Polycystic ovarian syndrome (PCOS) is getting one of the most prevalent endocrine abnormalities for women of reproductive age. The prevalence of PCOS varies among ethnic populations and appears to decrease with age. It is estimated that British women aged 20–25 years have a prevalence of 33% ; Finish women aged less than 36 years have a prevalence of 21.6% ; and the prevalence is 21% in New Zealand , and 23% in Australia  among reproductive-aged women. The prevalence of PCOS in South Asian women, especially in Pakistani women, is much higher (52%) as compared to the white population (20–25% in the UK) .
PCOS was initially described by Stein and Leventhal in 1935, although it had a history of at least a century beforehand . Stein and Leventhal initially defined this disorder with enlarged ovaries, hirsutism, obesity, and anovulation. Rotterdam criteria described PCOS as a disorder with at least two of the clinical features: i) oligo- or anovulation, ii) clinical or biochemical signs of hyperandrogenism, and iii) polycystic ovaries, with the exclusion of other etiologies (congenital adrenal hyperplasia, androgen, secreting tumors, Cushing’s syndrome) .
Women with PCOS can be classified into four potential phenotypes based on history, physical examination, and investigations : i) PCOS complete, which is oligo-/anovulation (O) + polycystic ovaries (P) + hyperandrogenism (H), ii) polycystic ovaries + oligo-/anovulation, iii) polycystic ovaries + hyperandrogenism, and iv) oligo-/anovulation + hyperandrogenism .
Establishing a diagnosis of PCOS is difficult among adolescents and menopausal women . The features of PCOS begin at menarche, but appear after puberty. Several hormonal factors are responsible for promoting such risk factors, especially including high levels of gonadotropin-releasing hormone (GnRH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), insulin, androgen, Anti-Müllerian hormone (AMH), vitamin D deficiency, and calcitonin.
The LH level is often two to three times that of the FSH level. It is typical for women with PCOS to have an LH level of about 18 IU/mL and an FSH of 6 IU/mL. LH hypersecretion, both basally and in response to GnRH, is a characteristic hallmark of PCOS and can be recognized as the primary abnormality in classic PCOS causing androgen excess .
Women with PCOS were found to have higher serum AMH due to a greater number of antral follicles and increased production of AMH per follicle. There is limited evidence to define the cutoff value for AMH as a diagnostic tool for PCOS. Some studies have recommended that an AMH level greater than 3.8–5 ng/mL can be used as a diagnostic factor for PCOS  and suggested using Rotterdam criteria and AMH level concurrently for early and accurate diagnosis. The presence of two out of three clinical features (OA, HA, and AMH) was found to have 96% sensitivity and 100% specificity among patients previously diagnosed with PCOS according to the Rotterdam criterion .
The diagnosis of PCOS among the reproductive age group using AMH level has been studied in many populations, but evidence from Pakistan is missing on AMH level association with PCOS. Therefore, this study aims to analyze serum AMH levels as a predictor of PCOS among women of the reproductive age group. This study will help to understand the pattern and utilization of serum AMH level as a diagnostic factor among PCOS women.