Use of anti-mullerian hormone for testing ovarian reserve: a survey of 796 infertility clinics worldwide

Tobler, K.J.; Shoham, Gon; Christianson, Mindy S.; Zhao, Yulian; Leong, Milton; Shoham, Zeev

doi:10.1007/s10815-015-0562-7

Cited by 24 publications

(19 citation statements)

References 35 publications

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“…A survey of 796 fertility centers worldwide showed that 51% considered AMH was the best test for measuring ovarian reserve, while 40% reported AFC was the best test and only 6% selected basal FSH. However, when asked which test or factor best predicted pregnancy, the majority of centers, 80%, selected age with a small percentage selecting AMH (4%) or AFC (3%) [14]. It is imperative for providers to understand that when ordering ovarian reserve screening tests, the predictive value of these tests can be low in a younger low-risk population [15].…”

Section: Diagnosis Of Diminished Ovarian Reservementioning

confidence: 99%

Reproductive ovarian testing and the alphabet soup of diagnoses: DOR, POI, POF, POR, and FOR

Pastore

Christianson

Stelling

et al. 2017

J Assist Reprod Genet

Self Cite

139

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There are large variations in the number of oocytes within each woman, and biologically, the total quantity is at its maximum before the woman is born. Scientific knowledge is limited about factors controlling the oocyte pool and how to measure it. Within fertility clinics, there is no uniform agreement on the diagnostic criteria for each common measure of ovarian reserve in women, and thus, studies often conflict. While declining oocyte quantity/quality is a normal physiologic occurrence as women age, some women experience diminished ovarian reserve (DOR) much earlier than usual and become prematurely infertile. Key clinical features of DOR are the presence of regular menstrual periods and abnormal-but-not-postmenopausal ovarian reserve test results. A common clinical challenge is counseling patients with conflicting ovarian reserve test results. The clinical diagnosis of DOR and the interpretation of ovarian reserve testing are complicated by changing lab testing options and processing for anti-mullerian hormone since 2010. Further, complicating the diagnostic and research scenario is the existence of other distinct yet related clinical terms, specifically premature ovarian failure, primary ovarian insufficiency, poor ovarian response, and functional ovarian reserve. The similarities and differences between the definitions of DOR with each of these four terms are reviewed. We recommend greater medical community involvement in terminology decisions, and the addition of DOR-specific medical subject-heading search terms.

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Section: Diagnosis Of Diminished Ovarian Reservementioning

confidence: 99%

Reproductive ovarian testing and the alphabet soup of diagnoses: DOR, POI, POF, POR, and FOR

Pastore

Christianson

Stelling

et al. 2017

J Assist Reprod Genet

Self Cite

139

View full text Add to dashboard Cite

show abstract

“…Several studies [ 1 – 4 ] have revealed that age, antral follicle count (AFC), and serum anti-Müllerian hormone (AMH) levels reflect the ovarian reserve admittedly, so these factors are considered valuable predictors of the ovarian response to exogenous gonadotrophins. In addition, AMH was a key for ovarian reserve-related outcomes, and has indeed been widely used in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

“…Sixty percent of the respondents from 796 infertility clinics worldwide reported using AMH as a first-line test in in vitro fertilization (IVF) cycles, and 54% reported AMH as the best test for evaluating ovarian reserve; 89% reported that AMH results were relevant to clinical practice. [ 1 ] And AMH was an effective measure of quantitative ovarian reserve and was strongly associated with the ovarian response and oocyte yield after ovarian stimulation, [ 2 , 3 ] moreover, using AMH, AFC, and age together constituted a new model for predicting poor or excessive ovarian response. [ 4 ]…”

Section: Introductionmentioning

confidence: 99%

The comparison of evaluative effectiveness between antral follicle count/age ratio and ovarian response prediction index for the ovarian reserve and response functions in infertile women

