OR19-2 Serum Anti-Müllerian Hormone Variation Throughout the Menstrual Cycle in Healthy Regularly Menstruating Young Women

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: OR19-Female Reproductive Endocrinology
Clinical
Sunday, June 16, 2013: 11:15 AM-12:45 PM
Presentation Start Time: 11:30 AM
Room 102 (Moscone Center)
Kerri Ann Kissell*1, Michelle Danaher1, Enrique Schisterman1, Neil Perkins1, Karen Schliep1, Katherine Ahrens1, Lindsey George Sjaarda1, Jean Wactawski-Wende2 and Sunni Mumford1
1NIH/NICHD, Bethesda, MD, 2University at Buffalo, SUNY, Buffalo, NY
Serum anti-Müllerian hormone (AMH), a well-established marker of ovarian reserve, is considered by many experts to be the only biomarker that does not vary throughout the menstrual cycle, as it reflects continuous, non-cyclic growth of small follicles in the ovary. We evaluated AMH variation across the menstrual cycle in 259 healthy premenopausal women aged 18-44 years from Buffalo, New York (2005-2007).  Menstrual cycles (n=509) were timed by ovulation prediction kits and serum samples were collected up to 8 times/cycle during  menses, mid-follicular phase, three samples during peri-ovulation and three samples throughout the luteal phase.  Repeated measures analysis of variance was used on log-transformed AMH concentrations.  Age-adjusted geometric mean AMH levels varied significantly across the menstrual cycle (P<0.001) with peak levels observed during the mid-follicular phase at 2.11 ng/mL (95% Confidence Interval [CI]: 1.85, 2.41), a nadir occurring around the time of ovulation at 1.84 ng/mL (95% [CI]: 1.61, 2.10), and increasing at late luteal phase to 1.97 ng/mL (95% [CI]: 1.73, 2.25); (mid-follicular vs ovulation: p<0.001; ovulation vs late luteal: p = 0.007; mid-follicular vs late luteal: p = 0.008). This pattern was observed across all age groups with decreased variability observed among women >35 years. The mean ± SE change within an individual woman throughout the cycle was 1.7 ± 0.1 ng/mL for women ≤20, and 0.6 ± 0.1 ng/mL for women >35 years. This study challenges existing evidence that AMH levels are consistent across the menstrual cycle and suggests that AMH measurements among premenopausal women should be timed to menstrual cycle phase.

Nothing to Disclose: KAK, MD, ES, NP, KS, KA, LGS, JW, SM

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