Anti-Mullerian hormone: poor assay reproducibility in a large cohort of subjects suggests sample instability

Rustamov, Oybek; Smith, Alwyn; Roberts, Stephen A.; Yates, Allen P.; Fitzgerald, Cheryl; Krishnan, Monica; Nardo, Luciano G.; Pemberton, Philip W.

doi:10.1093/humrep/des260

Cited by 152 publications

(112 citation statements)

References 30 publications

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“…One challenge has been that the IOT assays produced AMH concentrations up to 40 % higher than DSL, making interpretation of the absolute values difficult [28,30]. Studies that produced cut-off values and nomograms must be scrutinized for the assay used prior to applying the information, regardless of how compelling the data appears, to the reader's own clinical situation [1,31]. Currently, the above listed labs DSL and IOT have been acquired by Beckman Coulter, and a single patented assay for testing AMH (AMH Gen II) is now available.…”

Section: Discussionmentioning

confidence: 99%

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

Tobler

Shoham

Christianson

et al. 2015

J Assist Reprod Genet

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Purpose The aim of this study is to assess how anti-mullerian hormone (AMH) is used worldwide to test ovarian reserve and guide in vitro fertilization (IVF) cycle management. Methods An internet-based survey was sent electronically to registered IVF providers within the IVF-Worldwide.com network. This survey consisted of nine questions which assessed the clinics' use of AMH. The questionnaire was completed online through the IVF-Worldwide.com website, and quality assurance tools were used to verify that only one survey was completed per clinical IVF center. Results are reported as the proportion of IVF cycles represented by a particular answer choice. Results Survey responses were completed from 796 globally distributed IVF clinics, representing 593,200 IVF cycles worldwide. Sixty percent of the respondent-IVF cycles reported to use AMH as a first line test, and 54 % reported it as the best test for evaluating ovarian reserve. Eighty-nine percent reported that AMH results were extremely relevant or relevant to clinical practice. However in contrast, for predicting live birth rate, 81 % reported age as the best predictor. Conclusions AMH is currently considered a first line test for evaluating ovarian reserve and is considered relevant to clinical practice by the majority of IVF providers.

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Section: Discussionmentioning

confidence: 99%

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

Tobler

Shoham

Christianson

et al. 2015

J Assist Reprod Genet

View full text Add to dashboard Cite

show abstract

“…These ELISA assays are inevitably limited by their technical characteristics that limit their up scaling for routine clinical chemistry laboratories. Furthermore the Beckman Coulter Generation II assay exhibited complement interference in fresh samples requiring a modified protocol to be developed, introducing a further step that would complicate robotic instrumentation (10,11).…”

Section: Introductionmentioning

confidence: 99%

Two new automated, compared with two enzyme-linked immunosorbent, antimüllerian hormone assays

Nelson

Pastuszek

Kloss³

et al. 2015

Fertility and Sterility

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3 Capsule:The new automated AMH assays provide values that are substantially lower than existing AMH ELISAs. Assay specific interpretation is necessary with international standardization urgently required. Conclusions:The novel automated assays exhibit strong concordance in calibration but derived values are substantially lower than obtained from preexisting assays with assay specific interpretation required for routine clinical use. These results highlight the need for an international AMH standard.5

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“…28 AFC on the other hand, is the sum of antral follicles on both ovaries as visualized through transvaginal ultrasonography. 3 Histologically, the number of antral follicles visualized appear to correlate with the number of primordial follicles at any age.…”

Section: Reliabilitymentioning

confidence: 99%

A review of luteinizing hormone and its role in ovarian reserve testing

Smith

Osianlis

Vollenhoven

2014

Int J Reprod Contracept Obstet Gynecol

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Ovarian reserve tests (ORTs) have become part of the antecedent workup for individuals undergoing assisted reproductive technology (ART). In 1988, the foundations for ORTs were first laid by studies indicating a potential role for basal follicle stimulating hormone (FSH) in predicting pregnancy. 1Since then basal FSH measurement has gone on to become the most commonly used marker of ovarian reserve.2 Given the synergistic interplay of both FSH and luteinizing hormone (LH) in ovarian physiology which ARTs attempt to mimic, it is of interest that LH has not been explored in the same capacity. This review aims to illustrate the physiological role played by LH in folliculogenesis and critically review the available literature to determine if LH does indeed have a role in ovarian reserve testing. OVARIAN RESERVE TESTINGThe term ovarian reserve aims to correlate reproductive potential with the number and quality of remaining oocytes in women of reproductive age.3 Ovarian reserve testing aims to quantify this relationship by measuring either oocyte quality, quantity or the ability for an individual to achieve pregnancy. These tests can be conducted either through biochemical means or through ultrasonographic measures. ABSTRACTBackground: Ovarian physiology illustrates the synergistic interaction between luteinizing hormone and follicle stimulating hormone in the process of folliculogenesis. While follicle stimulating hormone has been well established as a marker of ovarian reserve, the role of luteinizing hormone has remained somewhat controversial and it seems to have become the 'forgotten gonadotropin'. The following review aims to investigate the available evidence surrounding luteinizing hormone as an ovarian reserve test and examine the issues which need to be addressed in order to establish it as an ovarian reserve test. It then further attempts to propose a model to direct effective research to ascertain if it does have a role to play in ovarian reserve testing. Findings: The evidence is equivocal in the use of luteinizing hormone as an independent predictor of ovarian reserve. However, there is much stronger evidence to suggest that the follicle stimulating hormone/luteinizing hormone ratio is a useful marker of ovarian reserve-in particular when it is ≥2 and approaching 3. The evidence base for this ratio at present however is sparse. In addition, ovarian reserve tests are fraught with issues over reliability, accuracy, definition and the implications of testing itself. In order to overcome these issues, more quality research needs to be carried out to test this relationship between luteinizing hormone and follicle stimulating hormone.

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Anti-Mullerian hormone: poor assay reproducibility in a large cohort of subjects suggests sample instability

Abstract: S. Roberts is supported by the NIHR Manchester Biomedical Research Centre.

Cited by 152 publications

References 30 publications

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

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

Two new automated, compared with two enzyme-linked immunosorbent, antimüllerian hormone assays

A review of luteinizing hormone and its role in ovarian reserve testing

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