Comparative assessment of five serum antimullerian hormone assays for the diagnosis of polycystic ovarian syndrome

Capsule:
The performance of the different commercial antimullerian hormone assays for polycystic ovary syndrome diagnosis is comparable, but different threshold values should be used for automatic and manual assays.

Authors:
Pascal Pigny, Ph.D., Elisse Gorisse, M.D., Amjad Ghulam, M.D., Geoffroy Robin, M.D., Sophie Catteau-Jonard, M.D., Ph.D., Alain Duhamel, M.D., Ph.D., Didier Dewailly, M.D.

Volume 105, Issue 4, Pages 1063-1069

Abstract:

Objective:
To determine whether the different antimüllerian hormone (AMH) immunoassays on the market offer the same performance for the diagnosis of polycystic ovary syndrome (PCOS).

Design:
A total of 95 serum AMH samples were retrospectively evaluated for a period of 3 months in the same laboratory.

Setting:
Academic center laboratory.

Patient(s):
Forty-eight control women with regular menses and no hyperandrogenism and 47 patients with classic PCOS (i.e., hyperandrogenism plus oligoanovulation) attending our department for infertility.

Intervention(s):
None.

Main Outcome Measure(s):
AMH measurement using five commercial assays. Method comparison and evaluation of the diagnostic performance by receiver operating characteristic analysis.

Result(s):
Values obtained with Gen II and AL-105i ELISAs were similar to those provided by EAI AMH/MIS, whereas automatic assays generated lower values. A significant mean difference was observed between Access Dxi (1.35 ng/mL) or Cobas (1.73 ng/mL) and EIA AMH/MIS ELISA. By ROC analysis each assay displayed similar efficiency for PCOS diagnosis. Sensitivities varied from 49% to 74% when setting the specificity at 92%. Cluster analysis run in the control group identified a subgroup of asymptomatic women with polycystic ovary morphology (PCOM). After exclusion of PCOM, the 95th percentile of controls was 4.2 ng/mL (30 pmol/L) with the automatic assays and 5.6 ng/mL (40 pmol/L) with the manual assays.

Conclusion(s):
Performance of the different AMH assays for PCOS diagnosis is comparable, providing that different threshold values are used for manual and automatic assays. Measurement of serum AMH level appears as a robust tool for the definition of PCOM.

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