Study On The Correlations Of Anti-mullerian Hormone And Polycystic Ovary Syndrome

Objective:To investigate the expression and analysis of related factors of anti-mullerian hormone among polycystic ovary syndrome,premature ovarian failure and among the difference clinic phenotype.Method:124patients were recruited (2010October to2011December) from the gynecologicail endocrine outpatient clinic and the center of Assisted reproductive who diagnosed as PCOS as case group,30POF were recruited as another case group,30healthy volunteers or the one who needs the reproductive because of the factor of male factor or Blocked fallopian tubes as control group. All the subjects were excluded from other endocrinopathy and did not have any hormonal therapy for the past3months before releasing test were measured; All PCOS patients in the third-fifth day of menstrual cycle or without diameter greater than10mm eggs development do the associated analytical review;POF group and control group measure the level of hormones,testing all the samples anti-mullerin hormone.Record the all the samples’menstrual cycle,body height,bodyweight,waist,hip circumference and so on.Accordance with HOMA-IR and unHOMA-IR,the defferent level of androgen,the menstrual cycle,obesitas and unobesitas,the defference of the antral follicle count devise five group.Results:1.The characteristic of clinic and endocrine and the defferent expression of AMH in the PCOS,POF and control group.1.1The clinical and characterisitics of the women with PCOS:the mean age was25.90±4.21years,BMI was27.71±4.21kg/m2;Among124patients64.23%displayed obesity;Hyperandrogenism was62.10%;insulin resistant was66.13%;amenorrhea was40.32%and oligomenorrhea was59.68%.AFC≤30was29exaples,30<AFC<45was56example,45≤AFC was39example;AMH(13.23±5.20)ng/ml.1.2The characterisitics of the control group:In the POF group,the mean age was (26.19±4.61) years,the mean first catamenia was(15.58±0.72)years, BMI (20.39±2.31) kg/m2,the AMH level was (2.98±1.98) ng/ml;In the control group, the mean age was(26.01±4.32) years,the mean first catamenia was(13.58±0.72)years, the AMH level was (6.27±2.79) ng/ml.1.3Compare the level of AMH in PCOS group,POF group and the control group, the difference were significant (p<0.01) in the three group;The sensitivity and the specificity of AMH used in PCOS diagnosis were90.8%and89.5%, The sensitivity and the specificity of AMH used in POF dianosis were93.2%and90.3%.2. The clinical characterisitics、Serum sex hormones and insulin metabolic features in defferent PCOS group.2.1According to the androgen level:LH/FSH,LH,AFC,AMH,E2were higher in hyperandrogenism than unhyperandrogenism (p<0.05),other markers difference has no significance in statistics (p>0.05)2.2According to the antral follicle count:the AMH uninterrupted increasing coupled with the antral follicle count,the difference were significant (p<0.01), BMI,LH/FSH,T,HOMA-IR were constantly higher in30≥AFC group,30>AFC>45group and45≥AFC group, the difference were significant (p<0.05)2.3According to the HOMA-IR:BMI,LH/FSH,LH,T,menstrual cycle were higher in IR group than unIR group, the difference were significant (p<0.05) AMH were higher in unIR group than IR group, the difference were significant (p<0.05)2.4According to the BMI:LH,AMH were lower in BMK25group han BMI>25group(p<0.01),T、LH、HOMA-IR and menstrual cycle were higher in BMK25group han BMI>25group (p<0.01),but LH/FSH was lower in BMI>25group than in BMK25group (p<0.05)2.5According to the menstrual cycle:BMI,T,HOMA-IR,AFC were higher in amenorrhea group than oligomenorrhea group (p<0.05) while E2was lower in amenorrhea group than oligomenorrhea group (p<0.05), The difference of AMH between amenorrhea group than oligomenorrhea group has significance in statistics (p<0.05)Conclusion:1. the serum level of AMH in PCOS was higher than those in the control group, the serum level of AMH was lower in POF patients than in normal control group. 2.The level of AMH in PCOS patients with different clinical phenotypes exist correlation:AMH in PCOS patient have a negative relationship in different T, in different AFC group and in different menstrual cycle,but have a positive relationship in different BMI and HOMA-IR group.3.The detection of serum AMH for the PCOS and POF diagnosis with higher sensitivity and specificity.4. AMH is an new effectiveness factor using for evaluating the function of ovary store and expected to become effective on ovulation treatment.