Quantifying the intraindividual variation of antimüllerian hormone in the ovarian cycle

Narelle Hadlow, S.J. Brown, A. Habib, R. Wardrop, J. Joseph, M. Gillett, R. Maguire, J. Conradie

    Research output: Contribution to journalArticle

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    Abstract

    © 2016Objective To quantify intraindividual variability of antimüllerian hormone (AMH) as analytical and biological coefficients of variation and assess the effects of variation on clinical classification. Design Retrospective cohort study. Setting Not applicable. Patient(s) Thirty-eight women referred by general practitioners. Intervention(s) None. Main Outcome Measure(s) Total intraindividual variability (CVW), analytical (CVA) and biological variability (CVI) for each woman and for AMH ranges: low (10–30) and high (>30 pmol/L), with calculation of proportion of women crossing clinical cutoffs and expected variability around each cutoff. Result(s) Cycling women (n = 38) contributed 238 blood samples (average 6 samples each). The average total intraindividual AMH variability was 20% (range: 2.1% to 73%). Biological variation was 19% (range: 0 to 71%) and at least twice the analytical variation of 6.9% (range: 4.5% to 16%). Reclassification rates were highest in women with low (33%) or reduced AMH (67%) levels. Expected variations around the 5, 10, and 30 pmol/L cutoffs were 3–7, 7–13, and 20–40 pmol/L, respectively. In a woman with mean AMH in the 10–30 pmol/L range, the span of results that could occur was 7–40 pmol/L. Conclusion(s) Total variation in AMH was 20%, and the majority of this was biological. Changes in AMH resulted in reclassification in 29% of women and occurred most frequently in those with low and reduced AMH. In cycling women, the variability in AMH should be considered by clinicians, especially if a result is close to a clinical cutoff.
    Original languageEnglish
    Pages (from-to)1230-1237
    JournalFertility and Sterility
    Volume106
    Issue number5
    DOIs
    Publication statusPublished - 2016

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    Menstrual Cycle
    Hormones
    General Practitioners
    Cohort Studies
    Retrospective Studies
    Outcome Assessment (Health Care)

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    Hadlow, N., Brown, S. J., Habib, A., Wardrop, R., Joseph, J., Gillett, M., ... Conradie, J. (2016). Quantifying the intraindividual variation of antimüllerian hormone in the ovarian cycle. Fertility and Sterility, 106(5), 1230-1237. https://doi.org/10.1016/j.fertnstert.2016.06.009
    Hadlow, Narelle ; Brown, S.J. ; Habib, A. ; Wardrop, R. ; Joseph, J. ; Gillett, M. ; Maguire, R. ; Conradie, J. / Quantifying the intraindividual variation of antimüllerian hormone in the ovarian cycle. In: Fertility and Sterility. 2016 ; Vol. 106, No. 5. pp. 1230-1237.
    @article{6fbd0f3671934323a827c849c6260c41,
    title = "Quantifying the intraindividual variation of antim{\"u}llerian hormone in the ovarian cycle",
    abstract = "{\circledC} 2016Objective To quantify intraindividual variability of antim{\"u}llerian hormone (AMH) as analytical and biological coefficients of variation and assess the effects of variation on clinical classification. Design Retrospective cohort study. Setting Not applicable. Patient(s) Thirty-eight women referred by general practitioners. Intervention(s) None. Main Outcome Measure(s) Total intraindividual variability (CVW), analytical (CVA) and biological variability (CVI) for each woman and for AMH ranges: low (10–30) and high (>30 pmol/L), with calculation of proportion of women crossing clinical cutoffs and expected variability around each cutoff. Result(s) Cycling women (n = 38) contributed 238 blood samples (average 6 samples each). The average total intraindividual AMH variability was 20{\%} (range: 2.1{\%} to 73{\%}). Biological variation was 19{\%} (range: 0 to 71{\%}) and at least twice the analytical variation of 6.9{\%} (range: 4.5{\%} to 16{\%}). Reclassification rates were highest in women with low (33{\%}) or reduced AMH (67{\%}) levels. Expected variations around the 5, 10, and 30 pmol/L cutoffs were 3–7, 7–13, and 20–40 pmol/L, respectively. In a woman with mean AMH in the 10–30 pmol/L range, the span of results that could occur was 7–40 pmol/L. Conclusion(s) Total variation in AMH was 20{\%}, and the majority of this was biological. Changes in AMH resulted in reclassification in 29{\%} of women and occurred most frequently in those with low and reduced AMH. In cycling women, the variability in AMH should be considered by clinicians, especially if a result is close to a clinical cutoff.",
    author = "Narelle Hadlow and S.J. Brown and A. Habib and R. Wardrop and J. Joseph and M. Gillett and R. Maguire and J. Conradie",
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    language = "English",
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    Hadlow, N, Brown, SJ, Habib, A, Wardrop, R, Joseph, J, Gillett, M, Maguire, R & Conradie, J 2016, 'Quantifying the intraindividual variation of antimüllerian hormone in the ovarian cycle' Fertility and Sterility, vol. 106, no. 5, pp. 1230-1237. https://doi.org/10.1016/j.fertnstert.2016.06.009

