Comparison of serum antimullerian hormone levels amongfour different phenotypes of polycystic ovary syndrome

Comparison of serum antimullerian hormone levels amongfour different phenotypes of polycystic ovary syndrome

Aim: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders, with a prevalence of 5-10% among women of reproductive. Antimullerian hormone (AMH) may play important role in the pathophysiology and diagnosis of this syndrome. The goal of the current report was to compare serum AMH levels and clinical and hormonal features among four PCOS phenotypes.Materials and Methods: Participants included women diagnosed with PCOS (n = 116), as defined by the Rotterdam consensus, and healthy subjects (n = 30). PCOS subjects were segregated into four phenotype groups based on the presence of oligo-ovulation or anovulation (OA), hyperandrogenism (HA), and polycystic ovarian morphology (POM) as follows: Group 1 (HA+OA+POM), Group 2 (HA+OA), Group 3 (HA+POM), Group 4 (OA+POM). The primary outcome measure used in the analysis was AMH serum level. Results: Serum AMH levels were 10.2 ± 6.4 in Group 1, 4.5 ± 2.8 in Group 2, 7.4 ± 2.7 in Group 3, 7.9 ± 3.7 in Group 4, and 4.5 ± 1.8 in control group. AMH levels were markedly elevated in Group 1 compared to Groups 2, 3, 4, and control group. Free testosterone (fT) levels were similar in Groups 1 and 2 and markedly higher than in Groups 3 and 4. Insulin levels and results from the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) were significantly higher in all four phenotype groups than in the controls group Insulin and HOMA-IR values were similar among the phenotype groups. Conclusion: Ovulatory dysfunction and POM may contribute to increased AMH levels. There may be an association between increased AMH levels and the severity of PCOS.

___

  • 1. Azziz R, Woods KS, Reyna R, et al. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol and Metab 2004;89:2745-9.
  • 2. Diamanti-Kandarakis E, Kouli CR, Bergiele AT, et al. A survey of the polycystic ovary syndrome in the Greek island of Lesbos: hormonal and metabolic profile. J Clin Endocrinol Metab 1999;84:4006-11.
  • 3. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004;81:19-25.
  • 4. National Institutes of Health. Evidence-based methodology workshop on polycystic ovary syndrome, December 3-5, 2012. Executive summary. https:// prevention.nih.gov/sites/default/files/2018-06/ FinalReport.pdf access date 08.09.2020.
  • 5. Piouka A, Farmakiotis D, Katsikis I, et al. Antimullerian hormone levels reflect severity of PCOS but are negatively influenced by obesity: relationship with increased luteinizing hormone levels. Am J Physiol Endocrinol Metab 2009;296:238-43.
  • 6. La Marca A, Sighinolfi G, Radi D, et al. Anti- Mullerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART). Hum Reprod Update 2010;16:113-30.
  • 7. Pellatt L, Rice S, Mason HD. Anti-Mullerian hormone in patients with polycystic ovary syndrome: a mountain too high? Reproduction.2010;139:825-33.
  • 8. Pigny P, Merlen E, Robert Y, et al. Elevated serum level of anti-mullerian hormone in patients with polycystic ovary syndrome: relationship to the ovarian follicle excess and to the follicular arrest. J Clin Endocrinol Metab 2003;88:5957-62.
  • 9. Nardo LG, Yates AP, Roberts SA, et al. The relationships between AMH, androgens, insulin resistance and basal ovarian follicular status in non-obese subfertile women with and without polycystic ovary syndrome. Hum Reprod 2009;24:2917-23.
  • 10. Diamanti-Kandarakis E, Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanism and implications. Endocr Rev 2012;33:981-1030.
  • 11. Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. J Clin Endocrinol Metab 1961;21:1440-7.
  • 12. International evidence-based guideline for the assessment and management of polycystic ovary syndrome 2018. https://www.eshre.eu/Guidelinesand-Legal/Guidelines/Polycystic-Ovary-Syndrome access date 08.09.2020.
  • 13. Balen AH, Dresner M, Scott EM, et al. Should obese women with polycystic ovary syndrome receive treatment for infertility? Br Med J 2006;332:434-5.
  • 14. Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: Insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412-9.
  • 15. Panidis D, Tziomalos K, Misichronis G, et al. Insulin resistance and endocrine characteristics of the different phenotypes of polycystic ovary syndrome: a prospective study. Hum Reprod 2012;27:541-9.
  • 16. Guastella E, Longo RA, Carmina E. Clinical and endocrine characteristics of the main polycystic ovary syndrome phenotypes. Fertil Steril 2010;94:2197-201.
  • 17. Yilmaz M, Isaoglu U, Delibas IB, et al. Anthropometric, clinical and laboratory comparison of four phenotypes of polycystic ovary syndrome based on Rotterdam criteria. J Obstet Gynaecol Res 2011;37:1020-6.
  • 18. Katsikis I, Karkanaki A, Misichronis G, et al. Phenotypic expression, body mass index and insulin resistance in relation to LH levels in women with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol 2011;156:181-5.
  • 19. Dilbaz B, Ozkaya E, Cinar M, et al. Cardiovascular disease risk characteristics of the main polycystic ovary syndrome phenotypes. Endocrine 2011;39:272- 7.
  • 20. Eilertsen T, Vanky E, Carlsen S. Anti-Mullerian hormone in the diagnosis of polycystic ovary syndrome: Can morphologic description be replaced? Hum Reprod 2012;27:2494-502.
  • 21. Saxena U, Ramani M, Singh P. Role of AMH as Diagnostic Tool for Polycystic Ovarian Syndrome. J Obstet Gynaecol India 2018;68:117-22.
  • 22. Bozdag G, Mumusoglu S, Coskun ZY, et al. AntiMüllerian hormone as a diagnostic tool for PCOS under different diagnostic criteria in an unselected population. Reprod Biomed Online 2019;39:522-9.
  • 23. Laven JS, Mulders AG, Visser JA, et al. Anti-Mullerian hormone serum concentrations in normoovulatory and anovulatory women of reproductive age. J Clin Endocrinol Metab 2004;89:318-23.
  • 24. Das M, Gillott DJ, Saridogan E, et al. Anti-Mullerian hormone is increased in follicular fluid from unstimulated ovaries in women with polycystic ovary syndrome. Hum Reprod 2008;23:2122-6.
  • 25. Sahmay S, Atakul N, Oncul M, et al. Serum antimüllerian hormone levels in the main phenotypes of polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol 2013;170:157-61.
  • 26. Jamil AS, Alalaf SK, Al Tawil NG, et al. Comparison of clinical and hormonal characteristics among four phenotypes of polycystic ovary syndrome based on the Rotterdam criteria. Arch Gynecol Obstet 2016;293:447-56.
  • 27. Romualdi D, Florio CD, Tagliaferri V, et al. The Role of Anti-Müllerian Hormone in the Characterization of the Different Polycystic Ovary Syndrome Phenotypes. Reprod Sci 2016;23:655-61.
  • 28. Fleming R, Deshpande N, Traynor I, et al. Dynamics of FSH-induced follicular growth in subfertile women: relationship with age, insulin resistance, oocyte yield and anti-Müllerian hormone. Hum Reprod 2006;21:1436-41.
  • 29. Moghetti P, Tosi F, Bonin C, et al. Divergences in insulin resistance between the different phenotypes of the polycystic ovary syndrome. J Clin Endocrinol Metab 2013;98:628-37.
  • 30. Wild RA, Carmina E, Diamanti-Kandarakis E, et al. Assessment of cardiovascular risk and prevention of cardiovascular disease in women with the polycystic ovary syndrome: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome (AEPCOS) Society. J Clin Endocrinol Metab 2010;95:2038- 49.
  • 31. Tian X, Ruan X, Mueck AO, et al. Serum anti-Mullerian hormone and insulin resistance in the main phenotypes of non-obese polycystic ovarian syndrome women in China. Gynecol Endocrinol 2014;30:836-9.
Annals of Medical Research-Cover
  • Yayın Aralığı: Aylık
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi
Sayıdaki Diğer Makaleler

