Literature DB >> 15730360

Anti-mullerian hormone as a marker of ovarian reserve.

Kelton P Tremellen1, Michele Kolo, Alan Gilmore, Dharmawijaya N Lekamge.   

Abstract

OBJECTIVE: To analyse the usefulness of plasma anti-mullerian hormone (AMH) measurement as a tool for assessing ovarian reserve in a general infertility population.
MATERIALS AND METHODS: Plasma AMH levels were analysed in 238 women aged 18-46 years during day 3-5 of their menstrual cycle. All 238 patients had follicle stimulating hormone (FSH) levels less than 10 i.u./L, suggesting normal ovarian reserve on traditional FSH criteria. Eighty-seven patients gave their consent to correlate their AMH levels with IVF oocyte retrieval outcome. Patients producing > or = 8 oocytes were classified as having normal ovarian reserve, while those producing < or = 4 oocytes were classified as having poor ovarian reserve.
RESULTS: Plasma AMH levels remained relatively static (20-25 pmol/L) from 18 to 29 years of age. By 30 years of age, plasma AMH levels start to drop rapidly, reaching only 10 pmol/L by 37 years. Despite this 50% fall in AMH levels between 29 and 37 years of age, minimal changes in FSH levels were observed. Using a cut off value of 8.1 pmol/L, plasma AMH assessment could predict poor ovarian reserve on a subsequent IVF cycle with a sensitivity of 80% and a specificity of 85%.
CONCLUSIONS: Plasma AMH assessments are superior to FSH in identifying women with reduced ovarian reserve. Anti-mullerian hormone assessment should be considered as a useful adjunct to FSH/oestradiol levels and antral follicle count when estimating ovarian reserve.

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Year:  2005        PMID: 15730360     DOI: 10.1111/j.1479-828X.2005.00332.x

Source DB:  PubMed          Journal:  Aust N Z J Obstet Gynaecol        ISSN: 0004-8666            Impact factor:   2.100


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