Zhou

Zhao

et al. 2020

Medicine

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Aim of the present study was to explore the evaluative effectiveness of age, ovarian volume (OV), antral follicle count (AFC), serum follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH), AFC/Age ratio, AMH/Age ratio, FSH/luteinizing hormone (LH) ratio, and ovarian response prediction index (ORPI) to determine which could more advantageously assess ovarian reserve and response. This research enrolled 319 consecutive infertile women who had undergone in vitro fertilization-ET/intracytoplasmic sperm injection (IVF-ET/ICSI) treatments. Abovementioned variables were measured and calculated. Receiver operating characteristic (ROC) curve analysis was used to analyze the predictive accuracy of variables and to calculate cut-off values and corresponding sensitivity and specificity. Our study revealed that the significant variables for evaluating a decline in ovarian reserve include age, OV, FSH, AFC/Age ratio, AMH/Age ratio, and ORPI. Moreover, the area under the curve (AUC) of AFC/Age ratio was higher than other 5 variables (AUC = 1.000), and the cut-off value of AFC/Age ratio was 0.111 (sensitivity 100.00%, specificity 100.00%). The significant variables forecasting excessive ovarian response were age, AFC, AMH, FSH, AFC/Age ratio, AMH/Age ratio, FSH/LH ratio, and ORPI, and the significant variables forecasting poor ovarian response were AMH, LH, OV, AFC/Age ratio, AMH/Age ratio, and FSH/LH ratio. When ORPI was used to predict excessive response, the cut-off value of ORPI was 0.880 (sensitivity 84.72%, specificity 67.32%) and ORPI presented better effectiveness. When used to predict poor response, the evaluative effectiveness of 6 variables was almost similar, although the AUC of AFC/Age ratio presented the largest value. Regarding the infertile women, AFC/Age ratio performed better than did the other variables in evaluating ovarian reserve, and it offered excellent effectiveness in predicting poor ovarian response, however, ORPI presented better effectiveness in predicting excessive ovarian response.

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“…Thereafter, the AMH level declines steadily until menopause when it reaches undetectable levels [11]. To date, AMH is mostly used to predict response to in vitro fertilization therapy [12]. However, recent studies show a decline in AMH levels in CCS when compared to controls [13][14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Anti-müllerian hormone compared with other ovarian markers after childhood cancer treatment

et al. 2018

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Background: Gonadal dysfunction is one of the major late complications after cancer diagnosis and treatment. The best markers of ovarian reserve in clinical practice are antral follicle count (AFC) and ovarian volume. We aimed to study the prevalence of premature ovarian insufficiency (POI) and evaluate anti-M€ ullerian hormone (AMH) and other serum markers for ovarian function in adult women who were childhood cancer survivors (CCS) in comparison with a control group. Material and methods: Altogether, 167 female CCS were compared to 164 matched controls. Prevalence of POI was documented and serum levels of AMH, inhibin B, follicle stimulating hormone (FSH), and estradiol (E2) were compared with AFC and ovarian volume. Results: POI was reported in 22 (13%) of the CCS and in none of the controls. Serum levels of AMH, inhibin B, and FSH, but not E2, correlated significantly with AFC and ovarian volume; AMH showed the highest correlation. There was no difference between CCS and controls regarding the different serum markers as measured by linear regression analysis. ROC curve AUC for primary POI showed the highest values for AMH (0.930) and AFC (0.944). For AFC <10, ROC curve AUC showed highest value for AMH for CCS (0.866) and controls (0.878). In a subgroup of female CCS <40 years (n ¼ 120), the results were similar. Conclusion: We found POI in 13% among CCS, slightly more than in other studies. Serum levels of AMH, inhibin B, and FSH correlated significantly with AFC and ovarian volume, and no difference was noted between CCS and controls. AMH was the most reliable serum marker for ovarian function in terms of POI and low AFC.

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Use of anti-mullerian hormone for testing ovarian reserve: a survey of 796 infertility clinics worldwide

Cited by 24 publications

References 35 publications

Reproductive ovarian testing and the alphabet soup of diagnoses: DOR, POI, POF, POR, and FOR

Reproductive ovarian testing and the alphabet soup of diagnoses: DOR, POI, POF, POR, and FOR

The comparison of evaluative effectiveness between antral follicle count/age ratio and ovarian response prediction index for the ovarian reserve and response functions in infertile women

Anti-müllerian hormone compared with other ovarian markers after childhood cancer treatment

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