Anti-Müllerian Hormone and Ovarian Morphology in Polycystic Ovary Syndrome: Toward More Precise Diagnosis and Phenotype Stratification

This review discusses the diagnostic challenges of polycystic ovary syndrome (PCOS), now proposed as polyendocrine metabolic ovarian syndrome (PMOS), emphasizing the roles of anti-Müllerian hormone (AMH) and ovarian morphology. AMH, reflecting granulosa-cell activity, is often elevated in PCOS, while ultrasound-defined ovarian morphology provides anatomical evidence of follicle excess. The 2023 guidelines allow AMH as an alternative to ultrasound for defining ovarian morphology in adults but not as a standalone diagnostic tool or for adolescents. The PMOS concept shifts focus from 'cystic' terminology to a multidomain framework, advocating for a precision diagnosis that integrates AMH or ovarian morphology with other factors like hyperandrogenism, metabolic assessment, and reproductive stage for effective phenotype stratification and clinical decision-making.