Polycystic Ovary Syndrome (PCOS), Diagnostic Criteria, and AMH

Majid Bani Mohammad; Abbas Majdi Seghinsara

doi:10.22034/APJCP.2017.18.1.17

PMOS / PCOS Diagnosis

Polycystic Ovary Syndrome (PCOS), Diagnostic Criteria, and AMH

Bani Mohammad M, Majdi Seghinsara A

Asian Pacific Journal of Cancer Prevention : APJCP, 18(1), 17-21, 2017

DOI 10.22034/APJCP.2017.18.1.17 PMID 28240001 PMC PMC5563096

RRM Academy Synopsis

AMH can help diagnose PCOS when paired with other clinical signs

A 2017 minireview reports that the AMH blood test can help diagnose PCOS, with better accuracy when paired with other clinical signs. AMH is anti-Müllerian hormone. PCOS is now renamed polyendocrine metabolic ovarian syndrome (PMOS). Cited prevalence estimates vary with the criteria, from 9% under one consensus to 18% under another.

Key Findings

Estimated PCOS prevalence ranges from 9% under the National Institutes of Health consensus to 18% under the Rotterdam consensus.
A diagnosis under the Rotterdam criteria needs two of three findings: missed or rare ovulation, excess androgen, and a polycystic look to the ovaries on ultrasound.
In one cited study of women already diagnosed under the Rotterdam criteria, AMH combined with hyperandrogenism had 73% sensitivity and 99% specificity for diagnosing PCOS.
In that study of women already diagnosed under the Rotterdam criteria, AMH with either oligo/amenorrhea or hyperandrogenism had 83% sensitivity and 100% specificity. With oligo/amenorrhea alone, it had 69% and 99%.
Used as a single screening tool, AMH had relatively low sensitivity and specificity in that study.

Interpretation

This minireview synthesizes findings from prior studies on PCOS diagnosis and AMH. Combining AMH with hyperandrogenism or with menstrual irregularity reached high sensitivity and specificity for PCOS diagnosis, well above AMH used alone as a single screening marker. The authors note that no worldwide standard exists for the AMH blood test, so thresholds remain undefined. The findings support larger studies that set standardized AMH thresholds for PCOS diagnosis.

RRM Context

The review names PCOS as the most common cause of infertility from missed ovulation. Restorative reproductive medicine begins with evaluation and asks why ovulation is missing in each woman. A cycle chart records ovulation-related signs month after month. A single AMH blood draw gives no such record.

Our editorial summary of this paper, not the article's abstract.

Abstract

The polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility and a notable proportion of women of reproductive age are affected. It may constitute a risk factor for cancer development. Different factors could result in different manifestations and many of these are related to predispositions. It is essential to establish criteria to achieve an exact diagnosis of PCOS, especially among adolescent patients because of the overlap between features of PCO syndrome and physiological findings in puberty. Day by day the technology of ultrasonography is improving and accuracy is increasing, but remains dependent on the specific equipment available. Some factors are inter-related in determining PCOS prognosis. Serum AMH is synthesized by small antral follicles, which are precisely those seen on ultrasound and could help us to diagnose PCOS but there are many aspects that still require elucidation. In this mini- review we have attempted to identify some of these correlations.

Read the guide

PMOS / PCOS: Causes, Diagnosis, and Treatment

PMOS / PCOS has four diagnostic phenotypes and distinct metabolic, reproductive, and mental health implications. How RRM-trained clinicians approach diagnosis and treatment differently.

20 min read

Topics

PMOS / PCOS › Diagnosis › Diagnostic Criteria · Reproductive Endocrinology › Ovarian Hormones › Androgens · Diagnostics › Hormone Testing › Serum Panels

Majid Bani Mohammad, Abbas Majdi Seghinsara

M Mohammad, A Seghinsara

PMID 28240001 28240001 DOI 10.22034/APJCP.2017.18.1.17 10.22034/APJCP.2017.18.1.17 Bani Mohammad et al. 2017, Bani Mohammad 2017

Polycystic Ovary Syndrome (PCOS), Diagnostic Criteria, and AMH

AMH can help diagnose PCOS when paired with other clinical signs

Key Findings

Interpretation

RRM Context

Abstract

Read the guide

PMOS / PCOS: Causes, Diagnosis, and Treatment

Topics

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