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Review
. 2020 Dec 9:11:606744.
doi: 10.3389/fendo.2020.606744. eCollection 2020.

Clinical Application of AMH Measurement in Assisted Reproduction

Hang Wun Raymond Li  1 , Scott M Nelson  2   3   4
Affiliations
Review

Clinical Application of AMH Measurement in Assisted Reproduction

Hang Wun Raymond Li et al. Front Endocrinol (Lausanne). .

Abstract

Anti-Müllerian hormone reflects the continuum of the functional ovarian reserve, and as such can predict ovarian response to gonadotropin stimulation and be used to individualize treatment pathways to improve efficacy and safety. However, consistent with other biomarkers and age-based prediction models it has limited ability to predict live birth and should not be used to refuse treatment, but rather to inform counselling and shared decision making. The use of absolute clinical thresholds to stratify patient phenotypes, assess discordance and individualize treatment protocols in non-validated algorithms combined with the lack of standardization of assays may result in inappropriate classification and sub-optimal clinical decision making. We propose that holistic baseline phenotyping, incorporating antral follicle count and other patient characteristics is critical. Treatment decisions driven by validated algorithms that use ovarian reserve biomarkers as continuous measures, reducing the risk of misclassification, are likely to improve overall outcomes for our patients.

Keywords: anti-Müllerian hormone; assisted reproduction; gonadotropin dosing; in vitro fertilization; intrauterine insemination; ovarian response.

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Conflict of interest statement

SN reports personal fees from Access Fertility, personal fees and non-financial support from Ferring, personal fees and non-financial support from Merck, personal fees from Coopers Genomics, personal fees and non-financial support from Ferring Pharmaceuticals, personal fees from The Fertility Partnership, grants, personal fees and non-financial support from Roche Diagnostics, personal fees from Modern Fertility, other from Delivery I, outside the submitted work. The remaining author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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