Specificity and predictive value of circulating testosterone assessed by tandem mass spectrometry for the diagnosis of polycystic ovary syndrome by the National Institutes of Health 1990 criteria

ObjectiveHyperandrogenism is one of the diagnostic criteria for the polycystic ovary syndrome (PCOS) despite no agreed definition of hyperandrogenism. In part, this is due to the quality of testosterone immunoassays. We have developed liquid chromatography–tandem mass spectrometry methods for analysing testosterone and androstenedione (Ad) to study their reference ranges and diagnostic utility in PCOS.Design, setting and subjectsA consecutive series of 122 women attending a reproductive medicine clinic.MethodsBlood samples were taken during the early follicular phase for measurement of LH, FSH, oestradiol, Ad, testosterone and sex hormone-binding globulin (SHBG). Retrospective case note analysis was used to determine the clinical features and ultrasound findings.ResultsThe incidence of PCOS was 13.9%. The reference interval for testosterone was <1.8 nmol/l and for Ad was 1.4–7.4 nmol/l. There were significant differences in total testosterone (P=0.001), Ad (P<0.05) and free androgen index (FAI; P<0.0001) between the women with and without PCOS. Diagnostic performance using receiver operator characteristic plots showed area under the curve (AUC) for FAI 0.81, testosterone 0.75 and Ad 0.66. The AUC for the LH:FSH ratio was 0.72.ConclusionsOur analysis of a consecutive series of women attending a reproductive clinic has provided an appropriate series on which to construct reference ranges for key androgens in women. Secondly, it has allowed us to conclude that early follicular serum testosterone measured using tandem mass spectrometry, FAI and the LH:FSH ratio are valuable laboratory tests in the diagnosis of PCOS.

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Predictive value of serum androstenedione basal levels on the choice of gonadotropin or laparoscopic ovarian electrocautery as ovulation induction in clomiphene citrate-resistant patients with polycystic ovary syndrome

Gynecological Endocrinology ◽

10.3109/09513590009167659 ◽

2000 ◽

Vol 14 (1) ◽

pp. 42-49 ◽

Cited By ~ 8

Author(s):

M. Vicino ◽

G. Loverro ◽

S. Bettocchi ◽

S. Simonetti ◽

L. Mei ◽

...

Keyword(s):

Polycystic Ovary Syndrome ◽

Predictive Value ◽

Ovulation Induction ◽

Polycystic Ovary ◽

Clomiphene Citrate ◽

Ovary Syndrome

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Assessment of the Role of the Anti-Mullerian Hormone, Luteinizing Hormone/Follicle Stimulating Hormone Ratio in the Diagnosis of Polycystic Ovary Syndrome in Sudanese Women

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2018.260 ◽

2018 ◽

Vol 6 (7) ◽

pp. 1244-1247

Author(s):

Hafza Tola ◽

Mohammed Abbas ◽

Elsir Abu Alhassan ◽

Nassr Eldin Shrif ◽

Mohammed Rida

Keyword(s):

Luteinizing Hormone ◽

Polycystic Ovary Syndrome ◽

Predictive Value ◽

Polycystic Ovary ◽

Test Group ◽

Control Group ◽

P Value ◽

Diagnostic Efficiency ◽

Ovary Syndrome ◽

Stimulating Hormone

BACKGROUND: The diagnosis of polycystic ovary syndrome (PCOS) is not an easy procedure, as the signs and symptoms are heterogeneous and of undefined aetiology.AIM: This study is aimed to evaluate serum anti-Mullerian hormone (AMH) level and luteinizing hormone (LH)/folic stimulating hormone (FSH) ratio in women with PCOS in Sudan and to assess the diagnostic efficiency for the diagnosis of PCOS.METHODS: In a case-control study, Serum AMH, LH, FSH was measured in the early follicular phase from Sudanese patients (N = 230) with PCOS and100 controls. The LH/FSH ratio was calculated, and its diagnostic power was evaluated by receiver operating characteristic curves.RESULTS: The means of serum AMH, serum LH level and LH/FSH ratio of the test, were significantly increased in the test group compared to the control group (P-value < 0.000). The AMH sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) were found to be 83%, 99%, 99%, and 72% respectively. Serum AMH was considered adequate measures for the diagnosis of PCOS; its level showed an area under the ROC curve of 0.98 (95% confidence, P-value < 0.000). The best compromise between 98% specificity and 90% sensitivity was obtained with a cut-off value of 3.3 ng/mL for PCOS diagnosis. There was no correlation between age, body mass index (BMI) and AMH level in the test group.CONCLUSIONS: The Serum AMH level and LH/FSH ratio were higher in patients than in control. However AMH level has better discriminative power and good diagnostic potency for the diagnosis of the PCOS among Sudanese women.

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