Antimüllerian hormone as indicator of ovarian dysfunction

A. Bothou1, N. Koutlaki2, G. Iatrakis3, G. Mastorakos4, P. Tsikouras2, V. Liberis2, G. Galazios2, A. Liberis2, A. Lykeridou3, S. Zervoudis5

Democritus University of Thrace, 1Research on Female Reproduction, 2Department of Obstetrics and Gynaecology, Komotini, 3TEI Technical University of Athens, 4University of Athens, Aretaieion Hospital, 5Rea Hospital, Athens, Greece

Abstract
Aim. The purpose of this study was to examine various hormonal, biochemical and environmental factors (i.e., smoking and alcohol intake) and to investigate their possible correlation to the development of polycystic ovary syndrome (PCOS). The main objective was to evaluate the associations between hormonal profile and the antimüllerian hormone (AMH) levels in PCOS patients and their relation to environmental factors.
Patients and Methods. In two gynecological clinics, 38 women with PCOS (defined according to the Rotterdam criteria) were enrolled and observed in relation to AMH, follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), Δ4-androstendione (Δ4- A), dehydroepiandrosterone sulfate (DHEA-S) and glucose plasma concentrations. Obesity, smoking and alcohol exposure were also studied.
Results. AMH, T, Δ4-Α, DHEA-S, LH and FSH were increased in 76.3%, 50%, 31.8%, 23.7%, 21% and 18.4% of the patients, respectively. The LH/FSH ratio and glucose concentrations increased abnormally in 18.4% and 15.8% of the patients, respectively. AMH and T levels were both increased in 47.4% of the patients whereas both AMH and LH levels increased in 21% of the patients. Smoking, alcohol intake, obesity and glucose concentrations were not associated with AMH concentrations. On the contrary, high levels of T and LH were linked to higher levels of AMH. FSH concentrations were not increased in these patients.
Conclusion. AMH is an important hormonal parameter for the diagnosis of PCOS. Larger clinical controlled studies are necessary in an effort to further investigate the inclusion of AMH measurement in the diagnostic criteria of PCOS.

Key words: Polycystic ovary syndrome (PCOS), Stein-Leventhal syndrome, Antimüllerian hormone (AMH), Androgens, Testosterone, luteinizing hormone (LH).

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