Factors affecting the accuracy and reliability of the measurement of anti-Müllerian hormone concentration in the clinic

Abstract

Objective We aimed to identify the factors that influence serum anti-Müllerian hormone (AMH) concentration measurements. Methods We collected serum samples between May and September 2018 and compared the effect on AMH concentration measured by ELISA of conditions including venepuncture, storage time, storage temperature, locations of the reaction microplate, and the use of the oral contraceptive pill and gonadotrophin-releasing hormone (GnRH). Results AMH concentration was not affected by food intake but was affected by haemolysis. It was also much higher in samples on the edge of the ELISA microtitre plate. AMH concentration increased after incubation at room temperature for 1 day, 4°C for 3 days, −20°C for 1 month and −40°C for 4 months, but no change occurred during storage at −80°C for 9 months. AMH concentration was high in patients following GnRH agonist treatment but was not affected by oral contraceptives. Conclusions No fasting is required prior to AMH measurement. Placement of serum samples on the edge of microtitre plates affects the results of the AMH ELISA. If serum samples cannot be assayed immediately, it is best to store them at −80°C. Basal AMH concentration cannot be used as a measure of ovarian reserve after GnRH agonist treatment.

A prospective study on the relationship between polycystic ovary syndrome and age at natural menopause

“…13 Although proposed models of age at menopause based on the AMH levels have shown satisfactory reliability, they may not be as accurate as actual menopausal age because of potential variations caused by hormonal assay methods. 36 In addition, because AMH levels decline at different rates among women, 37 using AMH measurements as a proxy for determining menopausal age can lead to inaccurate results. Several studies have compared the actual age of menopause between PCOS patients and healthy control groups, with conflicting results.…”

Physiological role and diagnostic value of anti-Mullerian hormone in pediatrics

“…У дітей із порушеннями статевого розвитку визначення АМГ у сироватці може бути використаний як тест першої лінії для постановки етіологічного діагнозу: низький рівень АМГ вказує на дизгенетичну форму порушення статевого розвитку, тоді як нормальний АМГ вказує на порушення синтезу андрогенів або дефекти їх дії. У пацієнтів із персистуючим синдромом мюллерової протоки невизначений АМГ у сироватці призводить до генетичного пошуку мутацій у гені АМГ, тоді як нормальний або високий рівень АМГ вказує на дефект органа-мішені через дефект гена рецептора АМГ [68][69][70][71][72][73][74].…”

Development of a quantitative fluorescence lateral flow immunoassay (LFIA) prototype for point-of-need detection of anti-Müllerian hormone

“…Significant inter-laboratory and inter-assay variation in AMH ELISAs has been reported [ 8 , 9 ]. Moreover, there has been a question of the stability of AMH during storage/transport, which also might affect measured serum AMH values [ 2 , 10 , 11 ] and of the general utility of a single measurement for reliable clinical decisions due to AMH level fluctuations during a normal cycle [ 12 ]. Streamlining AMH testing (and other hormonal assays used in combination with AMH to provide reliable ovarian reserve estimates) to a patient's physician's office would reduce inconvenience, turnaround time, patient stress and potentially also the total cost of testing, allowing for increased patient awareness [ 13 ] and more frequent monitoring.…”