title: High frequency of discordance between antimüllerian hormone and follicle-stimulating hormone levels in serum from estradiol-confirmed days 2 to 4 of the menstrual cycle from 5,354 women in U.S. fertility centers.
abstract: OBJECTIVE
  To determine the frequency of clinical discordance between antimüllerian hormone (AMH, ng/mL) and follicle-stimulating hormone (FSH, IU/L) by use of cut points defined by response to controlled ovarian stimulation in the same serum samples drawn on estradiol-confirmed, menstrual cycle days 2 to 4.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  Fertility centers in 30 U.S. states and a single reference laboratory with uniform testing protocols.
  
  
  METHODS
  5,354 women, 20 to 45 years of age.
  
  
  METHODS
  None.
  
  
  METHODS
  Frequency of discordance between serum AMH and FSH values.
  
  
  RESULTS
  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 the women with reassuring FSH values (n = 4,469), the 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 values (n = 3,742), 1 in 18 had concerning FSH values, a frequency that did not vary in a statistically significant fashion 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.
authors: Clinical Research Division, ReproSource, Inc, Woburn, Massachusetts 01801, USA. leader@reprosource.com
authors: Benjamin
authors: B
authors: Leader
authors: Aparna
authors: A
authors: Hegde
authors: Quentin
authors: Q
authors: Baca
authors: Kimberly
authors: K
authors: Stone
authors: Benjamin
authors: B
authors: Lannon
authors: David B
authors: DB
authors: Seifer
authors: Frank
authors: F
authors: Broekmans
authors: Valerie L
authors: VL
authors: Baker
mesh_terms: D000328:Adult; D000367:Age Factors; D054304:Anti-Mullerian Hormone / Q000097:blood*; D002624:Chemistry, Clinical / Q000379:methods / Q000592:standards*; D004958:Estradiol / Q000097:blood*; D005260:Female; D005298:Fertility / Q000502:physiology; D043373:Follicle Stimulating Hormone, Human / Q000097:blood*; D006801:Humans; D008597:Menstrual Cycle / Q000502:physiology*; D008875:Middle Aged; D009865:Oocytes / Q000166:cytology; D010062:Ovulation Induction / Q000379:methods / Q000592:standards*; D011237:Predictive Value of Tests; D011379:Prognosis; D012015:Reference Standards; D018456:Reproductive Medicine / Q000379:methods / Q000592:standards; D012189:Retrospective Studies; D014481:United States; D055815:Young Adult
chemical_list: D043373:Follicle Stimulating Hormone, Human; D004958:Estradiol; D054304:Anti-Mullerian Hormone