Paediatric reference intervals for plasma anti-Müllerian hormone: comparison of data from the Roche Elecsys assay and the Beckman Coulter Access assay using the same cohort of samples

Abstract

Background Autoanalyser methods for the measurement of anti-Müllerian hormone have been introduced into clinical laboratories but few reports of paediatric reference intervals using these new assays have been published. Methods After prior evaluation of the Roche Elecsys anti-Müllerian hormone assay against the Beckman Coulter modified second generation anti-Müllerian Hormone enzyme-linked immunosorbent assay using samples from adult females, a cohort of paediatric samples which had previously been assessed using the Beckman Coulter Access anti-Müllerian hormone assay was analysed using the Roche Elecsys anti-Müllerian hormone assay. Results The Roche Elecsys anti-Müllerian hormone assay measured significantly lower than the Beckman Coulter modified second generation anti-Müllerian Hormone enzyme-linked immunosorbent assay. In the paediatric cohort measured with the Roche Elecsys assay, male levels are very high from birth to puberty after which they fall towards postpubertal female levels. Male results were similar to those previously obtained using the Beckman Coulter Access anti-Müllerian hormone assay on the same cohort. Roche Elecsys anti-Müllerian hormone in the females was very low in the neonatal and prepubertal years and the postpubertal trend, with a steady rise from 15 years, was smoother than previously modelled using the Beckman Coulter Access anti-Müllerian hormone assay. Conclusion Anti-Müllerian hormone levels measured with the Roche Elecsys assay were significantly lower than the Beckman Coulter modified second generation enzyme-linked immunosorbent assay suggesting the need for new reference ranges. In the paediatric cohort, Roche Elecsys anti-Müllerian hormone levels between boys and girls showed good prepubertal delineation and small but statistically significant differences to previously measured levels using the Beckman Coulter Access anti-Müllerian hormone assay on the same sample cohort.

Performance evaluation of a fully automated anti-Müllerian hormone immunoassay and multicentre study on the establishment of reference range in adult women

“…indicated that AMH concentrations measured with Elecsys AMH were significantly different from that measured with Access AMH assay (Beckman Coulter). 20 Although the median AMH concentrations decrease gradually with age, the range of AMH concentrations at each age group showed significant overlap between age groups throughout 20–50 years old and indicates a significant individual variation of AMH concentrations. This highlights the clinical utility of measurement of serum AMH concentrations which reflect and correlate the antral follicle count and ovarian reserve.…”

Clinical Utility of Anti-Mullerian Hormone in Pediatrics

“…After a transient decline postnatally, AMH levels rise in infancy and continue to remain comparatively higher in males until they decline by stages 2 and 3 of puberty as intratesticular testosterone levels start to rise ( 32 ). At this point, AMH levels in postpubertal males are comparable and overlap with AMH levels in females considerably although median AMH remains 2- to 3-fold higher compared with females ( 33 ). Immunohistochemistry has shown that the expression of AMH type 2 receptor parallels AMH in serum declining after puberty in males ( 34 ).…”

“…2 ). Throughout childhood, AMH concentrations are distinctly higher in males (almost 35-fold) ( 51 ), so despite individual variability and a broad normal range, it is easily discriminated from female norms ( 33 ) ( Fig. 2 ).…”

“…2 ). In adolescence with progression through puberty, the mean AMH levels decline in males and increase in females with considerable overlap ( 33 , 52 ).…”

Age-specific reference intervals of serum anti-Müllerian hormone in Chinese girls

“…[2][3][4] In girls, AMH is extremely low after birth, and then it gradually increases during infancy and childhood. 5 The serum AMH concentrations show strong and positive correlations with the antral follicle count, and it declines steadily with advancing age. 6 AMH is therefore considered an accurate marker in the evaluation of the ovarian follicular reserve.…”