Safier Lauren Z, Grossman Lisa C, Chan Cariann W, Sauer Mark V, Lobo Rogerio A, Douglas Nataki C
Obstetrics and Gynecology, Columbia University Medical Center, New York, NY, USA.
Level Health, Inc, New York, NY, USA.
Int J Gynaecol Obstet. 2016 Oct;135(1):73-6. doi: 10.1016/j.ijgo.2016.03.026. Epub 2016 Jun 16.
To assess the applicability of anti-Müllerian hormone (AMH) testing in the identification of women at risk for polycystic ovary syndrome (PCOS) when AMH is used in ovarian reserve screening in the general population.
A secondary analysis was undertaken of a large cross-sectional study. Women aged 27-37years, presently delaying childbearing but interested in future fertility, completed an online questionnaire to assess knowledge and attitudes about ovarian reserve testing, and underwent serum AMH testing between October 2014 and April 2015 in New York, NY, USA. For the secondary analysis, women considered to have elevated AMH levels (≥4.7ng/mL) were invited for physical examination and transvaginal ultrasonography.
Among 97 women who underwent AMH testing, 32 (33.0%) had elevated AMH levels. Hyperandrogenism was reported by 8 (25.0%) women with elevated AMH and none with AMH concentrations lower than 4.7ng/mL (P<0.001). Irregular menstrual cycles before hormonal contraceptive use were reported by 16 (24.6%) of 65 women with AMH concentrations lower than 4.7ng/mL and 11 (34.4%) with elevated AMH (P=0.34). Of the 20 women with elevated AMH who returned for further evaluation, 16 (80.0%) had polycystic ovaries and 13 (65.0%) were diagnosed with PCOS (Rotterdam criteria).
When AMH levels are used as a screening test for fertility, elevated concentrations can identify women at risk for PCOS.
在一般人群中，当抗苗勒管激素（AMH）用于卵巢储备功能筛查时，评估AMH检测在识别多囊卵巢综合征（PCOS）风险女性中的适用性。
对一项大型横断面研究进行二次分析。年龄在27 - 37岁、目前推迟生育但对未来生育感兴趣的女性，完成一份在线问卷以评估对卵巢储备功能检测的知识和态度，并于2014年10月至2015年4月在美国纽约接受血清AMH检测。对于二次分析，AMH水平被认为升高（≥4.7ng/mL）的女性被邀请进行体格检查和经阴道超声检查。
在97名接受AMH检测的女性中，32名（33.0%）AMH水平升高。8名（25.0%）AMH水平升高的女性报告有高雄激素血症，而AMH浓度低于4.7ng/mL的女性中无一例报告有高雄激素血症（P<0.001）。65名AMH浓度低于4.7ng/mL的女性中有16名（24.6%）报告在使用激素避孕药之前月经周期不规律，而AMH水平升高的65名女性中有11名（34.4%）报告月经周期不规律（P = 0.34）。在20名AMH水平升高并返回进行进一步评估的女性中，16名（80.0%）有多囊卵巢，13名（65.0%）根据鹿特丹标准被诊断为PCOS。
当AMH水平用作生育力筛查试验时，升高的浓度可识别PCOS风险女性。
