Is the understanding of AMH being confounded by study designs that do not adequately reflect that it is an atypical hormone?

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Abstract
Anti-Müllerian hormone (AMH) is an atypical hormone, as its circulating levels are predominantly determined by size of the endocrine gland (i.e. number and type of ovarian follicles). Thus, ovarian reserve is the dominant influence on circulating levels of AMH, accounting for 55~75% of the variance in this hormone in premenopausal women ( Fanchin et al., 2003; Hansen et al., 2011; Bentzen et al., 2013). The lesser determinants of AMH levels are incompletely known, and are the subject of current controversy, arising from differences in methodology. When studies involve repeated measurement from the same individual, then circulating AMH levels appear to be influenced by the ovarian cycle ( Hadlow et al., 2013), pregnancy ( Nelson et al., 2010; Koninger et al., 2013; Hamilton et al., 2016; Pankhurst et al., 2016b) and vitamin D status ( Dennis et al., 2012). In contrast, when the study group involves either a single AMH value per women or averaged AMH values from multiple women, variable conclusions have been reached, with negative findings being commonly reported for pregnancy ( La Marca et al., 2005; Lutterodt et al., 2009) and vitamin D status, both previously ( Chang et al., 2014; Pearce et al., 2015; Neville et al., 2016) and now ( Drakopoulos et al., 2016) in this issue. In some instances, the negative results generated are false, leading to controversy within the literature. This commentary discusses the circumstances when methodological issues arise in AMH research and gives examples of robust, efficient alternative methodologies.
Funding Information
  • The Health Research Council, New Zealand (14/441)

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