Lab Med Online.  2022 Jan;12(1):46-52. 10.47429/lmo.2022.12.1.46.

Age-Specific Reference Values of Anti-Müllerian Hormone in Korean Women with Normal Menstruation: Time Trend and Clinical Suitability (2015–2021)

• Kim HJ
• Park JY
• Han MS

• KMID: 2538583
• DOI: http://doi.org/10.47429/lmo.2022.12.1.46

Abstract

Anti-Müllerian hormone (AMH) levels can be affected by various factors, including age, lifestyle, and test method. This study aimed to review the time trend of AMH levels and the clinical suitability of current age-specific AMH reference values in Korean women. Population-based data of AMH levels, collected from 2015 to 2021 at a clinical laboratory, in Korean women aged 20–49 year with normal menstruation were evaluated (N=19,032 for Gen II assay [Beckman Coulter, USA]; N=14,497 for Access assay [Beckman Coulter, USA]). We found significant differences of AMH levels over time measured using the Gen II assay, but not those assessed by the Access assay. Based on current age-specific reference values, the AMH levels in Korean women with normal menstruation were considered relatively low in the groups at both age extremes (late 20s and late 40s). The AMH levels of Korean women did not show any time trends, except for the influence of the test method. We found that in the case of the Gen II assay, current age-specific AMH reference values, based on an AMH-age regression model, may not be clinically suitable for age groups at both extremes. Therefore, we established new age-specific AMH reference values measured using the Access assay for the general population.

Keyword

Anti-Mü,llerian hormone; Menstruation; Reference values

Figure

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  Fig. 1 Levels of anti-Müllerian hormone (AMH) in Korean women with normal menstruation by (A) Gen II assay (N=19,032) and (B) Access assay (N=13,078). *P<0.05, **P<0.001.

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  Fig. 2 Medians of low and high percentiles applied current and new AMH percentiles for Access assay in Korean women with normal menstruation (Same population with ‘RV verification’ in table 3).

Reference

1. Keane K, Cruzat VF, Wagle S, Chaudhary N, Newsholme P, Yovich J. 2017; Specific ranges of anti-Mullerian hormone and antral follicle count correlate to provide a prognostic indicator for IVF outcome. Reprod Biol. 17:51–9. DOI: 10.1016/j.repbio.2016.12.002. PMID: 28132758.

2. National Institute for Health, Care Excellence. Fertility problems: assessment and treatment. Clinical guideline [CG156]. https://www.nice.org.uk/guidance/cg156. Updated on Sep 2017.

3. Clinical, Laboratory Standards Institute. 2010. Defining, establishing, and verifying reference values in the clinical laboratory, Approved guideline-Third edition. CLSI document EP28-A3c. Wayne, PA: Clinical and Laboratory Standards Institute.

4. Asada Y, Tsuiki M, Sonohara M, Fukunaga N, Hattori Y, Inoue D, et al. 2019; Performance of anti-Müllerian hormone (AMH) levels measured by Beckman Coulter Access AMH assay to predict oocyte yield following controlled ovarian stimulation for in vitro fertilization. Reprod Med Biol. 18:273–7. DOI: 10.1002/rmb2.12271. PMID: 31312106. PMCID: PMC6613014.

5. van Helden J, Weiskirchen R. 2015; Performance of the two new fully automated anti-Müllerian hormone immunoassays compared with the clinical standard assay. Hum Reprod. 30:1918–26. DOI: 10.1093/humrep/dev127. PMID: 26093541.

6. Beckman Coulter. Urgent field safety notice-FSN 20434-3 AMH Gen II ELISA (REF A79765). http://www.hpra.ie/img/uploaded/documents/fsn/FSNJun2013/V16335_FSN.pdf. Updated on Jun 2013.

7. Lee JY, Jee BC, Lee JR, Kim CH, Park T, Yeon BR, et al. 2012; Age-related distributions of anti-Müllerian hormone level and anti-Müllerian hormone models. Acta Obstet Gynecol Scand. 91:970–5. DOI: 10.1111/j.1600-0412.2012.01448.x. PMID: 22574827.

8. Lee JY, Ahn S, Lee JR, Jee BC, Kim CH, Seo S, et al. 2017; Reference values for the revised anti-Müllerian hormone generation II assay: Infertile population-based study. J Korean Med Sci. 32:825–9. DOI: 10.3346/jkms.2017.32.5.825. PMID: 28378557. PMCID: PMC5383616.

9. Lee JE, Park DS, Kim ML, Yoon BS, Song T, Kim MK, et al. 2012; Age-related distribution of anti-Müllerian hormone levels in 2,879 Korean women with regular menstruation. Korean J Obstet Gynecol. 55:920–8. DOI: 10.5468/KJOG.2012.55.12.920.

10. Yoo JH, Kim HO, Cha SW, Park CW, Yang KM, Song IO, et al. 2011; Age specific serum anti-Müllerian hormone levels in 1,298 Korean women with regular menstruation. Clin Exp Reprod Med. 38:93–7. DOI: 10.5653/cerm.2011.38.2.93. PMID: 22384425. PMCID: PMC3283054.