Assessment of the Role of the Anti-Mullerian Hormone, Luteinizing Hormone/Follicle Stimulating Hormone Ratio in the Diagnosis of Polycystic Ovary Syndrome in Sudanese Women

  • Hafza Tola Faculty of Medical Laboratory Sciences, Alzaim Alazhari University
  • Mohammed Abbas Medical Laboratory Sciences Program, Allied Health Department, College of Health Sciences, University of Bahrain
  • Elsir Abu Alhassan Dr. Elsir Abu Alhassan Fertility Center, Khartoum
  • Nassr Eldin Shrif Faculty of Medical Laboratory Sciences, Alzaim Alazhari University
  • Mohammed Rida Dr. Elsir Abu Alhassan Fertility Center, Khartoum
Keywords: Anti-Müllerian hormone, Follicle Stimulating Hormone, Luteinizing Hormone, Ovulation, Polycystic Ovary Syndrome, Sudanese women

Abstract

BACKGROUND: The diagnosis of polycystic ovary syndrome (PCOS) is not an easy procedure, as the signs and symptoms are heterogeneous and of undefined aetiology.

AIM: This study is aimed to evaluate serum anti-Mullerian hormone (AMH) level and luteinizing hormone (LH)/folic stimulating hormone (FSH) ratio in women with PCOS in Sudan and to assess the diagnostic efficiency for the diagnosis of PCOS.

METHODS: In a case-control study, Serum AMH, LH, FSH was measured in the early follicular phase from Sudanese patients (N = 230) with PCOS and100 controls. The LH/FSH ratio was calculated, and its diagnostic power was evaluated by receiver operating characteristic curves.

RESULTS: The means of serum AMH, serum LH level and LH/FSH ratio of the test, were significantly increased in the test group compared to the control group (P-value < 0.000). The AMH sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) were found to be 83%, 99%, 99%, and 72% respectively. Serum AMH was considered adequate measures for the diagnosis of PCOS; its level showed an area under the ROC curve of 0.98 (95% confidence, P-value < 0.000). The best compromise between 98% specificity and 90% sensitivity was obtained with a cut-off value of 3.3 ng/mL for PCOS diagnosis. There was no correlation between age, body mass index (BMI) and AMH level in the test group.

CONCLUSIONS: The Serum AMH level and LH/FSH ratio were higher in patients than in control. However AMH level has better discriminative power and good diagnostic potency for the diagnosis of the PCOS among Sudanese women.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Goodarzi MO, Dumesic DA, Chazenbalk G, Azziz R. Polycystic ovary syndrome: aetiology, pathogenesis and diagnosis. Nat Rev Endocrinol. 2011; 7(4):219–231. https://doi.org/10.1038/nrendo.2010.217 PMid:21263450

Durlinger AL, Gruijters MJ. (2001); Anti-Mullerian hormone attenuates the effects of FSH on follicle development in the mouse ovary. Endocrinology. 2001; 142:4891–4899. https://doi.org/10.1210/endo.142.11.8486 PMid:11606457

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. https://doi.org/10.1016/j.fertnstert.2003.10.004

Hoeger KM. Role of lifestyle modification in the management of polycystic ovary syndrome. Best Pract Res Clin Endocrinol Metab. 2006; 20:293–310. https://doi.org/10.1016/j.beem.2006.03.008 PMid:16772159

Bungum L, Franssohn F, Bungum M, Humaidan P, Giwercman A. The Circadian Variation in Anti-Müllerian Hormone in Patients with Polycystic Ovary Syndrome Differs Significantly from Normally Ovulating Women. PLoS ONE. 2013; 8(9):e68223. https://doi.org/10.1371/journal.pone.0068223 PMid:24023708 PMCid:PMC3762839

Pawelczak M, Kenigsberg L, Milla S, Liu YH, Shah B. Elevated serum anti-Müllerian hormone in adolescents with polycystic ovary syndrome: relationship toultrasound features. J Pediatr Endocrinol Metab. 2012; 25:983–989. https://doi.org/10.1515/jpem-2012-0013 PMid:23426830 PMCid:PMC3763943

Siebert TI, Kruger TF, Steyn DW, Nosarka S. Is the addition of metformin efficacious in the treatment of clomiphene citrate-resistant patients with polycystic ovary syndrome? A structured literature review. Fertil Steril. 2006; 86:1432–1437. https://doi.org/10.1016/j.fertnstert.2006.06.014 PMid:17007847

Sahmay S, Atakul N, Aydogan B, Aydin Y, Imamoglu M, Seyisoglu H. Elevated serum levels of anti-Müllerian hormone can be introduced as a new diagnostic marker for polycystic ovary syndrome. Acta Obstet Gynecol Scand. 2013; 92:1369–74. https://doi.org/10.1111/aogs.12247 PMid:23980726

Wetzka B, Textor W, Ochsner A, Geisthövel F. Anti-Mullerian hormone confirms the novel classification of female functional androgenization including polycystic ovary syndrome, Eur J Endocrinol. 2011; 165:323-330. https://doi.org/10.1530/EJE-10-1179 PMid:21602314

Pigny P, Jonard S, Robert Y, Dewailly D. Serum anti-Mullerian hormone as a surrogate for antral follicle count for definition of the polycystic ovary syndrome. J Clin Endocrinol Metab. 2006; 91:941-945. https://doi.org/10.1210/jc.2005-2076 PMid:16368745

Cengiz H, Ekin M, Dagdeviren H, Yildiz Ş, Kaya C, Kanawati A. Comparison of serum anti-Müllerian hormone levels in normal weight and overweight–obese adolescent patients with polycystic ovary syndrome. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2014; 80:46-50. https://doi.org/10.1016/j.ejogrb.2014.06.018 PMid:25036408

Li L, Chen X, Mo Y, Chen Y, Wenig M, Yang D. Elevated serum anti-M€ullerian hormone in adolescent and young adult Chinese patients with polycystic ovary syndrome. Wien Klin Wochenschr. 2010; 122:519–24. https://doi.org/10.1007/s00508-010-1426-x PMid:20809108

Hart R, Doherty DA, Norman RJ, Franks S, Dickinson JE, Hickey M, et al. Serum anti-M€ullerian hormone (AMH) levels are elevated in adolescent girls with polycystic ovaries and the polycystic ovarian syndrome (PCOS). Fertil Steril. 2010; 94:1118–21. https://doi.org/10.1016/j.fertnstert.2009.11.002 PMid:20060112

Woo HY, Kim KH, Rhee EJ, Park H, Lee MK. Differences of the association of anti-M€ullerian hormone with clinical or biochemical characteristics between women with and without polycystic ovary syndrome. Endocr J. 2012; 59:781–90. https://doi.org/10.1507/endocrj.EJ12-0055 PMid:22673409

Published
2018-07-19
How to Cite
1.
Tola H, Abbas M, Alhassan EA, Shrif NE, Rida M. Assessment of the Role of the Anti-Mullerian Hormone, Luteinizing Hormone/Follicle Stimulating Hormone Ratio in the Diagnosis of Polycystic Ovary Syndrome in Sudanese Women. Open Access Maced J Med Sci [Internet]. 2018Jul.19 [cited 2020Nov.27];6(7):1244-7. Available from: https://www.id-press.eu/mjms/article/view/oamjms.2018.260
Section
B - Clinical Sciences