A Game-Changer in the Workup of Polycystic Ovarian Syndrome?

Anti-Mullerian hormone (AMH) assays show promise as diagnostic tools for polycystic ovarian syndrome (PCOS). Experts from the Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, will explore the capabilities of the unique AMH biomarker during the session, Anti-Mullerian Hormone from the Laboratory Perspective (72414) at the 69th AACC Annual Scientific Meeting & Clinical Lab Expo.

PCOS is an elusive condition typically diagnosed through the process of exclusion. “AMH hasn’t been formally incorporated into the PCOS diagnostic criteria,” Rob Nerenz, PhD, assistant director of clinical chemistry at Dartmouth-Hitchcock Medical Center, told CLN Stat. Nerenz plans to discuss current and future approaches to PCOS diagnosis. His co-presenter, Mark Cervinski, PhD, director of clinical chemistry at Dartmouth-Hitchcock Medical Center, will talk about the medical and technical evolution of AMH testing methods.

Most clinicians rely on Rotterdam criteria, which require the presence of at least two of three factors: polycystic ovaries, biochemical or physical evidence of hyperandrogenism, and/or ovulatory dysfunction, Nerenz said. “PCOS is also largely a clinical diagnosis with relatively limited contribution from the laboratory, but that may be changing in the near future if AMH is formally integrated into updated criteria for PCOS diagnosis,” he added.

PCOS is also marked by arrested ovarian follicular development; women with this condition typically have an unusually high number of immature follicles detected by ultrasound. “These immature follicles are precisely the ones that secrete AMH, making AMH an excellent surrogate marker for the antral follicle count, which is used to define the polycystic ovary element of the Rotterdam criteria,” according to Nerenz.

A modified diagnostic criterion that substitutes a serum AMH measurement for the antral follicle count would greatly expand the role of clinical laboratories in PCOS diagnosis, he continued. The assay still needs some work, however. “Formal cutoffs need to be established for each assay platform and the variation of serum AMH concentrations with age, body weight, and potentially with racial background need to be taken into account,” he noted.

Nerenz believes it won’t be long before AMH is incorporated into the PCOS diagnostic criteria.

To encourage audience participation, the AMH session will be using FXP Touch, a mobile device-based response and engagement system that AACC is offering for the first time this year. “We’ll have interactive questions throughout the session to assess audience understanding and facilitate real-time feedback,” Nerenz said.

This afternoon short course takes place from 12:30 p.m. to 2 p.m. on July 31 and is worth 1.5 CE hours. Take in this topic and other evolving areas of science and practice at the 69th AACC Annual Scientific Meeting & Clinical Lab Expo.