Anti-Müllerian hormone measurement for the diagnosis of polycystic ovary syndrome

Objective: Anti-Müllerian hormone (AMH) is derived from the small antral follicles, and an elevated level has been suggested to add value to the Rotterdam criteria for the diagnosis of PCOS in cases of diagnostic uncertainty. Therefore, the role of AMH in the classical phenotype of PCOS was defined within a Caucasian population. Design: This was a cross-sectional study. Patients: Sixty Five women without PCOS and 110 women with PCOS fulfilling all 3 diagnostic Rotterdam criteria. Measurements: The main outcomes were the utility of serum AMH for the diagnosis of PCOS and its relationship to the metabolic parameters. Results: Anti-Müllerian hormone was increased in PCOS compared to controls (P  < .001). Areas under the receiver operator curve showed AMH to be predictive of PCOS (0.76) using a cut-off AMH of 46 pmol/L, which is derived from the 95 th percentile of the controls that gave a 41% sensitivity and 86% specificity; an AMH cut-off of 35 pmol/L gave a 55% sensitivity and 79% specificity. Age- and BMI-adjusted multiple logistic regression showed that AMH was more predictive of PCOS independently of either serum testosterone (T) (OR = 4.04; 95% CI 1.42-11.11; P =.007) or free androgen index (FAI) (OR = 3.90; 95% CI 1.40-10.83; P =.009). Conclusion: Whilst an elevated AMH has poor sensitivity, it is fourfold more likely to be associated with a diagnosis of PCOS, and supplementary to biochemical parameters will make a positive diagnosis of PCOS in 22% of patients when neither serum testosterone nor FAI is elevated

MATERNAL, UMBILICAL, UTERINE AND AMNIOTIC PROSTAGLANDIN-E AND PROSTAGLANDIN-F-2-ALPHA LEVELS IN LABOR

This paper confirms the important role played by prostaglandins in the induction of uterine contractions and the initiation of human labour, although the exact mechanism of action in labour remains unclear. Seventeen pregnant women at term were studied. Of these nine were in labour and the remainder underwent elective section. Prostaglandin E and F2α levels were measured in maternal, umbilical and uterine plasma and amniotic fluid by radioimmunoassay. Levels of prostaglandin E were generally higher than prostaglandin F2α but they were significantly lower in maternal and uterine plasma. Levels of prostaglandin F2α were significantly higher in maternal plasma during labour. The highest levels of prostaglandin were found in amniotic fluid. Measurements indicate that the decreasing ratio of prostaglandin E/F2α is more important in the initiation of labour than absolute levels of either prostaglandin. </jats:p

Diagnosis of Polycystic Ovary Syndrome: AMH in combination with clinical symptoms

We assessed the utility of using anti-Mullerian hormone (AMH) and clinical features of polycystic ovary syndrome (PCOS), polycystic ovarian morphology (PCOM), oligo/amenorrhea (OA), and hyperandrogenism (HA) for diagnosing PCOS, and compared their diagnostic accuracy with those of classical diagnostic systems

Endometrial biopsy findings in infertility: Analysis of 12,949 cases

Objective - Endometrial biopsy has been an important way of assessing infertile couples for several years. In this review of a wide-ranging series of endometrial biopsies of infertile couples in the Turkish population it was our aim to find the distribution of results according to the years 1956-1966, 1967-1980, 1981-1992. Setting - University hospital. Subjects - 12,949 endometrial biopsies, referred to our gynecological pathology laboratory for infertility investigation between 1956 and 1992. Method - Patient report files from pathology laboratory data, analyzed retrospectively. The assessment of the biopsies is made by the same pathologist. Results - 78.8% of cases had primary infertility, 21.2% secondary. Most of them were in the age group 26-35 years (48.8%). 37.58% of cases were found to show normal secretory endometrium, 20.95% proliferative endometrial changes, and 28.22% signs of luteal phase defect (LPD). Other local endometrial factors were also encountered, but in 1.79% the sample was considered insufficient for diagnosis. Moreover, in nine cases, malignancy was diagnosed with the help of endometrial biopsy. During the study period, cases of normal secretory endometrium and tuberculous endometritis were observed to decrease and LPD to increase significantly. It is worthy to note that in only 28 (0.21%) cases had endometrial biopsies been performed during a pregnancy cycle. Conclusion - We conclude that endometrial biopsy not only shows the hormonal response of endometrium but gives additional information about the local factors of endometrium concerning atrophy, specific and non-specific infections, and malignancy

Elevated serum levels of anti-Mullerian hormone can be introduced as a new diagnostic marker for polycystic ovary syndrome

ObjectiveTo determine the possible role of anti-Mullerian hormone (AMH) in the diagnosis of polycystic ovary syndrome (PCOS) with a larger population of women and to evaluate its role as a new diagnostic marker