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CC BY 4.0 · Semin Reprod Med
DOI: 10.1055/s-0044-1786731
Review Article

Utility of Serum Anti-Müllerian Hormone Measurement as Part of Polycystic Ovary Syndrome Diagnosis

Terhi T. Piltonen   *
1   Department of Obstetrics and Gynecology, Research Unit of Clinical Medicine, Medical Research Center Oulu, University of Oulu, Oulu University Hospital, Oulu, Finland
,
Johanna Viita-aho
1   Department of Obstetrics and Gynecology, Research Unit of Clinical Medicine, Medical Research Center Oulu, University of Oulu, Oulu University Hospital, Oulu, Finland
,
Ulla Saarela
1   Department of Obstetrics and Gynecology, Research Unit of Clinical Medicine, Medical Research Center Oulu, University of Oulu, Oulu University Hospital, Oulu, Finland
,
Johanna Melin   *
2   Department of Obstetrics and Gynecology, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
,
Maria Forslund   *
3   Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
› Author Affiliations Funding This study relates to grants from the Finnish Medical Foundation (T.T.P.), the Academy of Finland (project grants 315921, 321763, T.T.P.), Oulu University Hospital regional fund (T.T.P.), the Sigrid Juselius Foundation (T.T.P.), Novo Nordisk Foundation (T.T.P.), the Finnish Cultural Foundation (T.T.P.), Finska Läkaresällskapet (J.M.), Swedish Medical Society (SLS-984944, M.F.). T.T.P. has received funding from Roche Diagnostics for AMH-related researcher-initiated studies.
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Abstract

The 2023 international evidence-based guideline update for the assessment and management of polycystic ovary syndrome (PCOS) recommends using the Rotterdam criteria for the diagnosis of PCOS. The updated guideline has evidence-based recommendation for the diagnosis, and it now also includes serum anti-Müllerian hormone (AMH) measurement as an alternative tool for gynecological ultrasound to diagnose polycystic ovary morphology (PCOM). The aim of this new recommendation was to facilitate PCOS diagnostic workup in primary care and other disciplines, as currently most diagnosing is done in gynecology and infertility clinics. Here, we review factors affecting AMH levels as well as the utility of AMH in PCOS diagnosis. We identified relevant studies that report different cut-offs for AMH to diagnose PCOM as part of PCOS diagnosis. There are, however, some limitations when using AMH that should be acknowledged. These include physiological aspects like age, ethnicity, and obesity and iatrogenic causes like hormonal medication and ovarian surgery. Also reference ranges are different depending on AMH assay used. As a summary, we conclude that AMH is a usable tool in PCOM diagnostics, but it does not have a single cut-off. Therefore, further studies are needed to establish age and assay-based reference ranges.

Keywords

PCOS - PCOS diagnosis - AMH

* Equal contribution as senior author.




Publication History

Article published online:
22 May 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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