Received July 04, 2022
Accepted November 12, 2022

Although numerous biomarkers have been identified as predictors of ovarian response, measurement of circulating anti-mullerian hormone (AMH) is widely employed to predict ovarian response and determine the dosing algorithm of in vitro fertilization treatment, particularly the ability to react to exogenous gonadotropins.Immunological methods are mostly preferred for AMH measurement. Currently, since no reference standard material has been developed for AMH measurement, immunoassays are calibrated by independent manufacturer calibrators, which increases the variation between different methods. Between-method bias values were reported as -25.2% to -9% at 1 ng/mL concentration and 34% to 45% at 5 ng/mL concentration in a study comparing AMH results from different immunoassays. Since the comparability of results by the clinician decreases as the variation between methods increases, standardization of immunological methods is important for appropriate follow-up of patients from different clinics. The difference between the two automated analyzers, Roche Elecsys and Beckman Coulter Access assay, was found to result in 29% of women being classified with an incorrect follitropin delta dose. Distribution of the same International Reference Reagents for accurate calibration of AMH is one step to be taken. Standardization of analyte-specific antibodies is another crucial step for more comparable AMH results. The establishment of working groups including clinicians and laboratory professionals might improve the between-method agreement. Clinicians' awareness of these preanalytical variables impacting test findings and the upcoming implementation of new standardized standards may lead to a more precise interpretation.