title: Anti-Mullerian-Hormone during pregnancy and peripartum using the new Beckman Coulter AMH Gen II Assay.
abstract: BACKGROUND
  AMH levels determined by the conventional AMH assay declined during pregnancy and postpartum. A new Beckman Coulter AMH Gen II assay removes the potentially assay-interfering complement which is activated in pregnancy. The aim of this study was to evaluate if the decline of AMH levels in the serum of pregnant women during the course of pregnancy and peripartum was assay-dependent and thus artificial.
  
  
  METHODS
  In this cross-sectional study prepartal blood samples were collected from 62 patients (median age 30.6 years [interquartile range: 25.6 - 34.5]) in the third trimester of pregnancy and again 1-4 days after delivery between 2011 and 2012. In another cohort of 11 patients (median age 34.1 years [interquartile range: 32.6 - 37.8]) blood samples were taken in different trimesters of pregnancy between 1995 and 2001. The conventional and the modified AMH assay were performed in the same patient serum samples. We used the conventional and the modified AMH-Gen-II ELISA (Beckman Coulter, Immunotech, Webster, USA) for the assessment of AMH levels. The Wilcoxon signed rank test was used for determining differences between AMH levels pre- and postpartum. The method of Bland and Altman was applied for analyzing the agreement of both methods for determining AMH levels.
  
  
  RESULTS
  AMH values peripartum were lower than those expected in fertile non-pregnant women of comparable age. An overall mean difference of 0.44 ng/ml was observed between the conventional and the modified assay. Measurements with the modified assay showed a significant decline of postpartal levels compared with prepartal levels which is consistent with values obtained using the conventional assay (both p < 0.00001). Compared to the longitudinal measurements of AMH levels determined using the conventional assay, AMH levels obtained using the modified assay suggest a steeper decline of values during the course of pregnancy.
  
  
  CONCLUSIONS
  By comparing the conventional assay for AMH determination with the modified assay the present study confirmed that AMH levels decline during the course of pregnancy and early after delivery.
authors.affiliation: Department of Gynecology and Obstetrics, University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany. angela.koeninger@uk-essen.de.
authors.forename: A
authors.initials: A
authors.lastname: Köninger
authors.affiliation: Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany. boerge.schmidt@uk-essen.de.
authors.forename: B
authors.initials: B
authors.lastname: Schmidt
authors.affiliation: Department of Gynecology and Obstetrics, University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany. pawel.mach@uk-essen.de.
authors.forename: P
authors.initials: P
authors.lastname: Mach
authors.affiliation: Department of Gynecology and Obstetrics, University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany. dani6385@yahoo.de.
authors.forename: D
authors.initials: D
authors.lastname: Damaske
authors.affiliation: Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany. stefanie.niessen@uk-essen.de.
authors.forename: S
authors.initials: S
authors.lastname: Nießen
authors.affiliation: Department of Gynecology and Obstetrics, University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany. rainer.kimmig@uk-essen.de.
authors.forename: R
authors.initials: R
authors.lastname: Kimmig
authors.affiliation: Department of Gynecological Endocrinology and Reproductive Medicine, University of Heidelberg, Voßstrasse 9, 69115, Heidelberg, Germany. Thomas.Strowitzki@med.uni-heidelberg.de.|Department of Gynecology and Obstetrics, University of Heidelberg, Voßstrasse 9, 69115, Heidelberg, Germany. Thomas.Strowitzki@med.uni-heidelberg.de.
authors.forename: T
authors.initials: T
authors.lastname: Strowitzki
authors.affiliation: Department of Gynecology and Obstetrics, University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany. alexandra.gellhaus@uk-essen.de.
authors.forename: A
authors.initials: A
authors.lastname: Gellhaus
mesh_terms: D000293:Adolescent; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D005260:Female; D006801:Humans; D058725:Peripartum Period / Q000097:blood*; D011247:Pregnancy; D011263:Pregnancy Trimester, Third / Q000097:blood*; D055815:Young Adult
chemical_list: D054304:Anti-Mullerian Hormone