engleski

Discordances between serum anti-Müllerian hormone values (AMH) and antral follicle count (AFC)

Background. Both AMH and AFC were found to be good markers of ovarian reserve that strongly correlate with each other. Nevertheless, discordances between these ovarian reserve tests are sometimes encountered during initial routine infertility evaluation. The objective of this study was to investigate clinical cases in which these discordances are to be expected. Methods. A total of 350 women aged 20-44 years undergoing infertility evaluation were included in the study and separated according to AFC in three groups: low (≤6), intermediate (7-20) and high (>20). Serum AMH concentration was determined using AMH Gen II ELISA. AFC was assessed by a single investigator using a two-dimensional transvaginal probe. Predicted AMH value for a given AFC (pAMH) was calculated using a regression equation (pAMH=-5.9570+1.7102xAFC). The ratio between pAMH and AMH was used as an index of discordance between AMH and AFC. AFC undercounting and overcounting was assumed if pAMH/AMH was <0.80 and >1.2, respectively. Results: The proportion of undercounted AFCs was the highest in the group with low AFC (76.9%), while intermediate group had the highest proportion of overcounted AFCs (51.3%). The similar proportions of undercounted AFCs were found in intermediate and high AFC groups (23.8% and 25.1%, respectively). Conclusion: Discordances between AMH and AFC are most expected in patients with low AFC and could be primarily attributable to AFC undercounting. This should be taken into consideration when counseling patients prior to infertility treatment.

AFC; AMH; infertility evaluation

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