Quantifying the intraindividual variation of antimüllerian hormone in the ovarian cycle

Hadlow, Narelle; Brown, Suzanne J.; Habib, Afsana; Wardrop, Robert; Joseph, John; Gillett, Melissa J; Maguire, Rhonda; Conradie, Johan

doi:10.1016/j.fertnstert.2016.06.009

Cited by 31 publications

(27 citation statements)

References 51 publications

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“…The large variance in the pre‐ and post‐salpingectomy AMH levels in women with a high pre‐operative AMH level is in line with studies reporting increased variability as AMH levels increase, with expected biological variation of 20–40 pmol/L for women with a baseline of >30 pmol/L …”

Section: Discussionsupporting

confidence: 82%

The effect of laparoscopic salpingectomy for ectopic pregnancy on ovarian reserve

Rodgers

Carter

Reid³

et al. 2020

Aust NZ J Obst Gynaeco

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Background: Salpingectomy may damage ovarian reserve by direct vascular interruption to the ovary or thermal vascular injury from electrosurgery. It is plausible that this risk may increase in the context of salpingectomy conducted for ectopic pregnancy due to the distension of the fallopian tube and vascular changes associated with pregnancy.Aim: To report anti-Müllerian hormone (AMH) concentrations before and after laparoscopic salpingectomy for ectopic pregnancy as an indicator of change in ovarian reserve. Materials and Methods:Women aged 18-44 years scheduled for salpingectomy for tubal ectopic pregnancy were prospectively recruited. Serum AMH concentrations were measured immediately prior to surgery, then repeated four months post-operatively. In all cases, salpingectomy was conducted laparoscopically using bipolar electrosurgery and mechanical scissors. A group of women scheduled for uterine curettage for first trimester miscarriage was recruited to ensure any observed change in AMH concentration in the women undergoing salpingectomy was secondary to surgery, rather than an effect of pregnancy.Results: Paired pre-and post-operative serum AMH concentrations were obtained from 32 women with tubal ectopic pregnancy. The mean age of the women was 33.6 ± 4.6 years. There was no significant difference in the median pre-and postoperative AMH concentrations (13.00 pmol/L (range 5-67 pmol/L) vs 15.25 pmol/L (range 3-96 pmol/L), P = 0.575). Median AMH concentrations also remained stable in women experiencing a first trimester miscarriage (10.40 pmol/L (range 3.9-37.8 pmol/L) vs 13.67 pmol/L (range 2.8-30.5 pmol/L), P = 0.185). Conclusion:Laparoscopic salpingectomy using electrosurgery and mechanical scissors does not damage ovarian reserve. AMH concentrations do not fluctuate from baseline in the first trimester of pregnancy. K E Y W O R D Santi-Müllerian hormone, ectopic pregnancy, ovarian reserve, salpingectomy

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Section: Discussionsupporting

confidence: 82%

The effect of laparoscopic salpingectomy for ectopic pregnancy on ovarian reserve

Rodgers

Carter

Reid³

et al. 2020

Aust NZ J Obst Gynaeco

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“…Limitations of this study include the cross‐sectional design, and the relatively small number of participants who were able to produce sufficient DBS samples. Serum AMH has been shown in some clinical studies to have significant intra‐woman variation across the menstrual cycle, regardless of ovulatory status (Kissell et al, ) and when samples are collected over several months, particularly during perimenopause (Hadlow et al, ). Respecting the practice of research in this part of Mexico, we did not collect blood spots in the rural communities where we carried out additional investigations.…”

Section: Discussionmentioning

confidence: 99%

Variation in levels of AMH among Maya and non‐Maya women in Campeche, Mexico

Kyweluk

Sievert

Gómez

et al. 2018

American J Phys Anthropol

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Increasing age and progression through the menopausal transition were both associated with declining levels of AMH. The association between Maya ethnicity and a lower likelihood of detecting AMH is consistent with the early ages at menopause reported in previous studies. We considered a rapid life history model as an explanatory framework, and suggest, from an ecological perspective, that future research should consider measures of developmental stress that may compromise ovarian reserves.

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“…However, more recently, the stability of AMH concentrations across and between menstrual cycles has been the subject of considerable debate. Some initial clinical studies suggest that AMH is stable across the menstrual cycle, whereas recent findings have suggested substantial fluctuations across the cycle . In addition, the reproducibility of AMH measurements may be influenced by the assay used: older assays are known to exhibit substantial analytical variability, and data obtained with these assays must therefore be interpreted with caution .…”

Section: Introductionmentioning

confidence: 99%

“…Some initial clinical studies suggest that AMH is stable across the menstrual cycle, [9][10][11] whereas recent findings have suggested substantial fluctuations across the cycle. [12][13][14] In addition, the reproducibility of AMH measurements may be influenced by the assay used: older assays are known to exhibit substantial analytical variability, and data obtained with these assays must therefore be interpreted with caution. 15 The clinical implications of such variations may also have been overstated, as previous studies used large step changes in gonadotropin doses at specific AMH thresholds, 4 and the size of these dose adjustments may have masked any effect of AMH variability on oocyte yield.…”

Section: Introductionmentioning

confidence: 99%

Anti‐Müllerian hormone variability and its implications for the number of oocytes retrieved following individualized dosing with follitropin delta

Nelson

Mannaerts

Andersen

et al. 2019

Clinical Endocrinology

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Summary Objective The stability of anti‐Müllerian hormone (AMH) across and between menstrual cycles has been the subject of debate. The objective of this analysis was to study the inter‐ and intracycle variability in repeated measurements and assess the impact on an individualized gonadotropin dosing algorithm and predicted oocyte yield. Design Retrospective analysis of repeat AMH measures from a randomized controlled trial. Patients A total of 1326 women aged 18‐40 years. Measurements Serum AMH levels at screening and at cycle day 2‐3 in up to three ovarian stimulation cycles. AMH variability and its impact on gonadotropin dose and the predicted number of oocytes. Results Repeat serum AMH measurements were strongly correlated within individual women (correlation coefficient 0.92). AMH exhibited limited within‐subject variation (coefficient of variation 23%), a small time‐related decline (mean 6% decrease/y), but no systematic variation across the menstrual cycle. Irrespective of whether the AMH screening value or the AMH at the initiation of ovarian stimulation was used, for women with an AMH level <15 pmol/L, 93% would receive the same gonadotropin dose and attain an identical number of oocytes in 97% of cases. For women with an AMH level ≥15 pmol/L, 80% would receive an individualized dose within ±1.5 μg and 90% would attain ±1 oocyte. Conclusion AMH variability had limited impact on individualized gonadotropin dosing, with 95% of women predicted to obtain an oocyte yield that does not vary beyond 1 oocyte count, irrespective of whether a random or early follicular AMH measurement was used to determine the individualized gonadotropin dose.

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Quantifying the intraindividual variation of antimüllerian hormone in the ovarian cycle

Cited by 31 publications

References 51 publications

The effect of laparoscopic salpingectomy for ectopic pregnancy on ovarian reserve

The effect of laparoscopic salpingectomy for ectopic pregnancy on ovarian reserve

Variation in levels of AMH among Maya and non‐Maya women in Campeche, Mexico

Anti‐Müllerian hormone variability and its implications for the number of oocytes retrieved following individualized dosing with follitropin delta

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