Fertility Unit, Homerton University Hospital, London E9 6SR, UK.
Hum Reprod. 2013 Apr;28(4):1077-83. doi: 10.1093/humrep/det015. Epub 2013 Feb 1.
What is the relationship of serum anti-Mullerian hormone (AMH) with polycystic ovarian morphology (PCOM) and polycystic ovary syndrome (PCOS)?
Serum AMH concentrations are capable of differentiating between normal ovaries, PCOM and PCOS.
Serum AMH levels are high in PCOS reflecting the number of small antral follicles and an intrinsic defect of individual granulosa cells.
STUDY DESIGN, SIZE, DURATION: Data were collected prospectively and analysed from three groups of women: those with PCOS according to Rotterdam criteria, those with PCOM but no symptoms and those with normal ovaries.
PARTICIPANTS/MATERIAL, SETTING, METHODS: Women with PCOS (n = 90), with PCOM (n = 35) and with normal ovaries (controls, n = 90), matched for age and body mass index, were all being treated for infertility at Homerton University Hospital, a tertiary referral centre.
Using adequate numbers and statistical methods for demographically similar groups, there were significant differences in the mean serum AMH concentrations between women with PCOS [77.6 pmol/l (95% CI 64.8-90.3)], those with PCOM [52.2 pmol/l (95% CI 40.1-64.2)] and controls [23.6 pmol/l (95% CI 20.5-26.7)] (P < 0.001). The combination of AMH >48 pmol/l and LH > 6 IU/l diagnosed 82.6% of women with PCOS. The mean serum FSH was lower in both PCOS and PCOM compared with controls, whereas LH was higher in PCOS compared with PCOM and controls and correlated positively with AMH (r = 0.321, P < 0.01).
LIMITATIONS, REASONS FOR CAUTION: Further research is needed to determine the relationship of AMH, PCOS and PCOM. The study was restricted to women who sought out treatment for infertility.
The study suggests that the severity of symptoms of PCOS is positively related to the number of small follicles and that AMH may play an important part in the pathophysiology of anovulation.
STUDY FUNDING/COMPETING INTEREST: None.
血清抗苗勒管激素（AMH）与多囊卵巢形态（PCOM）和多囊卵巢综合征（PCOS）的关系是什么？
血清 AMH 浓度能够区分正常卵巢、PCOM 和 PCOS。
PCOS 患者的血清 AMH 水平升高，反映了小窦卵泡的数量和单个颗粒细胞的内在缺陷。
研究设计、大小、持续时间：数据是前瞻性收集的，并从三组女性中进行分析：符合 Rotterdam 标准的 PCOS 患者、有 PCOM 但无症状的患者和正常卵巢的对照组患者。
参与者/材料、设置、方法：在 Homerton 大学医院，对 90 名 PCOS 患者（n = 90）、35 名 PCOM 患者（n = 35）和 90 名正常卵巢对照者（匹配年龄和体重指数）进行了治疗不孕症的治疗。
使用适当数量和统计方法对人口统计学相似的组进行分析，PCOS 患者的平均血清 AMH 浓度[77.6 pmol/L（95% CI 64.8-90.3）]、PCOM 患者[52.2 pmol/L（95% CI 40.1-64.2）]和对照组[23.6 pmol/L（95% CI 20.5-26.7）]之间存在显著差异（P < 0.001）。AMH > 48 pmol/L 和 LH > 6 IU/L 的组合诊断出 82.6%的 PCOS 患者。与对照组相比，PCOS 和 PCOM 患者的平均血清 FSH 均较低，而 LH 则在 PCOS 患者中较高，与 PCOM 患者和对照组呈正相关，与 AMH 呈正相关（r = 0.321，P < 0.01）。
局限性、谨慎的原因：需要进一步研究以确定 AMH、PCOS 和 PCOM 之间的关系。该研究仅限于寻求治疗不孕症的女性。
该研究表明，PCOS 症状的严重程度与小卵泡的数量呈正相关，并且 AMH 可能在排卵障碍的病理生理学中起重要作用。
研究资金/竞争利益：无。
