The Atellica IM immunoassay for anti-mullerian hormone (AMH) is widely used in fertility studies to assess ovarian reserve, which declines with age. Manufacturer-provided reference limits are partitioned in 5-year intervals, but these may be suboptimal due to rapid changes in AMH levels and statistical limitations. This study aimed to derive improved, indirect reference intervals. After excluding duplicate and hospital-based results, 48,437 AMH results from women (January 2015–November 2025) were analysed. The transition from Beckman Access to Siemens Atellica in September 2024 did not significantly affect results, though Roche assays were found to be 20–25% lower. Using GoCrunch RefLiand log transformation, reference limits were established for each year of age between 25 and 45. The limits showed strong linear correlation with age (R 2 > 0.95): upper reference limit (URL) = 229 – 4.15 × Age, lower reference limit (LRL) = 21.2 – 0.484 × Age, with annual declines <10%. RefLimR-derived limits provided more stable flag rates compared to kit inserts. One-year partitions reduced variability, supporting the use of age-specific AMH intervals that reflect physiological changes more accurately than broader partitions.
Sikaris et al. (Sun,) studied this question.