Exploration of the role of anti‐Mullerian hormone and LH/FSH ratio in diagnosis of polycystic ovary syndrome

Abstract

Objective: This study explores the role of anti-Mullerian hormone (AMH) and LH/ FSH ratio in diagnosis of polycystic ovary syndrome (PCOS). Methods: In this multicentre cross-sectional descriptive study, a total of 863 infertile women between 18 and 45 years were evaluated at three infertility centres in Vietnam and were recruited from June 2016 to June 2017. The patients were classified into two groups: Group I included 441 patients with PCOS (based on Rotterdam criteria consensus) and Group II included 422 non-PCOS women. Diagnosis of PCOS was established based on Rotterdam 2003 consensus, and exclusion criteria were ovarian disease (ovary cyst/tumour), history of ovarian surgery and ovarian failure. Results: At an optimum cut-off level of 32.79 pmol/L, AMH showed sensitivity and specificity of 78.50% and 75.83%, respectively, with the AUC 0.852 (95% CI: 0.826-0.875). The LH/FSH ratio had a similar AUC at the optimum cut-off of 1.33 (AUC = 0.867, 95% CI 0.842-0.889), which demonstrated a similar diagnosis value to AMH (P = 0.340). By using multiple logistic regression analysis, 1 ng/mL increase in AMH levels was associated with an increased risk of PCOS (OR = 1.63, 95% CI:1.506-1.764; P < 0.001). Similarly, one unit increase in LH/FSH ratio was associated with 14.433 times increased (95% CI: 9.302-22.395; P < 0.001) risk of PCOS. There were no significant differences between values of AMH and LH/FSH ratio in PCOS diagnosis, as the difference between the two AUCs was 0.013, 95% CI: −0.024 to 0.028 and P = 0.897. Conclusion:The value of serum AMH concentration has been found not significantly superior to LH/FSH ratio in PCOS diagnosis. Although these biomarkers separately are not adequate for PCOS diagnosis based on their own value, the combination of different endocrine factors including AMH, LH and LH/FSH ratio together with BMI and other anthropometric and clinical characteristics may offer extra value to establish the diagnosis of PCOS. K E Y W O R D Santi-Mullerian hormone, diagnostic value, LH/FSH ratio, polycystic ovary syndrome ACK N OWLED G EM ENTSWe thank the staff of the Hue Center for Reproductive Endocrinology and Infertility, Hue University Hospital for their excellent support.

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“…PCOS represents a chronic endocrine-metabolic disease with hyperandrogen and low estrogen (53). The LH/FSH ratio was regarded as a main biomarker of diagnosis in PCOS (54,55). The notably increased T level is usually considered as a marker of hyperandrogenism in PCOS (56).…”

Assessment the Correlations of Hormones,Lipid Profiles, Oxidative Stress, and Zinc Concentration in Iraqi Women with Polycystic Ovary Syndrome

“…In addition, the hormone profile was observed to have highly significant differences in LH, prolactin, and estradiol levels and insignificant differences in FSH and progesterone between PCOS patients and control groups. The studies showed that the LH/FSH ratio is 2-3-fold different between groups (20,21). In this study, the ratio of LH/FSH in PCOS women was 5:1 for study patients 15-29 years and 4:1 for 30-45 years compared with healthy women ratios in which an elevated LH/FSH ratio could disrupt ovulation.…”

Variations in the Profiles of Vascular-Related Factors Among Different Sub-Types of Polycystic Ovarian Syndrome in Northern China

“…This would help in the identification of PCOS patients from normal women. A recent case-control study (441 PCOS women and 422 non-PCOS women) was conducted to examine the diagnostic ability of the LH/FSH ratio in the identification of PCOS cases (39). An optimum LH/FSH ratio cut-off value of 1.33 was significant to diagnose PCOS (area under curve = 0.867).…”