Reliability of AMH in Serum after Long-term Storage at -80°C and an Extended Thawing Episode

Mörse, Helena; Öra, Ingrid; Turkiewicz, Aleksandra; Andersen, Claus Yding; Becker, Charlotte; Isaksson, Anders; Elfving, Maria

doi:10.21767/2386-5180.100061

Cited by 16 publications

(9 citation statements)

References 22 publications

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“…Although the samples were stored for between 2 and 17 years, there is strong evidence that AMH is stable over such time periods (31). Conversion to MoM prior to modeling has the advantage that it will account for proportional differences between AMH assays.…”

Section: Strengths Of the Studymentioning

confidence: 99%

Adjusting antimüllerian hormone levels for age and body mass index improves detection of polycystic ovary syndrome

Palomaki

Kalra²,

Kumar³

et al. 2020

Fertility and Sterility

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Objective: To examine whether accounting for a woman's age and body mass index (BMI) would improve the ability of antim€ ullerian hormone (AMH) to distinguish between women with (cases) and without (controls) polycystic ovarian syndrome (PCOS). Design: An opportunistic case-control dataset of reproductive age women having evaluations for PCOS as defined by National Institutes of Health criteria. Setting: Two medical centers in the United States enrolled women. Serum samples were analyzed for relevant analytes. Patients: Women were between 18 and 39 years of age when samples and clinical information were collected. Residual samples had been stored for 2À17 years. AMH was measured via immunoassay. Interventions: None; this was an observational study. Main outcome measures: Detection and false-positive rates for PCOS were computed for AMH results expressed as multiples of the median (MoM) both before and after adjustment for the woman's age and BMI. Results: Using unadjusted AMH MoM results, 168 cases (78%) cases were at or beyond the 90 th centile of controls (2.47 MoM). After accounting for each woman's age and BMI, 188 (87%) of those women were beyond the 90 th centile of controls (2.20 MoM), a significant increase (P ¼ .015). The adjusted AMH MoM levels fitted logarithmic normal distributions well (mean, standard deviation for controls and cases of 0.0000, 0.2765 and 0.6884, 0.2874, respectively) and this allowed for computation of patient-specific PCOS risks. Conclusions: Accounting for the woman's age and BMI resulted in significantly higher AMH-based detection rates for PCOS at a 10% false-positive rate, and patient-specific PCOS risks could be computed. (Fertil Steril Ò 2020;113:876-84. Ó2019 by American Society for Reproductive Medicine.) El resumen está disponible en Español al final del artículo.

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Section: Strengths Of the Studymentioning

confidence: 99%

Adjusting antimüllerian hormone levels for age and body mass index improves detection of polycystic ovary syndrome

Palomaki

Kalra²,

Kumar³

et al. 2020

Fertility and Sterility

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“…Freezing has been reported to affect the performance of some AMH assays 9 ; however, the manufacturer's guidelines state that the picoAMH assay is stable after freezing for up to 5 months 24 . It is reassuring that picoAMH measurements have been shown to be stable after long‐term storage at −80°C and episodes of thawing 25 …”

Section: Discussionmentioning

confidence: 93%

“…24 It is reassuring that picoAMH measurements have been shown to be stable after long-term storage at −80°C and episodes of thawing. 25 In conclusion, AMH is increasingly being measured as an adjunct to the diagnosis of conditions characterized by low ovarian reserve and cessation of ovarian function. It is also being discussed as potentially useful for the diagnosis of PCOS.…”

Section: Re Sultsmentioning

confidence: 99%

Differing performance of two assays for the measurement of anti‐Mullerian hormone in premenopausal women: A cross‐sectional study

