AMH estimation with cut-off between 5.595 ng/mL to 5.90 ng/mL, is proposed as a useful index for PCOS diagnosis.