Age-specific reference ranges of serum anti-müllerian hormone in healthy women and its application in diagnosis of polycystic ovary syndrome: a population study

BJOG. 2020 May;127(6):720-728. doi: 10.1111/1471-0528.16147. Epub 2020 Feb 25.

Abstract

Objective: To establish the age-specific centiles of serum anti-müllerian hormone (AMH) levels in Chinese women, and to explore the use of multiples of median (MoM) AMH levels for the diagnosis of polycystic ovary syndrome (PCOS).

Design: An observational study.

Setting: University-affiliated hospitals and community clinics.

Population: We included 3137 healthy women aged 20-44 years recruited prospectively or who had archived serum samples from previous research projects. Another validation cohort of 751 women with PCOS as well as ovulatory controls, which was a convenient sample of women attending for infertility or menstrual disorders, was also studied.

Methods: The serum samples were assayed for AMH by the automated Access AMH assay.

Main outcome measures: Age-specific reference ranges were constructed on the primary cohort with the Lambda-Mu-Sigma method. The MoM AMH of each subject in the validation cohort was calculated.

Results: Centile curves of serum AMH level against age were established. MoM AMH was significantly higher in women with PCOS than in controls (P < 0.05). The area under the ROC curve was 0.852 (95% confidence interval [CI] 0.825-0.877) (P < 0.0001) for discriminating women with PCOS from ovulatory controls by MoM AMH.

Conclusions: We established a set of year-by-year age-specific reference ranges of serum AMH levels in Chinese women. The MoM AMH derived from this set of reference ranges is a promising tool to replace antral follicle count in the diagnosis of PCOS.

Tweetable abstract: A set of age-specific reference ranges of AMH levels was established in Chinese women. Multiples of median AMH may be used to diagnose PCOS.

Keywords: Age-specific reference range; Chinese women; anti-Müllerian hormone; automated chemiluminescence assay; polycystic ovary syndrome.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Mullerian Hormone / blood*
  • Asian People / statistics & numerical data*
  • Female
  • Health Surveys
  • Humans
  • Polycystic Ovary Syndrome / blood*
  • ROC Curve
  • Reference Values
  • Women's Health*

Substances

  • Anti-Mullerian Hormone