Retrospective evaluation of patients who ingested drugsto commit suicide

Kasım TURGUT, Erdal YAVUZ

Subclinical hypothyroidism of unexplained infertilitypatients does not affect intrauterine inseminationsuccess: A case-control study

Süleyman Cemil OĞLAK, Mehmet OBUT

Comparison of colposcopic biopsy results of cervicalcytology-negative and HPV 16/18 or other high-risk HPVsubtypes

Zekiye SOYKAN SERT

Contrast nephropathy ıncidence after coronaryangiography among patients with acute renal dysfunction

İhsan ATEŞ, Bilal KATİPOĞLU, Fatih ACEHAN, Fatih DEDE

Efficacy and Safety of flecainide p.os. in cardioversion ofrecent-onset atrial fibrillation

Ioannis VOGIATZIS, Evangelos SDOGKOS, Konstantinos KOUTSAMPASOPOULOS, Savas GRIGORIADIS, Sarantis PITTA

First-time anterior shoulder dislocation after snowboardaccidents in amateur athletes

Mustafa YERLİ, Süleyman Semih DEDEOĞLU, Yunus İMREN, Ali YÜCE, Hakan GÜRBÜZ

Comparison of serum antimullerian hormone levels amongfour different phenotypes of polycystic ovary syndrome

Zeynep SOYMAN

Determination of bone age using deep convolutionalneural networks

Fatih Ahmet ŞENEL, Veysel Atilla AYYILDIZ, Ahmet DURSUN, Kenan ÖZTÜRK

Choroid and Retina: A potential guide for glycemic controlof diabetes mellitus without diabetic retinopathy

Refika Hande KARAKAHYA

Diagnostic value of ultrasonograpy and 99mTc-MIBIscintigraphy for preoperative localization of parathyroidadenomas

Arzu BİLEN, Habib BİLEN, Korhan KILIÇ, Muhammed Sedat SAKAT, Furkan ŞENGÖZ, Abdulkadir ŞAHİN, Bülent AKTAN