Age-specific serum anti-Mullerian hormone reference values for infertile Filipino women in a tertiary in vitro fertilization center in the Philippines

Virgilo M Novero Jr; Mary Liezl N Yu; Arnel D Gamilde; Rowena B Beramende; Alvin Duke R Sy

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Age-specific serum anti-Mullerian hormone reference values for infertile Filipino women in a tertiary in vitro fertilization center in the Philippines

Author: Virgilo M. Novero. Jr. ^{1
,

2} ; Mary Liezl N. Yu ¹ ; Arnel D. Gamilde ¹ ; Rowena B. Beramende ¹ ; Alvin Duke R. Sy ³
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1. Center for Advanced Reproductive Medicine and Infertility, St. Lukes Medical Center ‑ Global City, Taguig
2. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, College of Medicine and Philippine General Hospital, University of the Philippines, Manila
3. Department of Epidemiology and Biostatistics, College of Public Health, University of the Philippines, Manila
Publication Type:Journal Article
Keywords: Anti‑Mullerian hormone level; Filipino; Infertile; Reference range
MeSH: Fertilization in Vitro; Anti-Mullerian Hormone
From: Philippine Journal of Obstetrics and Gynecology 2021;45(2):68-75
CountryPhilippines
Language:English
Abstract: Background:Anti-Mullerian hormone (AMH) levels have been used as an invaluable tool in reproductive medicine for over a decade, especially in predicting ovarian reserve and follicular response during in vitro fertilization (IVF) cycles. Age-specific reference values of AMH levels have been derived from mostly Western and few Asian population groups but none from the Philippines. In this study, we attempted to determine the first age-specific AMH reference values from infertile Filipino women to be able to provide local infertility centers a guide in treating Filipinos and those with similar racial and lifestyle characteristics.
Materials and Methods:This was a retrospective cross-sectional study that was conducted at the Center for Advanced Reproductive Medicine and Infertility at St. Luke's Medical Center Global City. Age, serum AMH levels, body mass index (BMI), and cause of infertility of Filipino women who underwent IVF from August 2015 to March 2020 were taken. AMH was assayed using the automated Access AMH Immunoassay (Beckman Coulter).
Results:A total of 1463 women who underwent IVF and with valid AMH results were initially found but only 1233 were included in the study. Mean age was 36.67 + 4.35 years and mean BMI was 24.43 + 4.14 kg/m2. There was minimal effect of BMI on AMH levels and increasing age (R2 = 0.0068), but there were significant differences of mean AMH levels among the general causes of infertility. The mean and median AMH values decreased with advancing age (R2 = 0.1391) although the mean values were consistently higher than the median values. The mean level of the AMH was 2.32 ± 1.90 ng/mL with a 0.16 ng/ml (confidence interval: 0.14–0.19 ng/ml) level decrease per year of increase in age. By age category, the following were the derived AMH values (ng/ml) at the 25th to 75th percentiles: 25–29 = 1.52–4.92; 30–34 = 1.60–4.10; 35–39 = 0.95–3.13; 40–44 = 0.44–1.99; 45 = 0.47–1.08. The mean AMH in this study appears to be similar to several but lower than most other reported AMH nomograms from other population groups.
Conclusion:The first age-specific AMH reference values for infertile Filipino women are presented and may serve as a useful diagnostic marker in local infertility centers, especially those treating Filipino patients or others with similar characteristics.
Full text:PhilippJObstetGynecol45268-2209473_060814.pdf