- •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.
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.
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.
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.
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.
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Published online: April 11, 2017
Accepted: April 7, 2017
Received in revised form: April 5, 2017
Received: March 1, 2017
© 2017 Elsevier B.V. All rights reserved.