Transient variation in anti-Müllerian hormone concentrations with repeat testing in a fertility clinic setting

Research question

Is it possible for a patient to have low anti-Müllerian hormone (AMH) readings that recover to normal concentrations over the space of months or 1–2 years?

Design

This was a retrospective analysis of a fertility clinic patient database. Patients with repeat blood samples were examined to determine the degree of change in AMH concentrations over time. The main analysis consisted of 1871 patients.

Results

In 42% of patients with low AMH (<1.5 pmol/l) concentrations at the time of their first blood test, values had risen above this threshold at the time of the second blood test. In blood tests taken less than 6 months apart, AMH concentrations were equally likely to increase or decrease over time. Over longer time frames, AMH concentrations were more likely to show decreases, but this effect was strongest in women over 30 years old and minimal in women under 30. Patients with values in the interquartile range were likely to show a fluctuation of less than 5 pmol/l in AMH in tests taken less than 2 years apart. However, this also shows that larger changes can be expected in a sizeable minority of patients.

Conclusions

Serum AMH in younger patients tends to fluctuate without a substantial decline over time. In older patients, values in samples taken within 6–12 months tend to fluctuate in either direction, but declines are more likely over longer time frames. This study demonstrates that a small proportion of patients will have transiently depressed AMH concentrations, but it is possible for concentrations to recover in some cases.