Anogenital distance and anti-Müllerian hormone combined improves the diagnosis of polycystic ovary syndrome

Abstract

The objective of this study was to assess the accuracy of the combination of anogenital distance (AGD) and anti-Müllerian hormone (AMH) in the diagnosis of polycystic ovary syndrome (PCOS). The study included women diagnosed with PCOS and a control group who attended the Clinical University Hospital ‘Virgen de la Arrixaca’ in Murcia (Spain). Serum concentrations of AMH were measured and two AGD measurements were obtained: (i) from the anterior clitoral surface to the upper verge of the anus (AGD_AC); and (ii) from the posterior fourchette to the upper verge of the anus (AGD_AF). Data were assessed by receiver operator characteristic (ROC) curves. Women with PCOS (n = 126) had significantly larger AGD_AC (80.5 ± 11.3 versus 76.0 ± 10.4 mm; p < 0.001) and higher AMH (7.2 ± 4.7 versus 3.1 ± 2.2; p < 0.001) compared to control women (n = 159). Women with serum AMH above 3.8 ng/mL (clinical cut-off used in PCOS) were 9.1 times more likely to have PCOS (95% CI: 5.1–16.2). The area under the ROC curve of combined model of AMH and AGD_AC was 0.87 (95% CI: 0.83–0.91). The combined model for predicting PCOS based on AMH and AGD_AC has better diagnostic accuracy than that of AMH or AGD_AC alone. This model could be useful for clinicians and improve diagnosis and clinical management of these women.

Keywords:

• Anogenital distance
• Anti-Müllerian hormone
• polycystic ovary syndrome
• predictive model
• ROC curve

Disclosure Statement

The authors have no conflicts of interest.

Additional information

Funding

The present study was supported by the Ministry of Economy and Competitiveness, ISCIII [grant no. PI13/01237], and the Seneca Foundation, Murcia Regional Agency of Science and Technology [grant no. 19443/PI/14].