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. 2019 Jul;79(7):731-737.
doi: 10.1055/a-0840-3817. Epub 2019 Jul 10.

Is There a Need to Alter the Timing of Anti-Müllerian Hormone Measurement During the Menstrual Cycle?

Umit Gorkem  1 , Cihan Togrul  1
Affiliations

Is There a Need to Alter the Timing of Anti-Müllerian Hormone Measurement During the Menstrual Cycle?

Umit Gorkem et al. Geburtshilfe Frauenheilkd. 2019 Jul.

Abstract
in English, German

Introduction There are numerous conflicting studies which have addressed the question whether the measurement of anti-Müllerian hormone (AMH) concentrations should be done at a certain time during the menstrual cycle. We aimed to investigate AMH fluctuations during the follicular and luteal phases of the menstrual cycle and to determine whether AMH variations, if present, might influence the clinical utility of ovarian reserve markers. Materials and Methods A total of 257 infertile women eligible for inclusion were categorized into three groups based on their total antral follicle count: 1. hypo-response group (< 7 follicles, n = 66), 2. normo-response group (7 - 19 follicles, n = 98), and 3. hyper-response group (> 19 follicles, n = 93). Results Mean follicular AMH levels were elevated compared to levels in the luteal phase in all response groups (p < 0.001). There were significant and strong positive correlations between follicular and luteal AMH levels in all response groups (Spearman's r = 0.822, r = 0.836, and r = 0.899, respectively; p < 0.001 for all groups). Fisher's Z-test comparisons of these correlations in all response groups demonstrated that there was no statistically significant difference (Z = 0.277, Z = - 1.001, and Z = - 1.425, respectively; p < 0.001). Conclusion We found that serum AMH levels in the follicular phase were higher than those in the luteal phase in all three response groups. In current practice, fluctuations in serum AMH concentrations are not large enough to alter the timing of AMH measurements during the menstrual cycle. The issue is important for the assessment of ovarian reserve in infertile women with AMH levels near to the cut-off value.

Einleitung Es gibt zahlreiche widersprüchliche Studien, die sich der Frage widmen, ob die Messung des Anti-Müller-Hormon-(AMH-)Spiegels an einem bestimmten Zeitpunkt im Menstruationszyklus durchgeführt werden sollte. Ziel dieser Studie war es, Fluktuationen des Anti-Müller-Hormon-Spiegels während der Follikelphase und der Lutealphase des Menstruationszykluses zu messen, auch um zu bestimmen, ob Fluktuationen des AMH-Spiegels, falls es sie gibt, den klinischen Nutzen als Marker der ovariellen Reserve beeinflussen könnten. Material und Methoden Insgesamt 257 unfruchtbare Frauen, welche die Einschlusskriterien erfüllten, wurden in die Studien eingeschlossen und in 3 Reaktionsgruppen eingeteilt. Die Einteilung beruhte auf der jeweiligen Gesamtzahl antraler Follikel, wie folgt: 1. Hypo-Gruppe (< 7 Follikel, n = 66), 2. Normalgruppe (7 – 19 Follikel, n = 98), und 3. Hyper-Gruppe (> 19 Follikel, n = 93). Ergebnisse Verglichen mit der Lutealphase war der durchschnittliche AMH-Spiegel während der Follikelphase in allen 3 Gruppen erhöht (p < 0,001). Es gab eine signifikante und starke positive Korrelation zwischen dem AMH-Spiegel in der Follikelphase und dem AMH-Spiegel in der Lutealphase bei allen Gruppen (Korrelationskoeffizient nach Spearman r = 0,822, r = 0,836 bzw. r = 0,899; p < 0,001 für alle Gruppen). Der Vergleich dieser Korrelationen mithilfe des Fisher-z-Tests zeigte, dass es in keiner der Gruppen einen statistisch signifikanten Unterschied gab (z = 0,277, z = − 1,001 bzw. z = − 1,425; p < 0,001). Schlussfolgerung Es stellte sich heraus, dass in allen 3 Gruppen der AMH-Spiegel in der Follikelphase höher war als der AMH-Spiegel in der Lutealphase. Die Flukutationen des AMH-Spiegels sind jedoch nicht hoch genug, um den Zeitpunkt der AMH-Messung während des Menstruationszyklus in der aktuellen klinischen Praxis zu ändern. Dieses Thema ist aber für die Evaluierung der ovariellen Reserve von unfruchtbaren Frauen mit AMH-Spiegeln, die nahe beim Cut-off-Wert sind, von Bedeutung.

Keywords: AMH; Anti-Müllerian hormone; fluctuation; measurement; ovarian reserve; variation.

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Conflict of interest statement

Conflict of Interest The authors declare that they have no conflict of interest.

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References

    1. Dittrich R, Kliesch S, Schüring A. Fertility Preservation for Patients with Malignant Disease. Guideline of the DGGG, DGU and DGRM (S2 k-Level, AWMF Registry No. 015/082, November 2017) – Recommendations and Statements for Girls and Women. Geburtsh Frauenheilk. 2018;78:567–584. - PMC - PubMed
    1. Guenther V, Alkatout I, Junkers W. Fertility Preservation in Female Patients with Breast Cancer – a Current Overview. Geburtsh Frauenheilk. 2017;77:1088–1094. - PMC - PubMed
    1. Broer S L, Mol B W, Hendriks D. The role of anti-Mullerian hormone in prediction of outcome after IVF: comparison with the antral follicle count. Fertil Steril. 2009;91:705–714. - PubMed
    1. Broekmans F J, de Ziegler D, Howles C M. The antral follicle count: practical recommendations for better standardization. Fertil Steril. 2010;94:1044–1051. - PubMed
    1. Iliodromiti S, Anderson R A, Nelson S M. Technical and performance characteristics of anti-Müllerian hormone and antral follicle count as biomarkers of ovarian response. Hum Reprod Update. 2015;21:698–710. - PubMed