The value of normative data on AMH in women

Joop S.E. Laven*

*Corresponding author for this work

Research output: Chapter/Conference proceedingChapterAcademic

Abstract

One of the challenges for the reproductive endocrinologist is to predict whether and how long the ovaries of a woman will function properly. The way to ascertain how long the ovary will function normally is by assessing the number of primordial follicles also referred to as the ovarian reserve. Unfortunately, this ovarian reserve can only be assessed indirectly since primordial follicles are generally metabolically inactive. Nowadays AMH constitutes the most promising marker to assess ovarian reserve because it is produced by early pre- and antral follicles. AMH levels generally rise during the pre-pubertal and adolescent years and decline in an age dependent manner after the age of 25 years. Moreover, AMH levels are fairly constant throughout the menstrual cycle and are minimally affected by the use of OCPs. A small circadian variation in AMH levels is appreciated. Hence, AMH is good and reliable marker for ovarian ageing. It seems that apart from inhibiting recruitment of primordial follicles out of the ovarian reserve pool AMH plays an important role in modifying the response of an individual follicle to endogenous FSH. High levels of intrafollicular AMH seem to increase the FSH threshold of individual follicles. Moreover intrafollicular AMH levels seem to be independent of a woman's age and gonadotropin levels since normal levels are recorded during pregnancy. Hence it seems that AMH in particular exerts intrafollicular effects. Nowadays different assays to measure AMH are on the market. During the last decade some problems arose concerning reproducibility of some assays as well AMH assay-specific preanalytical instability. Comparisons amongst different laboratories indicated that the mean bias for all results was acceptable low, but there was large coefficient of repeatability indicating some inconsistency within and between laboratories. Taking the increasing importance of AMH for the assessment of ovarian reserve into account accurate AMH measurements are required. Moreover, to make results obtained by different assays comparable to each other the need for an international standard is even more urgent than ever. Hence there is an urgent need for reliable assays producing normative data measured against an accepted international standard.

Original languageEnglish
Title of host publicationAnti-Müllerian Hormone
Subtitle of host publicationBiology, Role in Ovarian Function and Clinical Significance
PublisherNova Science Publishers, Inc.
Pages61-71
Number of pages11
ISBN (Electronic)9781634840170
ISBN (Print)9781634840125
Publication statusPublished - 1 Jan 2016

Bibliographical note

Publisher Copyright:
© 2016 Nova Science Publishers, Inc.

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