Variation in antimüllerian hormone concentration during the menstrual cycle may change the clinical classification of the ovarian response

Hadlow, Narelle; Longhurst, Katherine; McClements, Allison; Natalwala, Jay; Brown, Suzanne J.; Matson, Phillip

doi:10.1016/j.fertnstert.2013.01.132

Cited by 63 publications

(53 citation statements)

References 28 publications

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“…It is well documented in literature that the stability of AMH levels -even during the menstrual cycle -is debatable and may result in conflicting interpretation [47]. Possible fluctuation may not be related to different AMH assays and hence may account for patient variability [48], hence the variability of AMH in the infertile population merits yet delineation [49]. The possible variability on AMH levels has been reported to be heightened for the "younger" in comparison to the "aging" ovary [50].…”

Section: Discussionmentioning

confidence: 99%

A Case Series on Platelet-Rich Plasma Revolutionary Management of Poor Responder Patients

Sfakianoudis¹,

Simopoulou

Nitsos³

et al. 2018

Gynecol Obstet Invest

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Poor responders are described as those In Vitro Fertilization (IVF) patients who are failing to respond to controlled ovarian stimulation protocols. Extensive research has focused on crafting the optimal treatment. However, it appears that each approach fails to be established as effective or guaranteed towards successful management. Platelet-Rich Plasma (PRP) is a novel, highly promising approach that has been successfully applied for an array of medical issues. In this case series, we present 3 poor responder patients with the common denominator of: failed IVF attempts, poor oocyte yield, and poor embryo quality. The option of oocyte donation was rejected. All patients were treated with autologous PRP ovarian infusion following written consent. Within a 3-month interval, follicle-stimulating hormone decreased by 67.33%, while Anti-Müllerian hormone increased by 75.18%. These impressive results on the biochemical infertility markers alone are classified as a complete biological paradox, coupled by improved embryo quality. Results report a natural conception at 24 weeks, an uncomplicated healthy pregnancy at 17 weeks and a successful live birth. To our knowledge, this is the first time such an approach and results are reported, where PRP treatment on poor responders lead to overcoming their challenging reproductive barrier.

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Section: Discussionmentioning

confidence: 99%

A Case Series on Platelet-Rich Plasma Revolutionary Management of Poor Responder Patients

Sfakianoudis¹,

Simopoulou

Nitsos³

et al. 2018

Gynecol Obstet Invest

View full text Add to dashboard Cite

show abstract

“…Correspondingly, circulating concentrations of AMH are generally considered to be noncyclic throughout normal menstrual cycles (Hehenkamp et al, 2006;La Marca et al, 2013;Tsepelidis et al, 2007). However, a recent study found that serum AMH levels were significantly lower in the late luteal phase compared with the early follicular phase, with a pattern similar to pituitary FSH (Hadlow et al, 2013). A small, but significant, variation in serum AMH level throughout the menstrual cycle was also reported in a separate study, although the authors indicated that this variation may not have any clinical significance (Deb et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Assessing ovarian response: antral follicle count versus anti-Müllerian hormone

Fleming¹,

Seifer

Frattarelli³

et al. 2015

Reproductive BioMedicine Online

227

148

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“…A recent study measuring AMH multiple times with the same menstrual cycle of 44 normally cycling healthy women demonstrated AMH values (ng/ml) within four individuals (9%) ranging approximately: 0.4–1.9, 1.9–4.2, 0.4–1.4, and 2.3–4.4 [91 ▪▪ ]. In another study, seven of 12 women re-measured during the same menstrual cycle were clinically reclassified [92 ▪ ]. Therefore, the clinician should avoid using AMH as the only marker of ovarian reserve, counsel patients that occasionally results can fluctuate, and consider re-testing if the AMH value is not consistent with the clinical picture.…”

Section: Biological Fluctuation In Serum Antimüllerian Hormone Valuesmentioning

confidence: 99%

Maximizing the clinical utility of antimüllerian hormone testing in women's health

Leader¹,

Baker

2014

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of reviewTo provide an update on the latest clinical applications of serum antimüllerian hormone (AMH) testing with practical approaches to mitigate the impact of significant variability in AMH results.Recent findingsRecent studies continue to demonstrate that AMH is the best single serum test for ovarian response management with, at most, a weak-to-moderate age-independent association with live-birth rate and time to conception. Data confirm serum AMH levels improve menopause prediction, monitoring of ovarian damage, and identification of women at risk for several ovary-related disorders such as polycystic ovary syndrome and premature or primary ovarian insufficiency. However, it is now recognized that serum AMH results can have dramatic variability due to common, biologic fluctuations within some individuals, use of hormonal contraceptives or other medications, certain surgical procedures, specimen treatment, assay changes, and laboratory calibration differences. Practical guidelines are provided to minimize the impact of variability in AMH results and maximize the accuracy of clinical decision-making.SummaryAMH is an ovarian biomarker of central importance which improves the clinical management of women's health. However, with the simultaneous rapid expansion of AMH clinical applications and recognition of variability in AMH results, consensus regarding the clinical cutpoints is increasingly difficult. Therefore, a careful approach to AMH measurement and interpretation in clinical care is essential.

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Variation in antimüllerian hormone concentration during the menstrual cycle may change the clinical classification of the ovarian response

Cited by 63 publications

References 28 publications

A Case Series on Platelet-Rich Plasma Revolutionary Management of Poor Responder Patients

A Case Series on Platelet-Rich Plasma Revolutionary Management of Poor Responder Patients

Assessing ovarian response: antral follicle count versus anti-Müllerian hormone

Maximizing the clinical utility of antimüllerian hormone testing in women's health

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