Clinical utility of different anti-Müllerian hormone – AMH assays for the purpose of pregnancy prediction

Abstract

Purpose: Comparison of outcomes of IVF cycles where the AMH levels was measured with five different AMH kits: Immunotech (IOT), Beckman Coulter II Gen. RUO, Beckman Coulter II Gen. IVD (BC II IVD), Ansh Labs ultrasensitive (Ansh) and the automated Elecsys Roche assay.

Methods: Retrospective analysis of clinical data for 3693 cycles.

Results: In women < 35 years with low (<0.6 ng/ml) and high (>1.4 ng/ml) AMH concentrations, and in those > 39 years with medium (≥0.6 and ≤1.4 ng/ml) and high AMH concentrations the clinical pregnancy rate differed significantly among groups of patients whose AMH level was measured with different kits. In those subgroups, the highest rates were recorded for the BC II IVD and Ansh groups, while the lowest in the IOT group. AMH concentrations differed significantly between different kits in all age groups (the highest in each age group was for the IOT kit and the lowest for BC II IVD). AMH correlates positively with antral follicle count, MII and number of oocytes retrieved.

Conclusions: This study demonstrated that we could expect very different pregnancy rates with the same AMH results depending on the AMH kit used. That would means, different values of AMH could similarly lead to misleading clinical decisions in IVF.

Chinese abstract

目的：对比在体外受精（IVF）周期中5种不同抗苗勒氏管激素（AMH）试剂盒所测得的AMH水平差异。五种AMH试剂盒分别为IOT, RUO, IVD, Ansh和Elecsys Roche试剂盒。

方法：对3693个体外受精周期数据进行回顾性分析。

结果：不同年龄亚组中5种AMH试剂盒的检测结果表明, 在<35岁组内的低浓度（<0.6 ng/ml）和高浓度（>1.4 ng/ml）AMH水平, 和>39岁组内的中等浓度（≥0.6 and ≤1.4 ng/ml）和高浓度AMH水平差异均有统计学意义。在不同亚组中, 使用BC II IVD 和Ansh 试剂盒检测临床妊娠率最高, IOT试剂盒检测妊娠率最低。所有年龄亚组内比较5种试剂盒所测AMH浓度水平差异均具有统计学差异（每个年龄亚组中的AMH水平最高值均为IOT试剂盒, 最高值均为BC II IVD试剂盒）。AMH水平与窦卵泡数、M II期卵母细胞数及获卵数呈正相关。

结论：本研究表明即使所得AMH数值相同, 但预测的妊娠率可能会根据所使用试剂盒不同而产生差异。这意味着所得AMH值的差异可能会对IVF的相关临床选择产生一定程度的误导。

Keywords:

• AMH
• Ansh Labs ultrasensitive
• Beckman Coulter II Gen. RUO
• Elecsys Roche
• Immunotech

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.