University of Oulu

Terhi T Piltonen, Elina Komsi, Laure C Morin-Papunen, Elisa Korhonen, Stephen Franks, Marjo-Riitta Järvelin, Riikka K Arffman, Meri-Maija Ollila, AMH as part of the diagnostic PCOS workup in large epidemiological studies, European Journal of Endocrinology, Volume 188, Issue 6, June 2023, Pages 547–554,

AMH as part of the diagnostic PCOS workup in large epidemiological studies

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Author: Piltonen, Terhi T.1; Komsi, Elina1; Morin-Papunen, Laure C.1;
Organizations: 1Department of Obstetrics and Gynaecology, Medical Research Center Oulu, Research Unit of Clinical Medicine, University of Oulu and Oulu University Hospital, FI-90029, Oulu, Finland
2Institute of Reproductive and Developmental Biology, Imperial College London, W12 0NN, London, United Kingdom
3Faculty of Medicine, Center for Life Course Health Research, University of Oulu, FI-90014, Oulu, Finland
4Unit of Primary Care, Oulu University Hospital, FI-90220, Oulu, Finland
5Department of Epidemiology and Biostatistics, School of Public Health, MRC Centre for Environment and Health, Imperial College London, W2 1PG, London, United Kingdom
6Department of Life Sciences, College of Health and Life Sciences, Brunel University London, UB8 3PH, London, United Kingdom
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
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Language: English
Published: Bioscientifica, 2023
Publish Date: 2023-09-26


Objectives: Previous studies have shown good correlation between polycystic ovarian morphology (PCOM) and serum anti-Müllerian hormone (AMH) levels. We evaluated the utility of AMH as a surrogate for PCOM as a part of the polycystic ovary syndrome (PCOS) diagnosis by describing how the use of different AMH cut-off values would change the prevalence of PCOS.

Methods: A general population-based birth cohort study. Anti-Müllerian hormone concentrations were measured from serum samples taken at age 31 years (n = 2917) using the electrochemiluminescence immunoassay (Elecsys). Anti-Müllerian hormone data were combined with data on oligo/amenorrhoea and hyperandrogenism to identify women with PCOS.

Results: The addition of AMH as a surrogate marker for PCOM increased the number of women fulfilling at least two PCOS features in accordance with the Rotterdam criteria. The prevalence of PCOS was 5.9% when using the AMH cut-off based on the 97.5% quartile (10.35 ng/mL) and 13.6% when using the recently proposed cut-off of 3.2 ng/mL. When using the latter cut-off value, the distribution of PCOS phenotypes A, B, C, and D was 23.9%, 4.7%, 36.6%, and 34.8%, respectively. Compared with the controls, all PCOS groups with different AMH concentration cut-offs showed significantly elevated testosterone (T), free androgen index (FAI), luteinizing hormone (LH), LH/follicle-stimulating hormone (FSH) ratio, body mass index (BMI), waist circumference, and homoeostatic model assessment of insulin resistance (HOMA-IR) values, as well as significantly decreased sex hormone-binding globulin (SHBG) values.

Conclusions: Anti-Müllerian hormone could be useful surrogate for PCOM in large data sets, where transvaginal ultrasound is not feasible, to aid the capturing of women with typical PCOS characteristics. Anti-Müllerian hormone measurement from archived samples enables retrospective PCOS diagnosis when combined with oligo/amenorrhoea or hyperandrogenism.

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Series: European journal of endocrinology
ISSN: 0804-4643
ISSN-E: 1479-683X
ISSN-L: 0804-4643
Volume: 188
Issue: 6
Pages: 547 - 554
DOI: 10.1093/ejendo/lvad065
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Funding: This work was supported by the Academy of Finland (315921, 321763, Profi6 336449), Sigrid Juselius Foundation, the Medical Research Center Oulu, the Novo Nordisk Foundation, and Roche Diagnostics International Ltd. The NFBC1966 31-year follow-up received financial support from the University of Oulu (65354), Oulu University Hospital Grant (2/97, 8/97), Ministry of Health and Social Affairs (23/251/97, 160/97, 190/97), National Institute for Health and Welfare, Helsinki (54121), and Regional Institute of Occupational Health, Oulu, Finland (50621, 54231). The NFBC1966 46-year follow-up received financial support from University of Oulu (24000692), Oulu University Hospital (24301140), and European Regional Development Fund (ERDF) (539/2010 A31592). The data generation, curation, and manpower were also supported by the following EU H2020 grants: DynaHEALTH (633595), LifeCycle (733206), LongITools (873749), EarlyCause, EDCMET (825762), and the Medical Research Council, UK: grant number MRC/BBSRC MR/S03658X/1 (JPI HDHL H2020). M.-R.J. is partly supported by the MRC Centre for Environment and Health at ICL, which is currently funded by the MRC (MR/S019669/1).
EU Grant Number: (633595) DYNAHEALTH - Understanding the dynamic determinants of glucose homeostasis and social capability to promote Healthy and active aging
(733206) LIFECYCLE - Early-life stressors and LifeCycle health
(874739) LONGITOOLS - Dynamic longitudinal exposome trajectories in cardiovascular and metabolic non-communicable diseases
(848158) EarlyCause - Causative mechanisms & integrative models linking early-life-stress to psycho-cardio-metabolic multi-morbidity
(825762) EDCMET - Metabolic effects of Endocrine Disrupting Chemicals: novel testing METhods and adverse outcome pathways
Academy of Finland Grant Number: 315921
Detailed Information: 315921 (Academy of Finland Funding decision)
321763 (Academy of Finland Funding decision)
Copyright information: © The Author(s) 2023. Published by Oxford University Press on behalf of European Society of Endocrinology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.