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It is often assumed, as it was in your article, that manually performed assays are more error- and variance-prone than an automated assay. The main source of AMH variability in the older tests was not operator error, as suggested. The concerns with the older assays were well researched and debated, but unfortunately they were not adequately published.¹

We agree that AMH is not likely to be a marker of pregnancy success in non-fertile women, but it still has utility in determining reproductive health relative to ovarian reserve and menopausal status so that women can plan when to start a family. The follicle pool will be in decline over time with age until menopause. AMH is reflective of that follicle pool, and its accurate measurement is meaningful in understanding a woman’s reproductive function and health throughout her natural reproductive life, whether or not she is trying to conceive. AMH is a valuable tool to identify women with a diminished ovarian reserve. In PCOS (polycystic ovary syndrome), high serum AMH correlates strongly with a high antral follicle count. Early diagnoses or reproductive function disorders can help physicians intervene and possibly prevent or ameliorate comorbidities of diminished ovarian reserve and PCOS throughout women’s reproductive lives and after menopause.

1. Clark CA, Laskin CA, Cadesky K. Anti-Mullerian hormone: reality check. Hum Reprod. 2014;29(1):184–185.

Tony Morrison, Director, Sales and Marketing, Ansh Labs, Webster, Tex.

Geralyn Lambert Messerlian, PhD, Department of Pathology and Laboratory Medicine, Women and Infants Hospital and Alpert Medical School, Brown University, Providence, RI

Patrick Sluss, PhD, Ansh Labs, Webster, Tex., Department of Pathology, Massachusetts General Hospital
Boston

Frank Z. Stanczyk, PhD, Department of Obstetrics and Gynecology, Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles