The 2023 International Evidence-Based Guideline for PCOS recommends anti-Müllerian hormone (AMH) as:

• A A diagnostic criterion to replace ovarian morphology on ultrasound in all age groups
• B The primary marker to assess ovarian reserve in infertile PCOS women only
• C Not recommended for clinical use in PCOS diagnosis due to lack of standardization
• D A supplementary criterion when ultrasound is unavailable or technically inadequate, using an adult threshold of ≥30 pmol/L on appropriate assays ✓

Explanation

The 2023 International PCOS Guideline update (Teede et al.) incorporated AMH as an alternative diagnostic criterion for polycystic ovarian morphology (PCOM) when ultrasound is unavailable or suboptimal (particularly for transvaginal ultrasound limitations). Using assay-specific thresholds (~30 pmol/L on newer-generation assays), AMH can substitute for follicle count on ultrasound. It is not yet recommended as a standalone diagnostic replacement in all women, particularly adolescents where AMH normative data is less established.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

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Written and medically reviewed by the StethoPrep medical team.