AMH CORRELATION WITH ENDOGENOUS HORMONES IN FEMALES: INDIAN PERSPECTIVE

Abstract

Introduction: AMH is an indicator of functional ovarian reserve, it is used in combination with other biochemical and radiological markers in assessing fertility status in women, selecting candidates for IVF stimulation, predicting menopause, diagnosis and management of PCOS. AMH alone may be considered for a good ovarian reserve, either low or high will give an indication of primary ovarian failure or anovulatory cycles as seen in polycystic ovarian syndrome respectively. With this basic investigation all the other hormones are added on to rule out the spectrum of differential diagnosis and plan IVF treatments. Materials and methods: A retrospective observational study was conducted in 38811 female patients 18 to 45 years of age, divided into 2 groups; abnormal AMH (Group I), and normal AMH values (Group II) as per biological reference ranges for age. Group I was further sub divided into Low AMH Group Ia, and High AMH group Ib, (lower and higher than the cut off for age) respectively. FSH, LH, LH/FSH ratio, E2, Progesterone, DHEAS, Free testosterone, FT3, FT4, TSH, and fasting insulin were studied in these groups. Results: Statistical analyses were performed using “R Studio version 1.4.1103”. A two-tailed p value of <0.05 was considered statistically signicant. Kruskal Wallis test was used for comparison of continues variables (Hormones) between the groups. A chi-square categorical test shows statistical signicance of difference in values of FSH, LH, LH/FSH ratio, Free and total testosterone, progesterone, fasting insulin, DHEAS and Free T3. No statistical signicance was seen with Prolactin, TSH, Free T4, and E2. Conclusion:Variation of normal and abnormal AMH levels with endogenous hormones plays a vital role in better interpretation of AMH. FSH, LH, free testosterone, fasting insulin, Free T3, signicantly correlate in patients with Normal AMH levels.