Updated meta‐analysis on the diagnostic accuracy of serum anti‐Mullerian hormone in poly cystic ovary syndrome involving 13 509 subjects

Abstract

Aim: To determine the diagnostic accuracy of anti-Mullerian hormone (AMH) in the diagnosis of polycystic ovary syndrome (PCOS). Methods: Two independent reviewers searched the electronic databases and search engines using PubMed, Cochrane library, and Google Scholar systematically to retrieve relevant articles published from inception to September 2021. The diagnostic efficacy of AMH was computed using the random-effects model in terms of pooled sensitivity, specificity, and diagnostic odds ratio (DOR) with 95% confidence interval (CI). A metaregression and subgroup analysis were performed to check for any source which could explain possible heterogeneity. Risk of bias assessment was conducted using the QUADAS-2 tool recommended by Cochrane Library. Results: This meta-analysis included a total of 41 studies involving 13 509 subjects. We observed promising pooled sensitivity 0.78 (95% CI 0.74 to 0.81), specificity 0.87 (95% CI 0.84 to 0.90), and diagnostic odds ratio (DOR) 24 (95% CI 15 to 37), for AMH in detecting PCOS and discriminatory power (summary receiver operating characteristic [SROC] curves, 0.89 [95% CI 0.86-0.92]). The most prominent bias was noted in the patient selection and index test assessment. Conclusions: With the findings of this current meta-analysis, we conclude serum AMH to be a promising biomarker for the diagnosis of PCOS, however, substantial heterogeneity among studies needs individual patient data analysis in order to identify an optimal cut-off value and homogenous findings. Registration Number and Guidelines: This meta-analysis was performed according to constructed protocol registered in the PROSPERO database with registration number CRD42021246910.

Anti‐Müllerian hormone for screening, diagnosis, evaluation, and prediction: A systematic review and expert opinions

“…57 Two other meta-analyses demonstrated the usefulness of AMH levels in diagnosing PCOS, regardless of age. 56,59 Although the cut-off value for AMH was set at 4.7 ng/mL, in the meta-analysis of In this regard, a meta-analysis of exclusively adolescents with PCOS has shown the usefulness of AMH measurement for diagnosing PCOS, and that the cut-off value is approximately 6-7 ng/mL. 55 PCOS is a syndrome with several different diagnostic criteria, of which polycystic ovary morphology (PCOM) is one.…”

“…A 2021 meta‐analysis demonstrated that the mean difference in AMH levels between the PCOS and control groups was 0.97 (0.60–1.34) ng/mL 57 . Two other meta‐analyses demonstrated the usefulness of AMH levels in diagnosing PCOS, regardless of age 56,59 . Although the cut‐off value for AMH was set at 4.7 ng/mL, in the meta‐analysis of individual participant data, 59 the cut‐off values were widely distributed in the recruited studies.…”

Diagnostic et prise en charge du syndrome des ovaires polykystiques

“…Le taux d’hormones antimüllériennes est aussi un marqueur du nombre de follicules. Une méta-analyse récente laisse entendre qu’un seuil de diagnostic approprié pour le de SOPK serait un taux d’hormones antimüllériennes de 34,2 pmol/L 15 . Les valeurs et les seuils dépendent étroitement de l’âge et des résultats d’analyses 1 .…”

Validation of an Anti-Müllerian Hormone Cutoff for Polycystic Ovarian Morphology in the Diagnosis of Polycystic Ovary Syndrome in the HARMONIA Study: Protocol for a Prospective, Noninterventional Study

“…Anti-Müllerian hormone (AMH) is a regulator of follicle recruitment from the primordial follicle pool and inhibitor of follicular growth that is expressed by granulosa cells in the preantral and small antral follicles [23,24]. Serum AMH levels correlate well with the 2-9 mm antral follicles found in TVUS examination in the diagnosis of PCOM [25,26]. Elevated levels of AMH are observed in women with PCOS [27][28][29][30], and a strong correlation between elevated levels of AMH and increased AFCs has been demonstrated [12,14,26,29], supporting the use of AMH as a biomarker for PCOM.…”

“…Serum AMH levels correlate well with the 2-9 mm antral follicles found in TVUS examination in the diagnosis of PCOM [ 25 , 26 ]. Elevated levels of AMH are observed in women with PCOS [ 27 - 30 ], and a strong correlation between elevated levels of AMH and increased AFCs has been demonstrated [ 12 , 14 , 26 , 29 ], supporting the use of AMH as a biomarker for PCOM.…”