High frequency of discordance between antimullerian hormone and follicle stimulating hormone levels in serum from estradiol confirmed days 2 to 4 of the menstrual cycle from 5354 women in US…

Frequent discordance was observed between antimullerian hormone and follicle-stimulating hormone, which increased with age in serum from 5,354 women in estradiol-confirmed cycle days 2 to 4.

Benjamin Leader, M.D., Ph.D., Aparna Hegde, M.D., Quentin Baca, Ph.D., Kimberly Stone, B.A., Benjamin Lannon, M.D., David B. Seifer, M.D., Frank Broekmans, M.D., Ph.D., Valerie L. Baker, M.D.

Volume 98, Issue 4, Pages 1037-1042, October 2012


To determine the frequency of discordance between AMH (ng/ml) and FSH (IU/L), using cut points defined by response to controlled ovarian stimulation, in the same serum sample drawn on estradiol-confirmed, menstrual cycle days 2 to 4.

Retrospective analysis.

Fertility centers in 30 US states; single reference laboratory, uniform testing protocols.

5,354 women, 20-45 years of age.


Main outcome measures:
Frequency of discordance between serum AMH and FSH values.

Of the 5,354 women tested, 1 in 5 had discordant AMH and FSH values defined as AMH<0.8 (concerning) with FSH<10 (reassuring) or AMH≥0.8 (reassuring) with FSH≥10 (concerning). Of women with reassuring FSH (n=4,469), concerning AMH values were found in 1 in 5 women in a highly age dependent fashion, ranging from 1 in 11 women under 35 years of age to 1 in 3 women above 40 years of age. On the other hand, of the women with reassuring AMH (n=3,742), 1 in 18 had concerning FSH, a frequency which did not differ significantly by age. Conclusions:
Clinical discordance in serum AMH and FSH values was frequent and age dependent using common clinical cut points, a large patient population, one reference laboratory, and uniform testing methodology. This conclusion is generalizable to women undergoing fertility evaluation, although AMH testing has not been standardized among laboratories, and the cut points presented are specific to the laboratory in this study.

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