Background/Aims: We aimed to investigate whether the anti-Müllerian hormone (AMH) levels in adolescents with polycystic ovary syndrome (PCOS), PCOS risk, and isolated oligomenorrhea (OM) were different than in adolescents with a normal/regular menstrual cycle (NMC). Methods: The diagnosis of PCOS was based on the 2012 Amsterdam [European Society of Human Reproduction and Embryology/American Society for Reproductive Medicine (ESHRE/ASRM)] criteria. The PCOS group consisted of cases meeting 3 diagnostic criteria (n = 21), and the PCOS risk group was the ‘at risk' group meeting 2 diagnostic criteria (n = 20). Cases with isolated OM that did not satisfy other PCOS diagnostic criteria made up the OM group (n = 21). Thirty adolescent girls with NMCs (21-45 days) were recruited in this study. Results: The AMH levels in the PCOS group were similar to those in the PCOS risk group but significantly higher than those in the OM and NMC groups. The AMH levels in the PCOS risk group were similar to those in the OM group and significantly higher than those in the NMC group. They were also significantly higher in the OM group compared to the NMC group. The specificity for PCOS and PCOS risk with a cutoff value of 7.25 ng/ml for AMH was 72.5% and the sensitivity was 58%. Conclusion: An AMH cutoff value of 7.25 ng/ml can be used for the diagnosis of PCOS in the adolescent period.

1.
Legro RS, Arslanian SA, Ehrmann DA, Hoeger KM, Murad MH, Pasquali R, Welt CK: Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2013;98:4565-4592.
2.
Shayya R, Chang RJ: Reproductive endocrinology of adolescent polycystic ovary syndrome. BJOG 2010;117:150-155.
3.
Bridges NA, Cooke A, Healy MJ, Hindmarsh PC, Brook CG: Standards for ovarian volume in childhood and puberty. Fertil Steril 1993;60:456-460.
4.
Pawelczak M, Kenigsberg L, Milla S, Liu YH, Shah B: Elevated serum anti-Müllerian hormone in adolescents with polycystic ovary syndrome: relationship to ultrasound features. J Pediatr Endocrinol Metab 2012;25:983-989.
5.
Rosenfield RL, Wroblewski K, Padmanabhan V, Littlejohn E, Mortensen M, Ehrmann DA: Antimüllerian hormone levels are independently related to ovarian hyperandrogenism and polycystic ovaries. Fertil Steril 2012;98:242-249.
6.
Josso N, Picard JY, Rey R, di Clemente N: Testicular anti-Müllerian hormone: history, genetics, regulation and clinical applications. Pediatr Endocrinol Rev 2006;3:347-358.
7.
Weenen C, Laven JS, Von Bergh AR, Cranfield M, Groome NP, Visser JA, Kramer P, Fauser BC, Themmen AP: Anti-Müllerian hormone expression pattern in the human ovary: potential implications for initial and cyclic follicle recruitment. Mol Hum Reprod 2004;10:77-83.
8.
Lee MM, Donahoe PK, Hasegawa T, Silverman B, Crist GB, Best S, Hasegawa Y, Noto RA, Schoenfeld D, MacLaughlin DT: Mullerian inhibiting substance in humans: normal levels from infancy to adulthood. J Clin Endocrinol Metab 1996;81:571-576.
9.
Pigny P, Merlen E, Robert Y, Cortet-Rudelli C, Decanter C, Jonard S, Dewailly D: 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;88:5957-5962.
10.
ACOG Committee on Adolescent Health Care: ACOG Committee Opinion No. 349, November 2006: menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Obstet Gynecol 2006;108:1323-1328.
11.
Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Mei Z, Wei R, Curtin LR, Roche AF, Johnson CL: 2000 CDC Growth Charts for the United States: methods and development. Vital Health Stat 2002;11:1-190.
12.
Balen AH, Laven JS, Tan SL, Dewailly D: Ultrasound assessment of the polycystic ovary: international consensus definitions. Hum Reprod Update 2003;9:505-514.
13.
Pigny P, Jonard S, Robert Y, Dewailly D: Serum anti-Müllerian hormone as a surrogate for antral follicle count for definition of the polycystic ovary syndrome. J Clin Endocrinol Metab 2006;91:941-945.
