Utility of age-specific serum anti-Müllerian hormone concentrations

Abstract

This study assessed whether age-specific (as-) cutoffs for anti-Müllerian hormone (AMH) have higher specificity in reflecting ovarian reserve than non-age-specific (nas-) AMH values. as-AMH values were defined in 792 consecutive infertility patients by establishing as-quartiles of AMH within five age groups. Oocyte yields were then compared among women with AMH below or above the 25th centile at each age group. AMH continually decreased with advancing female age (P<0.0001) and differed significantly in each of five selected age categories (P<0.001). In 442 women who reached IVF, as-AMH was predictive of lower oocyte yield if below as-25th centile and of higher oocyte yield if above as-75th centile. Combined normal and elevated as-AMH demonstrated 6.4 times (95% CI 3.9-20.6) odds of retrieving more than four oocytes than low as-AMH. Like as-FSH, as-AMH better reflects ovarian reserve than nas-ovarian reserve testing. However, in contrast to as-FSH, as-AMH defines risk for diminished ovarian reserve or high oocyte yields (i.e. ovarian hyperstimulation syndrome) and, therefore, may be a particularly useful ovarian reserve test in younger women in whom diminished ovarian reserved is most frequently overlooked, and who are at highest risk for ovarian hyperstimulation syndrome.