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Submitted on September 19, 2005
Accepted on December 12, 2005
Laboratoire de Biochimie et Hormonologie, Parc EURASANTE, CHRU, F-59037 Lille cedex, France; Service de Gynécologie Endocrinienne et de Médecine de la Reproduction, Hôpital Jeanne de Flandre, CHRU, F-59037 Lille cedex, France; Service de Radiologie, Hôpital Jeanne de Flandre, CHRU, F-59037 Lille cedex, France
* To whom correspondence should be addressed. E-mail: p-pigny{at}chru-lille.fr.
Context: Despite its frequency, the Polycystic ovary syndrome (PCOS) is still a difficult diagnosis in endocrinology, gynaecology and reproductive medicine. To help solving this issue, the Rotterdam consensus conference proposed to include the ultrasonographic (U/S) follicle count as a new diagnostic criterion, in addition to hyperandrogenism and oligo-anovulation. Unfortunately its assessment does not offer sufficient reliability worldwide.
Objective: The aim of our study was to check whether AMH measurement in the serum could be a surrogate for antral follicle count in the diagnostic criteria of PCOS.
Design, setting and patients: Measurement of serum AMH with a 2nd generation immunoassay in a cohort of seventy-three PCOS patients and 96 controls, and evalutation of its diagnostic power by Receiver Operating Characteristic (ROC) curves. PCOS was diagnosed according to the Rotterdam definition.
Results: Serum AMH levels were 3-fold higher in PCOS patients than in controls (81.6 pmol/L vs. 33.5 pmol/L, P < 0.001) and were significantly related to the follicle number (FN) in the 2 groups. The area under the ROC curve for the AMH assay was 0.851, indicating a good diagnostic potency. Setting the threshold at 60 pmol/L offered the best compromise between specificity (92%) and sensitivity (67%).
Conclusions: The serum AMH level is an accurate marker of the ovarian early antral FN and offers a good diagnostic potency. In situations where accurate U/S data are not available, AMH could thus be used instead of the follicle count as a diagnostic criterion and incorporated as such in the Rotterdam definition of PCOS.
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