Bell

Skiba

Sikaris

et al. 2021

Clinical Endocrinology

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Objective To compare the performance of two anti‐Mullerian (AMH) assays over a range of concentrations, in samples collected from young women. Design A cross‐sectional method‐comparison study of 168 non‐healthcare‐seeking women. Participants Included women were aged 18–39 years, not recently pregnant, breast feeding or using systemic hormones. Measurements Serum AMH levels were analysed with the Beckman Coulter Access 2 assay from fresh samples and the Ansh picoAMH assay using samples stored at −80°C, in a parallel setting. Comparisons between the two assays were examined using Bland‐Altman plots. Results Participants had a mean ± SD age of 32.6 ± 5.4 years and body mass index of 28.1 ± 7.9 kg/m2, and 60.1% were parous. Although the assay results were highly correlated (Spearman correlation .982, P < .001), the relationship between the assays was nonlinear. Serum AMH values below 4 pmol/L were lower with the picoAMH assay compared with the Access AMH assay (mean difference in this range was −0.49 pmol/L), but for samples with a mean value above 10 pmol/L, the picoAMH assay consistently measured higher than the Access AMH assay (mean difference in this range was +8.2 pmol/L). As AMH concentrations increased the absolute discrepancy between the assays also increased. Conclusions This study demonstrates that despite the high correlation between two commercially available AMH assays, the assays performed in a discordant manner at high and low concentrations. Hence, the results of these assays are not interchangeable, highlighting the need to establish specific reference limits for individual assays to guide clinical decision‐making and the challenge of establishing future universal cut‐offs for the application of AMH levels in clinical practice.

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“…Third, use of stored frozen samples for AMH measurements may potentially affect the stability of AMH. However, it has been documented that storage at -80°C and episodes of thawing have little effects on the AMH level, according to the AMH Gen II assay ( 40 , 41 ). Fourth, our results remained unchanged after adjustment for the sample storage time as the confounding variable.…”

Section: Discussionmentioning

confidence: 99%

Does the Anti-Mullerian Hormone Decline Rate Improve the Prediction of Age at Menopause?

et al. 2021

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ObjectivesThere are controversial studies investigating whether multiple anti-Mullerian hormone (AMH) measurements can improve the individualized prediction of age at menopause in the general population. This study aimed to reexplore the additive role of the AMH decline rate in single AMH measurement for improving the prediction of age at physiological menopause, based on two common statistical models for analysis of time-to-event data, including time-dependent Cox regression and Cox proportional-hazards regression models.MethodsA total of 901 eligible women, aged 18–50 years, were recruited from the Tehran Lipid and Glucose Study (TLGS) population and followed up every 3 years for 18 years. The serum AMH level was measured at the time of recruitment and twice after recruitment within 6-year intervals using the Gen II AMH assay. The added value of repeated AMH measurements for the prediction of age at menopause was explored using two different statistical approaches. In the first approach, a time-dependent Cox model was plotted, with all three AMH measurements as time-varying predictors and the baseline age and logarithm of annual AMH decline as time-invariant predictors. In the second approach, a Cox proportional-hazards model was fitted to the baseline data, and improvement of the complex model, which included repeated AMH measurements and the logarithm of the AMH annual decline rate, was assessed using the C-statistic.ResultsThe time-dependent Cox model showed that each unit increase in the AMH level could reduce the risk of menopause by 87%. The Cox proportional-hazards model also improved the prediction of age at menopause by 3%, according to the C-statistic. The subgroup analysis for the prediction of early menopause revealed that the risk of early menopause increased by 10.8 with each unit increase in the AMH annual decline rate.ConclusionThis study confirmed that multiple AMH measurements could improve the individual predictions of the risk of at physiological menopause compared to single AMH measurements. Different alternative statistical approaches can also offer the same interpretations if the essential assumptions are met.

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Reliability of AMH in Serum after Long-term Storage at -80°C and an Extended Thawing Episode

Cited by 16 publications

References 22 publications

Adjusting antimüllerian hormone levels for age and body mass index improves detection of polycystic ovary syndrome

Adjusting antimüllerian hormone levels for age and body mass index improves detection of polycystic ovary syndrome

Differing performance of two assays for the measurement of anti‐Mullerian hormone in premenopausal women: A cross‐sectional study

Does the Anti-Mullerian Hormone Decline Rate Improve the Prediction of Age at Menopause?

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