Prevalence of diminished ovarian reserve in Chinese women with polycystic ovary syndrome and sensitive diagnostic parameters

Abstract

Objectives: To assess the prevalence of diminished ovarian reserve (DOR) in patients with polycystic ovary syndrome (PCOS) in China, and to search for sensitive diagnostic parameters.

Methods: Three hundred and thirty eight PCOS women aged 20–39 years were recruited. Basic characteristics, follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), testosterone and anti-Müllerian hormone (AMH) were measured. The best indices to diagnose PCOS with DOR were assessed.

Results: The prevalence of DOR in our Chinese PCOS patients was 16.9%. The level of E2 and FSH and the FSH/LH ratio had a positive correlation with PCOS and DOR (OR > 1, p < 0.05) independent of age and testosterone, while AMH and baseline antral follicle count had a negative correlation (OR < 1, p < 0.05). AMH was a good parameter to diagnose PCOS with DOR, the cutoff was 2.53 ng/ml, with sensitivity 92.5%, specificity 73.7% and area under curve 0.932. AMH had a significant positive correlation with LH (r = 0.016, p < 0.05) and testosterone (r = 0.209, p < 0.01), while had significant negative correlation with age (r=–0.140, p < 0.05), FSH (r=–0.229, p < 0.01) and FSH/LH ratio (r=–0.240, p < 0.01).

Conclusions: In our study, AMH was a sensitive parameter to diagnose PCOS with DOR, but to improve the accuracy it will still need further studies.

Chinese abstract

目的：研究中国多囊卵巢综合征患者卵巢储备功能下降的患病率, 并寻找其灵敏的诊断指标。

方法：招募年龄在20-39之间的PCOS女性338名。测量其基本特征, 促卵泡激素（FSH）、黄体生成素（LH）、雌二醇（E2）、睾酮和抗苗勒氏管激素（AMH）。评估PCOS中患有DOR的最佳诊断指标。

结果：中国PCOS患者DOR的患病率为16.9%。除年龄和睾酮外, E2、FSH、FSH/LH比值的水平与PCOS中DOR呈正相关（OR >1, P＜0.05）, 而AMH和基础窦卵泡数呈负相关（OR＜1, P＜0.05）。AMH是诊断多囊卵巢综合征患者患有DOR较好的参数, 最佳临界值为 2.53 ng/ml, 灵敏度为92.5%, 特异度为73.7%, 曲线下面积为0.932。AMH与LH（r＝0.016, P＜0.05）和睾酮（r＝0.209, P＜0.01）呈显著正相关, 而与年龄（r =﹣0.140, P＜0.05）、FSH（R =﹣0.229, P＜0.01）、FSH/LH比值（R =﹣0.240, P＜0.01）呈显著负相关。

结论：在我们的研究中, AMH是诊断PCOS患者患有DOR的一个敏感指标, 但仍需要进一步研究来提高其准确性。

Keywords:

• Aging
• anti-Müllerian hormone
• diminished ovarian reserve
• polycystic ovary syndrome
• sex hormones

Declaration of interest

The authors have no declarations of interest relevant to this article.

Funding

This work was supported by research grants from Beijing Municipal Administration of Hospitals Incubating Program (code: PX2017053), and Beijing Obstetrics and Gynecology Hospital, Capital Medical University (No.: fcyy201427), and by grants to the corresponding author Xiangyan Ruan from Foundation of Beijing Municipal Science and Technology Commission (Z161100000516143), and Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (code: XMLX201710).