Polycystic ovary syndrome and anti-Müllerian hormone: role of insulin resistance, androgens, obesity and gonadotrophins

Clin Endocrinol (Oxf). 2014 Dec;81(6):899-906. doi: 10.1111/cen.12557. Epub 2014 Sep 1.


Objective: Polycystic ovary syndrome (PCOS) is a complex endocrine disorder associated with insulin resistance, hyperandrogenism, obesity, altered gonadotrophin release and anovulatory infertility. Anti-Müllerian hormone (AMH) has been proposed as a marker of ovarian function and fertility. Across a cohort of lean and overweight women with and without PCOS, we investigated the association of AMH with insulin resistance and body composition using gold standard measures. A secondary aim was to examine whether AMH was useful to determine PCOS status.

Design: Cross-sectional study.

Patients: A total of 22 lean and 21 overweight women with PCOS and 19 lean and 16 overweight non-PCOS healthy controls were recruited. PCOS was diagnosed based on the Rotterdam criteria.

Measurements: Euglycaemic-hyperinsulinaemic clamp for assessing insulin resistance, dual energy X-ray absorptiometry and computed tomography for assessing adiposity, and blood sampling for the assessment of androgens, gonadotrophins and AMH.

Results: Anti-Müllerian hormone levels were increased in women with PCOS (P <0·001) regardless of adiposity, with this increase associated with testosterone (P <0·001) rather than insulin resistance (P = 0·79), adiposity (P = 0·98) or gonadotrophins. In assessing the ability of AMH to predict PCOS, a value of 30 pmol/l or higher indicated 79% of women with PCOS were correctly identified as having the condition.

Conclusion: Anti-Müllerian hormone appears primarily related to androgen status suggesting a direct and predominant role of androgens in the pathophysiology of reproductive dysfunction in PCOS. As AMH reflects PCOS status, it may also be useful in PCOS diagnosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon
  • Adiposity*
  • Adult
  • Androgens / metabolism
  • Anti-Mullerian Hormone / metabolism*
  • Blood Glucose / metabolism
  • Case-Control Studies
  • Cross-Sectional Studies
  • Female
  • Follicle Stimulating Hormone / metabolism
  • Glucose Clamp Technique
  • Gonadotropins, Pituitary / metabolism*
  • Humans
  • Insulin / metabolism
  • Insulin Resistance*
  • Luteinizing Hormone / metabolism
  • Obesity / metabolism*
  • Overweight / metabolism
  • Polycystic Ovary Syndrome / metabolism*
  • Sex Hormone-Binding Globulin / metabolism
  • Testosterone / metabolism*
  • Tomography, X-Ray Computed
  • Young Adult


  • Androgens
  • Blood Glucose
  • Gonadotropins, Pituitary
  • Insulin
  • Sex Hormone-Binding Globulin
  • Testosterone
  • Anti-Mullerian Hormone
  • Luteinizing Hormone
  • Follicle Stimulating Hormone