Diagnostic accuracy of AMH for primary ovarian insufficiency/premature ovarian failure: a real-world cohort study.

Background/objectives: The global incidence of Premature Ovarian Insufficiency (POI)/Primary Ovarian Failure (POF) is rising annually, emerging as a critical health threat affecting women of reproductive age. This condition not only induces menopausal-like symptoms but also leads to severe consequences such as infertility, imposing significant physical, familial, and socioeconomic burdens. Given its detrimental impacts, enhancing preventive strategies is imperative. Anti-Müllerian Hormone (AMH), closely associated with ovarian reserve, has gained increasing application in gynecological diagnostics, particularly exhibiting considerable potential in POI/POF evaluation. However, the diagnostic reliability of AMH remains to be fully elucidated. This study aims to rigorously evaluate the diagnostic accuracy of AMH in POI/POF diagnosis, with the goal of improving diagnostic accuracy to facilitate early detection and intervention, thereby providing evidence-based support for POI/POF prevention efforts. Methods: A retrospective analysis was conducted on clinical data from 1,106 reproductive-aged women, divided into three groups: DOR group (n=502), POI group (n=143), and POF group (n=461). Statistical analyses were performed using SPSS 26.0. Comparisons of age, AMH, estradiol (E2), prolactin (PRL), luteinizing hormone (LH), follicle-stimulating hormone (FSH), and progesterone (PRG) were conducted. Significant variables (P<0.05) were included in binary logistic regression models. Receiver operating characteristic (ROC) curves evaluated the diagnostic performance of AMH and its combinations with other parameters. Results: Age, AMH, E2, PRL, LH, FSH, and PRG differed significantly among groups (P<0.05). For POI, the AUC values for individual markers and their combinations were age (0.494), AMH (0.885), E2(0.757), Age+ AMH (0.888), Age+ E2(0.756), AMH+ E2(0.909), Age+ AMH+ E2(0.910). For POF, the AUC values for individual markers and their combinations were age (0.526), AMH (0.872), E2 (0.803), Age+ AMH (0.877), Age+ E2 (0.805), AMH+ E2 (0.910), Age+ AMH+ E2 (0.912). Conclusions: AMH demonstrates robust diagnostic accuracy for POI/POF diagnosis, with significantly lower levels in affected patients compared to healthy controls. Its diagnostic performance surpasses age and E2, particularly for POF, supporting its utility as a standalone biomarker. These findings advocate for integrating AMH measurement into clinical protocols for early ovarian dysfunction detection in reproductive-aged women.