Highlights
- •Although many AMH assays with differing characteristics are currently available, there are relatively few comparisons between them.
- •AMH measurements performed by the picoAMH and Gen II assays were highly correlated in 1985 premenopausal women.
- •The picoAMH detected AMH in 78% of the samples in which it was deemed undetectable with the Gen II assay.
- •Future research could help determine the value of measuring very low levels of AMH.
Abstract
Objective
Anti-Müllerian hormone (AMH), a quantitative marker of ovarian reserve, is used for
both clinical and research purposes in the field of reproductive medicine. Numerous
AMH assays have been developed. Among other factors, the lack of large-scale comparisons
of the various assays hinders the universal interpretation of AMH levels. Moreover,
little is known of the practical performance of highly sensitive assays compared with
conventional assays with regard to the very low AMH levels found in women nearing
menopause. This study aimed to compare the measurements of the Gen II (Beckman Coulter)
assay with those of the highly sensitive picoAMH (AnshLabs) assay.
Methods
This cross-sectional study included 1985 premenopausal women who completed the second
visit of the population-based Doetinchem Cohort Study, with a mean age of 42 ± 7 years. AMH levels were measured with the Gen II and picoAMH assays. Passing-Bablok
and Bland Altman analyses were performed and differences in the proportion of detectable
samples were assessed.
Results
The results from the Gen II and picoAMH assays were highly correlated, with a Spearman
correlation coefficient of 0.91. The Passing-Bablok regression formula was picoAMH = 0.01 + 1.69 * GenII, meaning that on average picoAMH levels were 69% higher than Gen II levels. Of the
670 samples with an undetectable AMH value with the Gen II assay, AMH could be detected
in 78% with the picoAMH assay, at a median concentration [interquartile range] of
0.05 [0.01–0.14] ng/mL.
Conclusion
These results indicate that, despite a high correlation, there is a large relative
difference between results of the Gen II and picoAMH assays. The use of a highly sensitive
AMH assay is likely to result in a large increase in the proportion of samples with
detectable levels. This may enable research into women’s health across the menopausal
transition and research into the potential clinical benefits of distinguishing between
women with very low ovarian reserve.
Keywords
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Article info
Publication history
Published online: April 11, 2017
Accepted:
April 7,
2017
Received in revised form:
April 5,
2017
Received:
March 1,
2017
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
