Impact of Pre-Mixing AMH Serum Samples with Standard Assay Buffer: Ovarian Reserve Estimations and Implications for Clinical IVF Providers

Purpose: Recognizing the key role of AMH testing in shaping the medication and dosing protocols for IVF patients, our study aimed to characterize two common AMH testing platforms and compare the results from each. Methods: Standard AMH assay (no buffer) measurements were performed on the AMH Beckman Coulter Gen II device as controls, and samples (n=85) were run in parallel on the same equipment using the manufacturer’s buffer pre-mix of bovine serum albumin with ProClin and Sodium azide as preservatives. Standard vs.modified (pre-mixed/ buffered) assay techniques were also compared retrospectively by using archived serum samples (n=214) obtained at our clinic. Results: Comparison of these two AMH measurement protocols revealed a mean increase in reported values of 39% (range -7 to +300%) using the latter technique, compared to standard assay method. Moreover, interassay variance (standard vs. modified AMH protocol) ranged from -7% to +300%. A retrospective analysis of archived samples found the modified assay method yielded median AMH values 41% higher than results reported by standard assay. Conclusion: While AMH has become increasingly utilized to estimate ovarian reserve, remarkable variation in AMH levels can be reported based on assay techniques. When comparing the standard (non-buffered) AMH assay to the pre-mix/buffered AMH assay, this study provides compelling evidence that the latter testing method will return a significantly elevated value. Clinicians should be aware of these differences and interpret serum AMH measurements carefully, particularly AMH data reported by laboratories using different assay methodologies.


Kevin D Marron, E Scott Sills, Paul L Cummins, Connor Harrity, David J Walsh and Anthony PH Walsh

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