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Variation in the Measurement of Anti-Müllerian Hormone – What Are the Laboratory Issues?

Anti-Müllerian Hormone (AMH) is a 140 kDa homodimeric glycoprotein consisting of two identical subunits linked by disulphide bonds and is synthesised by the testes and ovaries. Its clinical applications are prediction of ovarian response and gonadotropin dose selection upon in vitro fertilization. I...

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Autores principales: Punchoo, Rivak, Bhoora, Sachin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8446602/
https://www.ncbi.nlm.nih.gov/pubmed/34539570
http://dx.doi.org/10.3389/fendo.2021.719029
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author Punchoo, Rivak
Bhoora, Sachin
author_facet Punchoo, Rivak
Bhoora, Sachin
author_sort Punchoo, Rivak
collection PubMed
description Anti-Müllerian Hormone (AMH) is a 140 kDa homodimeric glycoprotein consisting of two identical subunits linked by disulphide bonds and is synthesised by the testes and ovaries. Its clinical applications are prediction of ovarian response and gonadotropin dose selection upon in vitro fertilization. In males, AMH is used to investigate sexual developmental disorders and gonadal function. AMH is commonly assayed by enzyme-linked immunosorbent assay or automated immunoassay formats that show variation between methods. This review applies fundamental chemical pathology concepts to explain the observed analytical variation of AMH measurement. We examine the lack of standardisation between AMH assays, the impact of antibody design on variable measurements, consider the analytical detection of AMH isoforms, review analytical interference in AMH measurement, and briefly assess systematic bias between AMH assays. The improved attempt at standardising AMH measurement by the recent approval of a WHO Reference Reagent offers promise for harmonising immunoassay results and establishing consensus medical cut-off points for AMH in disease. Standardisation, however, will need to redress the issue of poor commutability of standard reference material and further assign a standard reference procedure to quantify AMH standard reference material. The improvement of the analytical phase of AMH testing will support harmonised method development and patient care.
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spelling pubmed-84466022021-09-18 Variation in the Measurement of Anti-Müllerian Hormone – What Are the Laboratory Issues? Punchoo, Rivak Bhoora, Sachin Front Endocrinol (Lausanne) Endocrinology Anti-Müllerian Hormone (AMH) is a 140 kDa homodimeric glycoprotein consisting of two identical subunits linked by disulphide bonds and is synthesised by the testes and ovaries. Its clinical applications are prediction of ovarian response and gonadotropin dose selection upon in vitro fertilization. In males, AMH is used to investigate sexual developmental disorders and gonadal function. AMH is commonly assayed by enzyme-linked immunosorbent assay or automated immunoassay formats that show variation between methods. This review applies fundamental chemical pathology concepts to explain the observed analytical variation of AMH measurement. We examine the lack of standardisation between AMH assays, the impact of antibody design on variable measurements, consider the analytical detection of AMH isoforms, review analytical interference in AMH measurement, and briefly assess systematic bias between AMH assays. The improved attempt at standardising AMH measurement by the recent approval of a WHO Reference Reagent offers promise for harmonising immunoassay results and establishing consensus medical cut-off points for AMH in disease. Standardisation, however, will need to redress the issue of poor commutability of standard reference material and further assign a standard reference procedure to quantify AMH standard reference material. The improvement of the analytical phase of AMH testing will support harmonised method development and patient care. Frontiers Media S.A. 2021-09-03 /pmc/articles/PMC8446602/ /pubmed/34539570 http://dx.doi.org/10.3389/fendo.2021.719029 Text en Copyright © 2021 Punchoo and Bhoora https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Punchoo, Rivak
Bhoora, Sachin
Variation in the Measurement of Anti-Müllerian Hormone – What Are the Laboratory Issues?
title Variation in the Measurement of Anti-Müllerian Hormone – What Are the Laboratory Issues?
title_full Variation in the Measurement of Anti-Müllerian Hormone – What Are the Laboratory Issues?
title_fullStr Variation in the Measurement of Anti-Müllerian Hormone – What Are the Laboratory Issues?
title_full_unstemmed Variation in the Measurement of Anti-Müllerian Hormone – What Are the Laboratory Issues?
title_short Variation in the Measurement of Anti-Müllerian Hormone – What Are the Laboratory Issues?
title_sort variation in the measurement of anti-müllerian hormone – what are the laboratory issues?
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8446602/
https://www.ncbi.nlm.nih.gov/pubmed/34539570
http://dx.doi.org/10.3389/fendo.2021.719029
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