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Role of Anti Mullerian Hormone (AMH) in Diagnosis of Polycystic Ovarian Syndrome (PCOS) in Indian Women

Uma Pandey, Neha Gupta, Surya Kumar Singh, Shivi Jain

Introduction: Polycystic ovarian morphology (PCOM) obtained by transvaginal ultrasound is an integral component of Rotterdam criteria most widely used for diagnosis of PCOS. Transvaginal ultrasound may not be widely available and possible in sexually inactive unmarried women in India. Anti-Mullerian hormone (AMH) is a surrogate marker of PCOM.

Aim: To assess diagnostic power of serum AMH for diagnosis of PCOS and to analyse if serum AMH can replace PCOM in Rotterdam criteria and co-relation of AMH with hyperandrogenaemia.

Methods: A study was done in SSH BHU, various PCOS parameters were used in diagnosis. Serum AMH and Radiology were used. By Transvaginal Sonography single observer obtained dimensions for ovarian volume and the maximum number of follicles in one section. AMH levels were estimated using commercially available Gen-II ELISA assay.

Result: Biochemical evaluation was done in the Department of Bio Chemistry IMS BHU. Serum AMH was estimated using commercially available ultra-sensitive anti-mullerian hormone GenII enzyme linked immunosorbent assay (ELISA, Beckman Coulter, CA) with lower limit of detectability (LoD) of 0.08 ng/ml, lower limit of quantification (LoQ) of 0.17 mg/ml and intraassay coefficient of variation of 5.8%. The unit of measurement is ng/mL (1ng/mL=7.14 pmol/L).

Conclusion: In this study, it was demonstrated that AMH levels were significantly higher in PCOS than in controls. AMH as an independent marker could not effectively diagnose PCOS. However, AMH levels as an adjunct to existing Rotterdam criteria for diagnosis of PCOS had good diagnostic potential.