Choi Young Min, Hwang Kyu Ri, Lee Dayong, Kim Sunmie, Kim Jin Ju
Department of Obstetrics and Gynecology, Grace Hospital, Goyang, Korea.
The Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.
Clin Endocrinol (Oxf). 2025 Oct;103(4):580-586. doi: 10.1111/cen.70000. Epub 2025 Jul 9.
The 2018 evidence-based guideline revised the follicle count threshold for polycystic ovary morphology (PCOM) from ≥ 12 to ≥ 20, thereby introducing a stricter definition than the Rotterdam criteria. In 2023, anti-Müllerian hormone (AMH) was incorporated into defining PCOM. Although PCOS-related symptoms often improve with age, some women continue to exhibit symptoms and meet the PCOS diagnostic criteria even as they age. This study examined AMH patterns across age groups in women who already met the PCOS diagnostic criteria according to either the Rotterdam or the stricter 2018 criteria.
This cross-sectional study included 725 women diagnosed with PCOS according to the Rotterdam criteria, of whom 520 also fulfilled the 2018 criteria. Serum AMH levels were compared across age groups: < 25, 25-34.9, and 35-45 years.
Among women meeting the Rotterdam criteria, AMH levels were significantly lower in the oldest group (9.0 ng/mL) than in those < 25 years (11.2 ng/mL, p = 0.032). Meanwhile, among women who met the 2018 criteria, mean AMH levels were 12.5, 12.0, and 10.0 ng/mL in < 25, 25-34.9, and 35-45 year groups, respectively (p = 0.077), with no correlation between age and AMH (r = -0.050, p = 0.178). Additionally, the oldest group showed worse metabolic profiles than the younger groups.
Women who continued to meet the stricter criteria at older reproductive ages showed AMH levels comparable to those of younger patients, and had worse metabolic profiles, supporting AMH as a stable diagnostic marker across reproductive ages in PCOS.
2018年循证指南将多囊卵巢形态（PCOM）的卵泡计数阈值从≥12个修订为≥20个，从而引入了比鹿特丹标准更严格的定义。2023年，抗苗勒管激素（AMH）被纳入PCOM的定义中。尽管多囊卵巢综合征（PCOS）相关症状通常会随着年龄增长而改善，但一些女性即使随着年龄增长仍会出现症状并符合PCOS诊断标准。本研究调查了根据鹿特丹或更严格的2018标准已符合PCOS诊断标准的女性各年龄组的AMH模式。
这项横断面研究纳入了725名根据鹿特丹标准诊断为PCOS的女性，其中520名也符合2018标准。比较了不同年龄组（<25岁、25 - 34.9岁和35 - 45岁）的血清AMH水平。
在符合鹿特丹标准的女性中，年龄最大组的AMH水平（9.0 ng/mL）显著低于<25岁组（11.2 ng/mL，p = 0.032）。同时，在符合2018标准的女性中，<25岁、25 - 34.9岁和35 - 45岁组的平均AMH水平分别为12.5、12.0和10.0 ng/mL（p = 0.077），年龄与AMH之间无相关性（r = -0.050，p = 0.178）。此外，年龄最大组的代谢状况比年轻组更差。
在较高生育年龄仍符合更严格标准的女性，其AMH水平与年轻患者相当，且代谢状况更差，这支持AMH作为PCOS整个生育年龄的稳定诊断标志物。
