In adolescence, diagnosis of polycystic ovary syndrome (PCOS) is challenging because characteristics of normal puberty often overlap with signs and symptoms of PCOS. Anti-Müllerian hormone (AMH) is one of the important biomarkers suggested to confirm the diagnosis of PCOS and to manage the treatment process in adolescence. The aim of this study was to evaluate the diagnostic role of anti-müllerian hormone for PCOS in adolescent females, and to study its association to other diagnostic criteria of the disorder. A cross-sectional study was conducted on 30 PCOS patients aged 15-19 years (having all three of the Rotterdam Criteria: abnormal uterine bleeding indicative of chronic anovulation, clinical or laboratory hyperandrogenism, and a typical polycystic appearance of the ovaries on ultrasonographic examination), 30 high risk patients (incomplete PCOS with 2 of the 3 criteria), and 30 age and sex-matched controls. Exclusion criteria included chronic illness, other endocrine or genetic disorder causing hirsuitism, patients taking medications that might potentially influence the biomedical assessments, e.g. oral contraceptive pills, metformin, anti-androgens.
Hirsutism was classified in terms of the distribution and degree of hair growth through Ferriman-Gallwey scale. The severity of acne was categorized as mild, moderate, or severe according to the classification system suggested by Luckey et al., 1997. Blood samples for hormonal assay were collected 5 days after menstruation. AMH, FSH, LH, prolactin, testosterone, estrogen, 17 hydroxy-progesterone. A single trans-vaginal ultrasound scan was performed at a random time (during the menstrual cycles) in the included married females. The number of follicles larger than 2.0 mm in each ovary was noted. The ovarian volume (cm3) was calculated by the formula length (centimeters) × width (centimeters) × height (centimeters) × 0.523. The results of these sonographic examinations were used to determine whether the woman fulfilled the criteria of having polycystic ovaries (PCO). The average ovarian volume was calculated summing the volumes of both ovaries and divided them by 2.
Mean serum AMH was 10.7±5 ng/ml in PCOS patients, 22±15 ng/ml in high risk group and 10±5 ng/ml in controls. There was no statistically significant difference in serum AMH levels between PCOS patients and controls. During adolescence, especially at an early post-menarcheal age, the use of AMH levels as a diagnostic tool for PCOS is still controversial and more studies on this topic are needed.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology