The Impact of the Biological Variability or Assay Performance on AMH Measurements: A Prospective Cohort Study With AMH Tested on Three Analytical Assay-Platforms

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  • Leif Bungum, Department of Obstetrics and Gynecology, Danmark
  • Julia Tagevi, Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Lund, Sweden.
  • ,
  • Ligita Jokubkiene, Department of Obstetrics and Gynecology, Skåne University Hospital Malmö, Lund University, Malmö, 20502, Sweden.
  • ,
  • Mona Bungum, Reproductive Medicine Centre, Skanes University Hospital, Malmö, Sweden. mona.bungum@med.lu.se
  • ,
  • Aleksander Giwercman, Reproductive Medicine Centre, Skanes University Hospital, Malmö, Sweden. mona.bungum@med.lu.se
  • ,
  • Nick Macklon, Obsterics and Gynecology, Denmark and London Women's Clinic, Zealand University Hospital, London, United Kingdom.
  • ,
  • Claus Yding Andersen, Laboratory of Reproductive Biology, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark. yding@rh.dk
  • ,
  • Tobias Wirenfeldt Klausen, Department of Obstetrics and Gynecology, Herlev and Gentofte Hospital, Herlev, Denmark
  • ,
  • Niels Tørring
  • Ajay Kumar, Ansh Labs LLC, Medical Center Blvd, Webster, IA, United States.
  • ,
  • Sven Olaf Skouby, Department of Obstetrics and Gynecology, Herlev and Gentofte Hospital, Herlev, Denmark
This study examined longitudinal, age-related and intra-individual variation in Anti-Müllerian Hormone (AMH) in regular menstruating women and correlated the hormonal levels to the antral follicle count (AFC). The impact of variations on an algorithm for calculation of follitropin-dose for ovarian stimulation were also tested. The study was carried out at a fertility clinic of a tertiary university hospital and had a prospective trial design. Twenty-six healthy women not receiving infertility treatment aged 22 to 50 years participated. Blood sampling for hormonal analysis was done every fifth day throughout three consecutive menstrual cycles, AFC was determined with 3-dimentional ultrasound and AMH measured by different assays from Beckman Coulter, Roche and Ansh Labs. Outcome measures were maximum and minimum difference in absolute and relative terms for each study subject during the test-period, coefficient of variation (Cv) for AMH for each cycle and cycle-day and correlation between AMH and AFC. The impact from variable AMH levels on an algorithm calculating follitrophin-delta dose in ovarian stimulation was explored. A significant longitudinal age-independent variation in AMH-levels and coefficient of variation in cycles and cycle days was found. A strong correlation between AMH-levels and AFC was confirmed and a case of significant divergence between assays was seen. Variations in AMH had a significant impact on an algorithm calculated dosage of gonadotrophins in ovarian stimulation. The finding of a substantial longitudinal variation in AMH question one recording being sufficient in quantifying gonadotrophins for ovarian stimulation, decision making and prognostication related to infertility treatment and counseling. Occasionally, commercial assays may fail to recognize specific AMH cleavage-products.
OriginalsprogEngelsk
TidsskriftFrontiers in Endocrinology
Vol/bind9
Sider (fra-til)603
ISSN1664-2392
DOI
StatusUdgivet - okt. 2018

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