Age specific references for anti-mullerian hormone and use as a potential diagnostic marker of PCOS in an Indian population

Abstract

: Polycystic ovary syndrome (PCOS) is the most common endocrine and metabolic disorder of reproductive age characterized by anovulatory infertility and diagnosed by Rotterdam criteria. The International evidence based guidelines for PCOS, confirms that raised levels of anti-Müllerian hormone (AMH) in patients with PCOS but lack of cutoff values in different age groups is limited. Hence the present study was aimed to determine a cutoff value of AMH in different age groups that could facilitate potential diagnostic marker of PCOS Chennai, India.: A total of 800 women aged 20 to 40 years, including 139 (17.3%) PCOS patients and 160 eumenorrheic non-hirsute control women were prospectively enrolled in this study between May 2020 and July 2021. The Rotterdam criteria were used for diagnosis of PCOS. The cut-off levels of AMH in different age categories were estimated, using the Bayesian method. Mann-Whitney and Chi-square statistical analysis were done for the variables.: Out of139 PCOS patients, 38/139 (27.3%) aged 20-25 years, 35/139 (25.1%) aged 26-30 years, 32/139 (23%) aged 31-35 years and 34 (24.4%) aged 36-40 years. Mean AMH concentrations in women with PCOS was higher 5.24 ± 3.61 ng/mL in comparison to controls 2.51 ± 1.74 ng/mL. The cutoff levels of PCOS in the age categories of 20-25, 26-30,31-35 and 36-40 years were 5.6 (95% CI: 5.20–6.18), 5.3 (95% CI: 5.14–4.28), 4.03 (95% CI: 3.55–4.42) and 3.52 (95% CI: 3.72–3.27), respectively.: Serum AMH concentration >3.52 ng/mL could be used as cutoff value as a potential diagnostic marker of PCOS in all age group. Further, studies needed with more PCOS patients to identify the reference intervals of serum AMH according to age groups and can be used an additional marker for PCOS diagnosis.