    Quantifying the intraindividual variation of antimüllerian hormone in the ovarian cycle. / Hadlow, Narelle; Brown, S.J.; Habib, A.; Wardrop, R.; Joseph, J.; Gillett, M.; Maguire, R.; Conradie, J.

    In: Fertility and Sterility, Vol. 106, No. 5, 2016, p. 1230-1237.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Quantifying the intraindividual variation of antimüllerian hormone in the ovarian cycle

    AU - Hadlow, Narelle

    AU - Brown, S.J.

    AU - Habib, A.

    AU - Wardrop, R.

    AU - Joseph, J.

    AU - Gillett, M.

    AU - Maguire, R.

    AU - Conradie, J.

    PY - 2016

    Y1 - 2016

    N2 - © 2016Objective To quantify intraindividual variability of antimüllerian hormone (AMH) as analytical and biological coefficients of variation and assess the effects of variation on clinical classification. Design Retrospective cohort study. Setting Not applicable. Patient(s) Thirty-eight women referred by general practitioners. Intervention(s) None. Main Outcome Measure(s) Total intraindividual variability (CVW), analytical (CVA) and biological variability (CVI) for each woman and for AMH ranges: low (10–30) and high (>30 pmol/L), with calculation of proportion of women crossing clinical cutoffs and expected variability around each cutoff. Result(s) Cycling women (n = 38) contributed 238 blood samples (average 6 samples each). The average total intraindividual AMH variability was 20% (range: 2.1% to 73%). Biological variation was 19% (range: 0 to 71%) and at least twice the analytical variation of 6.9% (range: 4.5% to 16%). Reclassification rates were highest in women with low (33%) or reduced AMH (67%) levels. Expected variations around the 5, 10, and 30 pmol/L cutoffs were 3–7, 7–13, and 20–40 pmol/L, respectively. In a woman with mean AMH in the 10–30 pmol/L range, the span of results that could occur was 7–40 pmol/L. Conclusion(s) Total variation in AMH was 20%, and the majority of this was biological. Changes in AMH resulted in reclassification in 29% of women and occurred most frequently in those with low and reduced AMH. In cycling women, the variability in AMH should be considered by clinicians, especially if a result is close to a clinical cutoff.

    AB - © 2016Objective To quantify intraindividual variability of antimüllerian hormone (AMH) as analytical and biological coefficients of variation and assess the effects of variation on clinical classification. Design Retrospective cohort study. Setting Not applicable. Patient(s) Thirty-eight women referred by general practitioners. Intervention(s) None. Main Outcome Measure(s) Total intraindividual variability (CVW), analytical (CVA) and biological variability (CVI) for each woman and for AMH ranges: low (10–30) and high (>30 pmol/L), with calculation of proportion of women crossing clinical cutoffs and expected variability around each cutoff. Result(s) Cycling women (n = 38) contributed 238 blood samples (average 6 samples each). The average total intraindividual AMH variability was 20% (range: 2.1% to 73%). Biological variation was 19% (range: 0 to 71%) and at least twice the analytical variation of 6.9% (range: 4.5% to 16%). Reclassification rates were highest in women with low (33%) or reduced AMH (67%) levels. Expected variations around the 5, 10, and 30 pmol/L cutoffs were 3–7, 7–13, and 20–40 pmol/L, respectively. In a woman with mean AMH in the 10–30 pmol/L range, the span of results that could occur was 7–40 pmol/L. Conclusion(s) Total variation in AMH was 20%, and the majority of this was biological. Changes in AMH resulted in reclassification in 29% of women and occurred most frequently in those with low and reduced AMH. In cycling women, the variability in AMH should be considered by clinicians, especially if a result is close to a clinical cutoff.

    U2 - 10.1016/j.fertnstert.2016.06.009

    DO - 10.1016/j.fertnstert.2016.06.009

    M3 - Article

    VL - 106

    SP - 1230

    EP - 1237

    JO - Ferility and Sterility

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    SN - 0015-0282

    IS - 5

    ER -