Study On The Relationship Between Anti-mullerian Hormone And Polycystic Ovary Syndrome

Objective To investigate anti-mullerian hormone (AMH) in women with polycystic ovary syndrome (PCOS) and explore its role in the pathogenesis.Methods 1. Samples from patients with PCOS (n=51) and controls (n=20) were collected. The levels of AMH were determined by ELISA; 2. Follicle stimulating hormone (FSH), Luteinizing hormone (LH), Prolactin (P), Testosterone (T), Androstenedione (A), Estradiol (E2) and number of follicles (FN) in both ovaries were measured in 51 PCOS women and 20 women with normal menstrual cycle. To analyze the relationships between these markers and AMH;3. Fasting plasma glucose (FPG) and fasting insulin (FIN) were measured in 51 PCOS patients and 20 control subjects by radioimmuno analysis. Insulin resistance index was calculated using homeostasis model assessment (HOMA) to analyze the relationship between AMH and insulin resistance (IR); 4. AMH and T were assayed in the follicular fluid of < 9mm follicles from 11 PCOS patients and size-matched follicles from 10 normally cycling women. Peripheral serum were collected and assayed at the same time. Comparison and correlation analysis of follicular fluid and serum hormone levels were also conducted.Results 1. The levels of serum LH, T, A, FIN, HOMA-IR and FN of both ovaries in PCOS were significantly higher than those of control groups respectively(P<0.001); 2. Serum levels of AMH in PCOS group (31.10±13.44) pmol/L were significantly higher compared with the control group (12.01±4.44) pmol/L. A significant positive correlation was found between serum levels of AMH and FN in PCOS (r=0.669, P <0.001) and normal women (r=0.508, P =0.019). In addition, AMH levels were positively and significantly correlated with T (r=0.515,P <0.001),A (r=0.57,P <0.001),HOMA-IR (r=0.54,P <0.001) in PCOS patients , but it was not found in control group; 3. Follicular fluid levels of AMH and T in 11 PCOS patients were significantly higher compared with 10 control women (P<0.001). In both control and PCOS women, follicular fluid concentrations of AMH, T were much higher than those found in serum (P<0.001); Further, there were significant and positive correlations between the follicular fluid levels of AMH and T (r = 0.54,P <0.001).Conclusions Levels of AMH in follicular fluid and serum in PCOS were significantly higher than those control groups, and AMH levels were positively and significantly correlated with T, FN in PCOS women. The data above suggest that AMH may have a role in the disordered folliculogenesis characteristic and dysregulation of steroidogenesis in PCOS; a significant positive correlation has been found between HOMA-IR and serum AMH levels. We hypothesize that the changes of AMH in PCOS may closely relate to insulin resistance of PCOS. The conclusions above indicate that AMH likely important mechanism leading to pathophysiological changes in PCOS.