Anti-müllerian Hormone Associated with Antral Follicular Count in Cases of Polycystic Ovary Syndrome

Abstract

Background: Anti-Müllerian hormone (AMH) is a glycoprotein, synthesized in the “granulosa cells” of the graffian follicles of the ovaries and can suppress the growth of primordial follicles.

Objective: to assess the association of concentration of AMH with antral follicular count (AFC) on day 2-3 of the menstrual cycle, in cases of polycystic ovary syndrome (PCOs).

Patients and methods

This case-control cross-sectional study was piloted on two groups of total hundred infertile women. The first group included fifty cases with PCOS, while the control group included 50 non-PCOS infertile cases. A detailed history was obtained from all candidates, and on days 2-3 of the cycle underwent the following hematological tests: testosterone, follicular stimulating hormone (FSH), AMH, luteinizing hormone (LH), and estradiol (E₂). As well, transvaginal ultrasonography (TVUS) was performed to assess hormonal/follicular association evaluated by the count of early antral follicles (2–9mm diameter).

Results

The AMH levels in the PCOS women were significantly (P-0.001) higher compared to the control group (13.8±5.9 vs. 6.0±2.6ng/ml), correspondingly. A significant increase (P-0.001) in the count of follicles measured (2-9 mm) in size at TVUS in PCOS women compared to control (17.6±6.8 vs. 8.0±3.8), respectively. AMH correlated significantly high (P-0.001) with AFC in the PCOS group. The plasma levels of AMH and testosterone were significantly correlated in the PCOS group (P-0.05).

Conclusion

During the initial follicular phase, serum AMH in PCOS is strongly correlated with the antral follicle status. Such a link is stronger when compared with other hormones affecting follicular function. Serum AMH concentration in PCOS on days 2-3 of the cycle is a superior predictor of the early AFCs than traditional hormonal assays. Hence, AMH serum levels offer a good diagnostic potency in the definition of PCOS.