Title: Levels of AMH in Main Phenotypes of PCOS and its role in predicting severity of PCOS

Authors: Dr Meenakshi Rana, Dr Kamini Randhawa

 DOI: https://dx.doi.org/10.18535/jmscr/v9i10.06

Abstract

Background: The ultimate pathogenesis of polycystic ovary syndrome is not well known but the failure of follicular maturation leading to accumulation of preantral and small antral follicles and anovulation, both of these significantly contribute to production and increased levels of AMH.

Objectives: To characterize the difference in circulating anti mullerian hormone level between main phenotypic groups and evaluate the role of AMH in predicting the severity of PCOS.

Design: Prospective observational study

Setting: Department of Obstetrics and Gynecology, KNHSH IGMC Shimla.

Subjects: 200 women of age group 15-35 yearwith complaints of menstrual irregularities or symptoms of hyperendrogenism fulfilling the inclusion and exclusion criteria were included.

Methods: Serum levels of FSH, LH, Prolactin, TSH, FBS and AMH were measured on 2nd day of natural cycle. For qualitative variables frequency/percentage was calculated and for quantitative variables mean/ standard deviation was calculated and compared.

Results: The mean serum AMH levels were 8.3 +_ 3.63 ng/mL in Group 1, 8.02+_4.2 ng/mL in Group 2, 7.89 +_4.4 ng/mL in Group 3, and 6.1+_2.4 ng/mL in Group 4. The highest levels of AMH  were found in Group 1. All other parameters were comparable among all four group.

References

  1. Sahmay S, Cetin M, Ocal P, et al. Serum anti-Mu¨ llerian hormone level as a predictor of poor ovarian response in in vitro fertilization patients. Reprod Med Biol 2011;10:9–14.
  2. Ocal P, Sahmay S, Cetin M, et al. Serum anti-Mu¨ llerian hormone and antral follicle count as predictive markers of OHSS in ART cycles. J Assist Reprod Genet 2011;28:1197–203.
  3. Weghofer A, Kim A, Barad DH, et al. Follicle stimulating hormone and anti- Mu¨ llerian hormone per oocyte in predicting in vitro fertilization pregnancy in high responders: a cohort study. PLoS One 2012;7:e34290.
  4. Cate RL, Mattaliano RJ, Hession C, et al. Isolation of the bovine and human genes for Mu¨ llerian inhibiting substance and expression of the human gene in animal cells. Cell 1986;45:685–98.
  5. Salmon NA, Handyside AH, Joyce IM. Oocyte regulation of anti-Mu¨ llerian hormone expression in granulosa cells during ovarian follicle development in mice. Dev Biol 2004;266:201–8.
  6. de Vet A, Laven JS, de Jong FH, et al. Anti-Mu¨ llerian hormone serum levels: a putative marker for ovarian aging. Fertil Steril 2002;77:357–62.
  7. Lie Fong S, Visser JA, Welt CK, et al. Serum anti-Mullerian hormone levels in healthy females: a nomogram ranging from infancy to adulthood. J Clin Endocrinol Metab 2012;97:4650–5.
  8. Rotterdam ESHRE/ASRM-sponsored PCOS Consensus Workshop Group Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 2004; 19:41–47.
  9. Siow Y, Kives S, Hertweck P, et al. Serum Mu¨ llerian-inhibiting substance levels in adolescent girls with normal menstrual cycles or with polycystic ovary syndrome. Fertil Steril 2005;84:938–44.
  10. Hart R, Doherty DA, Norman RJ, et al. Serum anti-Mu¨ llerian hormone (AMH) levels are elevated in adolescent girls with polycystic ovaries and the polycystic ovarian syndrome (PCOS). Fertil Steril 2010;94:1118–21.
  11. Jonard S, Robert Y, Cortet-Rudelli C, et al. Ultrasound examination of polycystic ovaries: is it worth counting the follicles? Hum Reprod 2003;18:598–603.
  12. Lin YH, Chiu WC, Wu CH, et al. Anti-Mu¨ llerian hormone and polycystic ovary syndrome. Fertil Streil 2011;96:230–5.

Corresponding Author

Dr Kamini Randhawa

Junior Resident, Department of Anesthesiology, IGMC Shimla