engleski

Follicular phase sampling for anti-Müllerian hormone (AMH) measurements – a real necessity?

Background: According to the manufacturer (Beckman Coulter, USA), blood sampling for AMH measurement should be performed between the 2nd and the 4th day of the menstrual cycle. The aim of this study was to assess the possible differences in AMH concentration, relative to the phase of menstrual cycle. Materials and Methods: Blood samples were collected from 12 healthy volunteers at three phases of regular menstrual cycle (i.e. 3 samples per each subject): 1) between the 2nd and 4th day (follicular phase), 2) on 14th (ovulation) and 3) on 21st day (luteal phase) of menstrual cycle. The samples were analyzed by chemiluminescent method on DXI 600 (Beckman Coulter, USA) analyzer. The concentrations of AMH were compared by non-parametric Friedman test using MedCalc Statistical Software version 16.2.0 (MedCalc Software bvba, Ostend, Belgium), wherein P-value ˂0.05 was considered as significant. Method CV(%) was assessed in accordance to CLSI EP15-A3 guideline. Mean bias of all subjects for luteal phase and ovulation compared with follicular phase were calculated. According to Bungum et al. (Front Endocrinol, 2018) bias was considered acceptable if <3.9 pmol/L. Results: The observed precision was below 5%. Median age of the participants was 37 years (24–45). Median values (in pmol/L) across menstrual phases were as follows: 16.4 (8.9– 28.55) for follicular phase, 20.35 (11.75– 28.55) and 18.55 (8.9–26.4) for ovulatory and luteal phase, respectively. Friedman test revealed no statistically significant difference between the median AMH values across the different stages of the menstrual cycle (P=0.058). Mean biases for ovulation (-1.7, 95% Cl: -3.1 - -0.4) and luteal phase (0.2, 95% Cl: -3.5 – 3.9) were within acceptance criteria. Conclusions: These preliminary results showed no significant difference of AMH concentration analyzed during different phases of menstrual cycle. Further investigations with higher number of samples should be done to confirm our findings.

preanalytical phase, anti- Müllerian hormone (AMH), menstrual phases

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