ANTI-MULLER'S HORMONE AS A PROGNOSTIC MARKER FOR THE DIAGNOSIS OF POLYCYSTIC OVARY SYNDROME IN DIFFERENT AGE GROUPS

Abstract

Background. Anti-Mullerian hormone is a peptide that is synthesized by granulosa cells of antral follicles and correlates with the number of follicles. The literature highlights the potential of using anti-Mullerian hormone for the detection and diagnosis of polycystic ovary syndrome (PCOS).
The aim: to determine the concentration of anti-Mullerian hormone in the blood serum of individuals of different age groups to justify its use in the diagnosis of polycystic ovary syndrome.
Materials and methods. A retrospective cartographic analysis of 187 case histories of patients with PCOS aged 21-35 years in groups with an age range of 5 years was conducted. The main group consisted of patients (n = 93) with PCOS according to the Rotterdam criteria. The control group (n  =  94) consisted of relatively healthy women of appropriate age.
Laboratory data included determination of estradiol, follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, total testosterone, dehydroepiandrosterone sulfate, sex hormone-binding globulin, androstenedione, anti-Müllerian hormone, and thyroid-stimulating hormone levels. The LH/FSH ratio was calculated. Body mass index, Ferriman-Hollway score, and antral follicle count were assessed. Normally distributed data were compared using the t-test, while non-normally distributed data were compared using the Mann-Whitney U-test. Correlation analysis was performed using the Pearson correlation coefficient. SPSS version 24 software was used.
Results. The rates of overt, ovulatory, normoandrogenic, and non-polycystic PCOS were 69.9 %, 10.8 %, 10.8 %, and 8.6 %, respectively. The Ferriman-Hollway score was significantly higher in PCOS patients than in controls. A significantly higher LH/FSH ratio was observed for all PCOS-groups. Serum concentrations of thyrotropin and prolactin were within the reference ranges for all patients. Serum anti-Müllerian hormone concentrations were higher in PCOS for each age group (P < 0.001), and the correlation between antral follicle count and serum anti-Müllerian hormone levels was strong (0.66 to 0.79, P < 0.001).
Conclusions. Serum anti-Müllerian hormone concentration is a valuable parameter for evaluating patients with symptoms suggestive of polycystic ovary syndrome. The measurement of serum anti-Müllerian hormone concentration to confirm the diagnosis of polycystic ovary syndrome or the use of this parameter instead of assessing the number of antral follicles in determining the Rotterdam criteria is justified.