title: Fluctuations in anti-Müllerian hormone levels throughout the menstrual cycle parallel fluctuations in the antral follicle count: a cohort study.
abstract: In this prospective cohort study we aimed to investigate the hypothesis that fluctuations in anti-Müllerian hormone levels stem from fluctuations in the number of antral follicles.
  
  
  
  Repeated measurements of anti-Müllerian hormone and antral follicles (follicles 2-8 mm) were performed in 44 women with a regular cycle, during one menstrual cycle. If our hypothesis that anti-Müllerian hormone fluctuations stem from fluctuations in the antral follicles is correct, a fluctuation in the antral follicles would result in an equal and parallel shift in anti-Müllerian hormone. Hence, the difference between antral follicles and anti-Müllerian hormone would remain constant over time. A mixed model analysis, assessing the stability between anti-Müllerian hormone and antral follicles, was performed using the difference between log antral follicles and log anti-Müllerian hormone. Cohen's D was calculated for the largest of fixed effects in order to assess stability in relative distance between antral follicles and anti-Müllerian hormone. To assess if fluctuation in anti-Müllerian hormone or antral follicles originated from between-subject fluctuation, or from within subject fluctuation, the intra-class correlation coefficient was calculated.
  
  
  
  Mixed model analysis and Cohen's D (0.12) confirmed the stability of the difference between log antral follicles and log anti-Müllerian hormone and so confirmed our hypothesis. The good intra-class correlation coefficient (0.73) indicated a small contribution of within-subject variation to anti-Müllerian hormone fluctuations.
  
  
  
  Fluctuations in anti-Müllerian hormone levels parallel fluctuations in antral follicles, suggesting that anti-Müllerian hormone levels are closely linked to variation in the antral follicles. This knowledge adds to the basic understanding of the origin of anti-Müllerian hormone and could aid in interpretation of individual anti-Müllerian hormone levels.
authors.affiliation: Department of Reproductive Medicine & Gynecology, University Medical Center, Utrecht, the Netherlands.
authors.forename: Martine
authors.identifier: 0000-0001-6520-6980
authors.initials: M
authors.lastname: Depmann
authors.affiliation: Department of Reproductive Medicine & Gynecology, University Medical Center, Utrecht, the Netherlands.
authors.forename: Jeroen
authors.identifier: 0000-0001-9053-5022
authors.initials: J
authors.lastname: van Disseldorp
authors.affiliation: Department of Reproductive Medicine & Gynecology, University Medical Center, Utrecht, the Netherlands.
authors.forename: Simone L
authors.identifier: 0000-0002-7699-0931
authors.initials: SL
authors.lastname: Broer
authors.affiliation: Department of Biostatistics and Research Support, Julius Center for Health Sciences and Primary Care, Utrecht, the Netherlands.
authors.forename: Marinus J C
authors.identifier: 0000-0001-9400-0615
authors.initials: MJ
authors.lastname: Eijkemans
authors.affiliation: Department of Obstetrics & Gynecology, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Joop S E
authors.identifier: 0000-0002-5444-9845
authors.initials: JS
authors.lastname: Laven
authors.affiliation: Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Jenny A
authors.identifier: 0000-0001-7182-3571
authors.initials: JA
authors.lastname: Visser
authors.affiliation: Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands.|Department of Clinical Chemistry, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Yolanda B
authors.identifier: 0000-0001-7759-4968
authors.initials: YB
authors.lastname: de Rijke
authors.affiliation: School of Paediatrics and Reproductive Health, The Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Ben W
authors.identifier: 0000-0001-8337-550X
authors.initials: BW
authors.lastname: Mol
authors.affiliation: Department of Reproductive Medicine & Gynecology, University Medical Center, Utrecht, the Netherlands.
authors.forename: Frank J M
authors.identifier: 0000-0003-1366-2727
authors.initials: FJ
authors.lastname: Broekmans
mesh_terms: D054304:Anti-Mullerian Hormone; D005260:Female; D005640:Follicle Stimulating Hormone; D006801:Humans; D008597:Menstrual Cycle; D006080:Ovarian Follicle; D011446:Prospective Studies
chemical_list: D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone
keywords: Anti-Müllerian hormone; antral follicle count; fluctuation