title: Anti-Müllerian hormone and inhibin B variability during normal menstrual cycles.
abstract: OBJECTIVE
  To describe anti-Müllerian hormone (AMH) variation across normal menstrual cycles.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Academic environment.
  
  
  METHODS
  Twenty regularly menstruating women.
  
  
  METHODS
  Serum AMH and inhibin B assayed daily during one normal menstrual cycle.
  
  
  METHODS
  Intracycle variability of AMH and inhibin B.
  
  
  RESULTS
  Data were classified into quartiles of AMH area-under-the-curve (AUCs). Mean AMH AUC was 15.7 ng/mL for quartile 1 versus 43.5, 80.9 and 144.9 ng/mL for quartiles 2, 3, and 4. Mean AMH levels (ng/mL) were 0.67, 1.71, 3.02, and 5.33, respectively. There was no variation in quartile 1 AMH rate of change from stochastic modeling, but in quartiles 2 to 4, there were increased rates of change in days 2 to 7. Women in quartile 1 had the lowest mean inhibin B (24.2 pg/mL vs. 44.3, 43.2, and 42.2 pg/mL), and had shorter menstrual cycles (24.6 days) than women in quartiles 3 and 4 (28.2 and 28.4 days).
  
  
  CONCLUSIONS
  There were two menstrual cycle patterns of AMH. The "aging ovary" pattern included low AMH levels with little variation, lower inhibin B, and shorter cycle lengths. The "younger ovary" pattern included higher AMH levels with significant variation days 2 to 7, suggesting that for women with AMH>1 ng/mL, the interpretation of AMH levels is contingent upon the day of the menstrual cycle on which the specimen is obtained.
authors.affiliation: Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan; Department of Obstetrics and Gynecology, School of Public Health, University of Michigan, Ann Arbor, Michigan. Electronic address: mfsowers@umich.edu.
authors.forename: MaryFran
authors.initials: M
authors.lastname: Sowers
authors.affiliation: Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan.
authors.forename: Daniel
authors.initials: D
authors.lastname: McConnell
authors.affiliation: Department of Obstetrics and Gynecology, School of Public Health, University of Michigan, Ann Arbor, Michigan.
authors.forename: Katherine
authors.initials: K
authors.lastname: Gast
authors.affiliation: Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan.
authors.forename: Huiyong
authors.initials: H
authors.lastname: Zheng
authors.affiliation: Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan.
authors.forename: Bin
authors.initials: B
authors.lastname: Nan
authors.affiliation: Department of Obstetrics and Gynecology, School of Public Health, University of Michigan, Ann Arbor, Michigan.
authors.forename: Jenifer D
authors.initials: JD
authors.lastname: McCarthy
authors.affiliation: Department of Obstetrics and Gynecology, School of Public Health, University of Michigan, Ann Arbor, Michigan.
authors.forename: John F
authors.initials: JF
authors.lastname: Randolph
mesh_terms: D000328:Adult; D000375:Aging / Q000097:blood / Q000502:physiology; D054304:Anti-Mullerian Hormone / Q000097:blood*; D019540:Area Under Curve; D015331:Cohort Studies; D005260:Female; D006262:Health; D006801:Humans; D007265:Inhibins / Q000097:blood*; D008597:Menstrual Cycle / Q000097:blood*; D015588:Observer Variation; D010053:Ovary / Q000166:cytology / Q000502:physiology; D013997:Time Factors
chemical_list: C422364:inhibin B; D007265:Inhibins; D054304:Anti-Mullerian Hormone