Age-Independent Serum AMH Levels in Women With PCOS Defined by the 2018 Evidence-Based Guideline Diagnostic Criteria: A Cross-Sectional Study

Abstract

Objective: The 2018 evidence-based guideline revised the follicle count threshold for polycystic ovary morphology (PCOM) from ≥ 12 to ≥ 20, thereby introducing a stricter definition than the Rotterdam criteria. In 2023, anti-Müllerian hormone (AMH) was incorporated into defining PCOM. Although PCOS-related symptoms often improve with age, some women continue to exhibit symptoms and meet the PCOS diagnostic criteria even as they age. This study examined AMH patterns across age groups in women who already met the PCOS diagnostic criteria according to either the Rotterdam or the stricter 2018 criteria. Methods: This cross-sectional study included 725 women diagnosed with PCOS according to the Rotterdam criteria, of whom 520 also fulfilled the 2018 criteria. Serum AMH levels were compared across age groups: < 25, 25–34.9, and 35–45 years. Results: Among women meeting the Rotterdam criteria, AMH levels were significantly lower in the oldest group (9.0 ng/mL) than in those < 25 years (11.2 ng/mL, p = 0.032). Meanwhile, among women who met the 2018 criteria, mean AMH levels were 12.5, 12.0, and 10.0 ng/mL in < 25, 25–34.9, and 35–45 year groups, respectively (p = 0.077), with no correlation between age and AMH (r = −0.050, p = 0.178). Additionally, the oldest group showed worse metabolic profiles than the younger groups. Conclusions: Women who continued to meet the stricter criteria at older reproductive ages showed AMH levels comparable to those of younger patients, and had worse metabolic profiles, supporting AMH as a stable diagnostic marker across reproductive ages in PCOS.