Role of Anti-Mullerin Hormone and LH/FSH Ratio in Diagnosis and Follow up of Patients with Poly Cystic Ovarian Syndrome in Khartoum Sate

Abstract

Background: The anti-Mullerian hormone (AMH) is a dimeric protein secreted by the female ovaries and has two fundamental roles in follicle genesis. It delays the entrance of the primordial follicle into the pool of follicles in growth and diminishes the sensitivity of the ovarian follicle towards follicle-stimulating hormone (FSH). Objective: The study aimed to find out the role of anti-Mullerian Hormone, FSH, LH and LH/FSH in diagnosis and follow up of patients with polycystic ovary syndrome. Material and Methods: In this study, 100 subjects with PCOS in reproductive age, and attended to Elsir Aboalhassan Fertility Center in Khartoum suffering from infertility and 60 controls were enrolled. Blood samples were collected from the subjects, senim samples were taken form Woman before and then after and after drilling. AMH was measured by using UNION immune analyzer, LH and F SH levels were measured by using TOSHO device. Data was analyzed using statistical package of social science (SPSS), version 21. Results: The results revealed that, the AMH, LH and LH/FSH were significantly increased in PCOS patients when compared to control group 0.006, 0.000 and 0.032 respectively. In contrast FSH level was significantly deceased in PCOS patients as compared to control p-value 0.002. AMH level was dropped after surgery as compared to before surgery p value 0.000, for the diagnostic accuracy of AMH, The AUC of AMH was 0.991, optimal AMH cut-off levcl was 18.5 ng/ml, yielding 99 % sensitivity and 98 specificity. AMI-I provided the highest sensitivity and specificity compared to other markers. Conclusion: In conclusion, the sensitivity and specificity of AMH in diagnosis of PCOS showed higher values with best cut off value 18.5 PM. FSH and LH have lower diagnostic values compared with AMH. AMH is a key diagnostic marker of PCOS, the optimal AMH cutoff for PCOS was 18.5 mg/ml (20-29 Years) in Sudanese population for this study so serum AMH, LH/FSH ratio could be used to improve the diagnostic sensitivity and specificity. AMH significantly decreased after drilling treatment, indicating it can be used to monitoring of the treatment. AMH was inversely correlated with F SH as well as age.