Fluctuations in anti-Müllerian hormone levels throughout the menstrual cycle parallel fluctuations in the antral follicle count: a cohort study

Introduction: In this prospective cohort study we aimed to investigate the hypothesis that fluctuations in anti-Müllerian hormone levels stem from fluctuations in the number of antral follicles. Material and methods: Repeated measurements of anti-Müllerian hormone and antral follicles (follicles 2–8 mm) were performed in 44 women with a regular cycle, during one menstrual cycle. If our hypothesis that anti-Müllerian hormone fluctuations stem from fluctuations in the antral follicles is correct, a fluctuation in the antral follicles would result in an equal and parallel shift in anti-Müllerian hormone. Hence, the difference between antral follicles and anti-Müllerian hormone would remain constant over time. A mixed model analysis, assessing the stability between anti-Müllerian hormone and antral follicles, was performed using the difference between logantral follicles and loganti-Müllerian hormone. Cohen's D was calculated for the largest of fixed effects in order to assess stability in relative distance between antral follicles and anti-Müllerian hormone. To assess if fluctuation in anti-Müllerian hormone or antral follicles originated from between-subject fluctuation, or from within subject fluctuation, the intra-class correlation coefficient was calculated. Results: Mixed model analysis and Cohen's D (0.12) confirmed the stability of the difference between logantral follicles and loganti-Müllerian hormone and so confirmed our hypothesis. The good intra-class correlation coefficient (0.73) indicated a small contribution of within-subject variation to anti-Müllerian hormone fluctuations. Conclusions: Fluctuations in anti-Müllerian hormone levels parallel fluctuations in antral follicles, suggesting that anti-Müllerian hormone levels are closely linked to variation in the antral follicles. This knowledge adds to the basic understanding of the origin of anti-Müllerian hormone and could aid in interpretation of individual anti-Müllerian hormone levels.

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