Changes in serum antimüllerian hormone levels across the ovulatory menstrual cycle in late reproductive age.

OBJECTIVE

The aim of this study was to assess the pattern of serum antimüllerian hormone (AMH) across the normal ovulatory menstrual cycle in women in late reproductive age when ovarian follicle reserve and, hence, serum AMH levels are reduced.

METHODS

Serum AMH levels were determined by enzyme-linked immunosorbent assay across the ovulatory menstrual cycle from women in mid (n = 18) and late (n = 43) reproductive life, including the menopausal transition.

RESULT

: No intracycle variation in AMH level was observed in women in mid reproductive life nor in 33% (n = 14) of women with normal ovulatory cycles in late reproductive age. In the remaining cycles, a significant 2-fold decrease (P < 0.01) in AMH in 11 cycles and a significant 4.2-fold increase (P < 0.01) in 10 cycles were observed between the follicular and luteal phases. In a further eight ovulatory cycles, AMH was below the level of assay detection. As ovarian follicle reserve decreases with age and AMH levels are reduced, separate patterns of AMH are detected in the follicular and luteal phases of ovulatory menstrual cycles, presumably reflecting the intermittent pattern of the emergence of follicles close to menopause.

CONCLUSIONS

It is concluded that when AMH levels are substantially reduced, as in late reproductive age, they become less reliable as markers of ovarian reserve because of the changing patterns observed in some cycles.