الفهرس 
Overview on polycystic ovary syndromeOnly 14 pages are availabe for public view
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Abstract
PCOS is one of the most common endocrine disorders in women of reproductive age (Franks 1995). It is characterized by anovulation manifested as oligo- or amenorrhea, elevated levels of circulating androgens, and polycystic ovaries as visualized by ultrasound. The diagnosis is based on the presence of at least two of the described characteristics, as defined by the Rotterdam Consensus (2004). PCOS encompasses a broad spectrum of clinical and biochemical characteristics, and, although the mechanisms leading to PCOS are still poorly understood, the common denominator is a disturbance in the selection of the dominant follicle resulting in anovulation.
In the ovary, Anti-Müllerian hormone (AMH) is produced by the granulosa cells of early developing follicles and inhibits the transition from the primordial to the primary follicular stage. AMH levels can be measured in serum and have been shown to be proportional to the number of small antral follicles. In women serum AMH levels decrease with age and are undetectable in the post-menopausal period. In contrast, AMH levels have been shown to be increased in women with polycystic ovary syndrome (PCOS). AMH levels appear to represent the quantity of the ovarian follicle pool and may become a useful marker of PCOS.
The aim of this study is to determine the levels of circulating AMH in the serum of healthy controls and patients with polycystic ovary syndrome, in order to evaluate its relation with the disease and its correlations with different markers used to diagnosis of PCOS.
The present study was conducted on thirty subjects suffering from PCOS and twenty healthy controls. They were selected from patients of the Fertility Unit in the department of Obstetrics and Gynaecology in Benha University Hospital.
All individuals were subjected to the following:
1- Clinical assessment.
2- Abdominal and pelvic ultrasonography.
3- Laboratory investigation :
(a) Routine laboratory investigations: FSH, LH and Testosterone hormones assay in the early follicular phase, between d 2 and 7 after the last menstrual period
(b) Specific laboratory investigations: AMH level using ELISA technique.
The result of this study revealed:
• There was a significant increase between the mean AMH, LH, and Testosterone level in serum of patients with PCOS compared to the control group.
• There was a significant increase in the LH/FSH ratio in patients with PCOS compared to the control group.
• There was a significant increase in the BMI in patients with PCOS compared to the control group.
• There is a significant negative correlation between serum level of AMH and age in both PCOS and controls groups.
• There is a significant negative correlation between serum level of AMH and BMI in PCOS group
• There is a significant negative correlation between serum level of AMH and serum level of FSH in PCOS group.
• There is a significant positive correlation between serum level of AMH and serum level of Testosterone in PCOS group.
• There is a significant increased serum level of AMH in PCOS patients with amenorrhea and oligoamenorrhea more than PCOS with regular cycles.
• There is a significant increased serum level of AMH in PCOS patients with irregular cycles +HA more than PCOS patients with irregular cycle –HA.
• With a cutoff value of 7.9 ng/ml, the serum AMH level had a good specificity of 85% and sensitivity of 64% for the diagnosis of PCOS.
Conclusion:
from the results of this study we can conclude that the assay of serum AMH in women with HA and/or oligo-anovulation could be added as a specific biochemical marker for the diagnosis of PCOS.
Recommendations:
from the present study it is recommended that:
1. Future studies should be done on a larger number of PCOS confirm that AMH could also be a prognostic marker of the extent of the ovarian dysfunction in PCOS patients and, in particular, whether it can predict response to ovulation induction. .Additional studies are needed to evaluate the utility of AMH in the early identification of adolscents at risk for the development of PCOS.Assessment of AMH should be included in the laboratory profile for early diagnosis and follow up of PCOS.