The Use Of AMH for the Discrimination of Polycystic and Multicystic Ovaries in Nonhyperandrogenic Patients
The Use Of AMH for the Discrimination of Polycystic and Multicystic Ovaries in Nonhyperandrogenic Patients
AMH is a member of the transforming growth factor family. It is produced by the granulosa
 cells from 36th weeks of pregnancy.Ovarian granulosa cells are the only source of the
 antimüllerian hormone. AMH production continues until response to exogenous FSH occurs and
 follicles reach 4-6 mm in diameter.The number of follicles in patients with polycystic
 ovaries are 2-6 times higher than normal women. Serum AMH levels are 2-3 times higher in
 patients with PCOS. The cause of elevated serum AMH levels in patients with PCOS is unknown.
 There are data showing elevated serum AMH level is due to the increase in the number of
 follicles 2-8 mm in diameter. Although there is no precise definition; multicystic ovarian is
 defined by the presence of more than six follicles 4-9 mm in diameter and mixed
 morphologically with PCO. PCO and multicystic ovaries are distinguished by the absence of the
 increase in stroma / volume.The aim of this study is to investigate whether there is a
 difference of serum AMH levels between patients with PCO or multicystic ovaries. A primary
 goal is to investigate the usability of AMH as a marker besides ultrasound for discrimination
 of nonhyperandrogenic patients with PCO or multicystic ovaries.
It is planned to compare the values of FSH/LH, AMH, and 75 gr OGTT between 20 patients
 diagnosed as PCOS according to the AES-Rotterdam criteria and 20 patients with multicystic
 ovarian structure but do not provide the PCOS-D3 criteria. The second purpose of this study
 is to investigate the mechanism that leads to the elevation of AMH in patients with PCOS, and
 to reveal the effects of intraovarian paracrine factors,insulin resistance and FSH /LH.
Inclusion Criteria:

 -  Between the ages of 15-43

 -  >6 4-9 mm follicles in bilateral ovaries at ultrasonographic examination

 -  Increased ovarian volume (>10 ml )

 Exclusion Criteria:

 -  Hormonal drug users

 -  Late onset congenital adrenal hyperplasia,androgen secreted ovarian or adrenal tumors