{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T07:52:05Z","timestamp":1759564325013,"version":"3.37.3"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,6,9]],"date-time":"2017-06-09T00:00:00Z","timestamp":1496966400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2017,10]]},"abstract":"Background<\/jats:title>Polycystic ovarian syndrome (PCOS<\/jats:styled-content>) is a heterogeneous disorder with clinical features shared with functional hypogonadotrophic hypogonadism (FHH<\/jats:styled-content>).<\/jats:p><\/jats:sec>Aim<\/jats:title>To investigate the usefulness of an elevated (>40\u00a0pmol\/L) anti\u2010Mullerian hormone (AMH<\/jats:styled-content>) in identifying PCOS<\/jats:styled-content> and distinguishing PCOS<\/jats:styled-content> from FHH<\/jats:styled-content>.<\/jats:p><\/jats:sec>Materials and methods<\/jats:title>141 patients with an elevated AMH<\/jats:styled-content> and body mass index either <20\u00a0kg\/m2<\/jats:sup> (lean) or >30\u00a0kg\/m2<\/jats:sup> (obese) were selected and three subgroups analysed \u2013 obese, lean, lean with suspected FHH<\/jats:styled-content>. FHH<\/jats:styled-content> was diagnosed clinically, incorporating diet, weight and exercise history; confirmatory tests included pituitary MRI<\/jats:styled-content>s, progestin challenges and endometrial thickness measurements. PCOS<\/jats:styled-content> features of oligo\/anovulation, polycystic ovarian morphology (PCO<\/jats:styled-content>m) and hyperandrogenism were determined by clinical history, pelvic ultrasound, free androgen index and physical examination, respectively. Features of PCOS<\/jats:styled-content> and blood levels of AMH<\/jats:styled-content>, follicle\u2010stimulating hormone, luteinising hormone, sex hormone binding globulin (SHBG<\/jats:styled-content>) and testosterone were compared between subgroups.<\/jats:p><\/jats:sec>Results<\/jats:title>Of 141 patients with elevated AMH<\/jats:styled-content>, 76 were obese and 65 lean. Greater than one\u2010third of lean women had the clinical picture of FHH<\/jats:styled-content>. Elevated AMH<\/jats:styled-content> predicted PCO<\/jats:styled-content>m and menstrual irregularity across all subgroups but uniquely associated with hyperandrogenism in the obese. Median AMH<\/jats:styled-content> levels were similar among FHH<\/jats:styled-content> and non\u2010FHH<\/jats:styled-content> women. Median SHBG<\/jats:styled-content> levels were significantly higher (111\u00a0\u00b1\u00a073 vs 56\u00a0\u00b1\u00a031, P<\/jats:italic>\u00a0<\u00a00.001) in lean women with FHH<\/jats:styled-content> compared to those without FHH<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>PCOS<\/jats:styled-content> and FHH<\/jats:styled-content> share common features of elevated AMH<\/jats:styled-content> levels, oligo\u2010anovulation and polycystic ovarian morphology. AMH<\/jats:styled-content> did not assist in differentiating FHH<\/jats:styled-content> from PCOS<\/jats:styled-content>. A higher SHBG<\/jats:styled-content> level shows promise as a discriminatory finding in FHH<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.12647","type":"journal-article","created":{"date-parts":[[2017,6,9]],"date-time":"2017-06-09T06:41:12Z","timestamp":1496990472000},"page":"552-557","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Elevated anti\u2010Mullerian hormone in lean women may not indicate polycystic ovarian syndrome"],"prefix":"10.1111","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7170-8730","authenticated-orcid":false,"given":"Rachel A.","family":"Bradbury","sequence":"first","affiliation":[{"name":"Westmead Fertility Centre Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Lee","sequence":"additional","affiliation":[{"name":"Diabetes and Metabolism Division Garvan Institute of Medical Research 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