8303 Analysis of Over 2.2 Million Anti-Mullerian Hormone Patient Results Across Lifespan From Birth to Over 80 Years Using a Lab Developed Chemiluminescent Immunoassay

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Abstract Disclosure: C. Cheng: None. D. Alfego: None. K.Y. Chun: None. Introduction: Anti-Mullerian hormone (AMH) is a glycoprotein produced by granulosa cells of the ovarian follicle in females and by Sertoli cells of the testes in males. AMH is best known to correlate with ovarian reserve in females. As such, AMH is among the most frequently ordered tests in reproductive age females. The clinical utility of AMH beyond ovarian reserve assessment, especially in males, pediatric and postmenopausal populations, is less commonly examined. As a national reference laboratory that serves approximately 50% of providers across the country, our large database provides an opportunity to examine the clinical utility of AMH testing in other areas of health besides fertility. Objective: To examine AMH test utilization across lifespan of males and females in the US. Methods: Retrospective AMH tests performed at Labcorp® endocrine specialty lab from year 2012 to 2023 of 2,229,845 female patients and 10,362 male patients have been analyzed. Patients with unspecified sex were excluded. Serum AMH levels from birth to 80 plus years for males vs females were compared. For clinical utility assessments, female results are separated into four age groups: pediatric (age 0-17), adult (age 18-39), perimenopausal (age 40-59), and postmenopausal (age >60), and males into pediatric (age 0-17), adult (age 18-59), and older adult (age >60). ICD-10 codes associated with testing order were reviewed for each subgroup based on age and sex Results: In postmenopausal females, AMH is most frequently ordered for evaluation of ovarian cancer, whereas menstrual disorders and PCOS make up the most frequent clinical entities associated with AMH orders in females <18 years. Fertility testing is the most common ICD-10 associated with AMH orders, particularly in reproductive age and perimenopausal females. The most common ICD-10s associated with AMH in pediatric males include delayed puberty, hypoplasia of penis, and childhood short stature. In the adult and older adult male groups, AMH is surprisingly found to also most commonly associate with fertility testing and hypogonadism, although the clinical significance of post pubertal AMH is less defined. Conclusion: AMH testing has most often been used for female fertility testing, but our data show that significant fraction (10-20%) of AMH testing is used to evaluate and manage other suspected endocrine disorders and malignancies including intersex conditions at birth, pubertal development disorder, polycystic ovarian syndrome, male gonadal disfunction at all ages and granulosa cell tumors. Analysis of our large database underscores a need for clinical study to better define AMH levels that are relevant for non-fertility-related conditions. Presentation: 6/2/2024