ANTI-MÜLLERIAN Hormone (AMH) may not accurately reflect ovarian reserve in the presence of systemic inflammation, according to an abstract presented at the 2026 Annual Congress of the International Society of Gynecological Endocrinology.
Fertility Preservation in Oncology Patients
Improved cancer survival among reproductive-age women has increased the demand for fertility preservation.
However, ovarian reserve assessment in women with cancer may be affected by disease-related factors, for example, systemic inflammation.
AMH, AFC, and Ovarian Reserve
The retrospective observational study at the Assisted Reproduction Unit, University Hospital of Padua, analysed more than 330 women: 178 with breast cancer, 88 with hematologic malignancies, and 65 with other tumours.
Researchers set out to investigate whether AFC or AMH better predicts ovarian response in the relevant demographics.
Women with blood cancers were younger and had higher antral follicle count (AFC) and oocyte yield, despite similar AMH.
Researchers thus found a discrepancy between elevated follicular activity and non-elevated AMH.
It was reported that AMH may not accurately reflect ovarian reserve in the relevant population.
AMH Versus AFC
Researchers suggested that the reason why women with hematologic malignancies showed high AFC and robust controlled ovarian stimulation outcomes despite non-elevated AMH was likely due to systemic inflammation.
Inflammatory cytokines can suppress AMH secretion or accelerate its degradation, causing AMH levels to appear lower.
It follows that blood tests with AMH in women with cancer indicate values lower than the true follicular reserve.
Researchers reported that AMH might, therefore, underestimate reproductive potential in inflammatory or hematologic contexts.
Alternatively, AFC provided more reliable results in predicting controlled ovarian stimulation response.
Application in Assisted Reproduction
Researchers made the case that clinicians should interpret low AMH cautiously in patients with hematologic disease.
They encouraged healthcare professionals to integrate AFC and clinical factors in assisted reproduction counselling.
Reference
Garbin G. Predicting ovarian response in women undergoing fertility preservation: AFC vs AMH. ISGE 6 Oral Presentation. ISGE Annual Congress, 4-6 March, 2026.
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