14.
Eilertsen TB, Vanky E, Carlsen SM: Anti-mullerian hormone in the diagnosis of polycystic ovary syndrome: can morphologic description be replaced? Human Reprod 2012;27:2494-2502.
15.
Dewailly D, Gronier H, Poncelet E, Robin G, Leroy M, Pigny P, Duhamel A, Catteau-Jonard S: Diagnosis of polycystic ovary syndrome (PCOS): revisiting the threshold values of follicle count on ultrasound and of the serum AMH level for the definition of polycystic ovaries. Hum Reprod 2011;26:3123-3129.
16.
Casadei L, Madrigale A, Puca F, Manicuti C, Emidi E, Piccione E, Dewailly D: The role of serum anti-Mullerian hormone (AMH) in the hormonal diagnosis of polycystic ovary syndrome. Gynecol Endocrinol 2013;29:545-550.
17.
Iliodromiti S, Kelsey TW, Anderson RA, Nelson SM: Can anti-Mullerian hormone predict the diagnosis of polycystic ovary syndrome? A systemetic review and meta-analysis of extracted data. J Clin Endocrinol Metab 2013;98:3332-3340.
18.
Hart R, Doherty DA, Norman RJ, Franks S, Dickinson JE, Hickey M, Sloboda DM: Serum antimullerian hormone (AMH) levels are elevated in adolescent girls with polycystic ovaries and the polycystic ovarian syndrome (PCOS). Fertil Steril 2010;94:1118-1121.
19.
Siow Y, Kives S, Hertweck P, Perlman S, Fallat ME: Serum müllerian-inhibiting substance levels in adolescent girls with normal menstrual cycles or with polycystic ovary syndrome. Fertil Steril 2005;84:938-944.
20.
Sopher AB, Grigoriev G, Laura D, Cameo T, Lerner JP, Chang RJ, McMahon DJ, Oberfield SE: Anti-Mullerian hormone may be a useful adjunct in the diagnosis of polycystic ovary syndrome in nonobese adolescents. J Pediatr Endocrinol Metab 2014;27:1175-1179.
21.
Piouka A, Farmakiotis D, Katsikis I, Macut D, Gerou S, Panidis D: Anti-Mullerian 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:E238-E243.
22.
Kriseman M, Mills C, Kovanci E, Sangi-Haghpeykar H, Gibbons W: Antimullerian hormone levels are inversely associated with body mass index (BMI) in women with polycystic ovary syndrome. J Assist Reprod Genet 2015;32:1313-1316.
23.
Panidis D: Serum luteinizing levels are markedly increased and significantly correlated with Delta 4-androstendione levels in lean women with polycystic ovary syndrome. Fertil Steril 2005;84:538-540.
24.
Bhide P, Dilgil M, Gudi A, Shah A, Akwaa C, Homburg R: Each small antral follicle in ovaries of women with polycystic ovary syndrome produces more antimüllerian hormone than its counterpart in a normal ovary: an observational cross-sectional study. Fertil Steril 2015;103:537-541.
25.
Laven JS, Mulders AM, Visser J, Themmen AP, de Jong FH, Fauser BC: Anti-müllerian hormone serum concentrations in normo-ovulatory and anovulatory women of reproductive age. J Clin Endocrinol Metab 2004;89:318-323.
26.
Katsikis I, Karkanaki A, Misichronis G, Delkos D, Kandaraki EA, Panidis D: 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;156:181-185.
27.
Karkanaki A, Vosnakis C, Panidis D: The clinical significance of anti-Mullerian hormone evaluation in gynecological endocrinology. Hormones (Athens) 2011;10:95-103.
28.
Yoo RY, Dewan A, Basu R, Newfield R, Gottschalk M, Chang RJ: Increased luteinizing hormone pulse frequency in obese oligomenorrheic girls with no evidence of hyperandrogenism. Fertil Steril 2006;85:1049-1056.
29.
Park AS, Lawson MA, Chuan SS, Oberfield SE, Hoeger KM, Witchel SF, Chang RJ: Serum anti-Müllerian hormone concentrations are elevated in oligomenorrheic girls without evidence of hyperandrogenism. J Clin Endocrinol Metab 2010;95:1786-1792.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.