[Effect of luteinizing hormone vs follicular stimulating hormone ratio on anti-Müllerian hormone secretion and folliculogenesis in patients with polycystic ovarian syndrome]

Abstract

Objective: To investigate characteristics of anti-Müllerian hormone (AMH) secretion and mechanism of aberrant folliculogenesis by the ratio of luteinizing hormone (LH)/follicle-stimulating hormone (FSH) in polycystic ovarian syndrome (PCOS) patients.

Methods: Base on the ratio of LH/FSH, total 95 patients with PCOS were divided into two groups, including 49 cases in higher ratio group (LH/FSH ≥ 2) and 46 cases in normal ratio group (LH/FSH < 2) matched with 62 infertile cases with tubal factor and regular menstruation as control group. Body mass index (BMI) were calculated in all objectives. The serum AMH were detected by enzyme linked immunosorbent assay (ELISA). Ovarian sexual hormones, fasting blood glucose, insulin and lipid were measured by chemiluminescence method. The correlation between AMH and metabolic index was analyzed by multilinear regression.

Results: (1) AMH: the serum level of AMH were (7.2 ± 4.3) µg/L in higher LH/FSH group, (5.2 ± 3.8) µg/L in normal LH/FSH group and (3.7 ± 2.2) µg/L in control group, which all reached significant difference among those 3 groups (P < 0.01). (2) The correlation between AMH and biological metabolic index: estradiol (E(2)) was negatively correlated with serum level of AMH in higher LH/FSH ratio group (r = -0.318). The serum level of AMH were positively correlated with BMI, fasting glucose, homeostasis model assessment insulin resistance index (HOMA-IR) in normal LH/FSH ratio group (r = 0.493, 0.362, 0.303). After controlling affect factors, serum levels of AMH were positively correlated with LH/FSH in higher LH/FSH ratio group (r = 0.301), but negatively correlated with E₂ (r = -0.429). However, in normal LH/FSH group, serum level of AMH was only positively correlated with BMI (r = 0.428).

Conclusion: The PCOS patients with higher LH/FSH ratio are primarily caused by hypothalamic-pituitary dysfunction, while the PCOS patients with normal LH/FSH ratio are mainly caused by metabolic disorders.