D Table 88 Evidence profile table for the analytical validity of AMH testing for girls or women undergoing gonadotoxic treatment No. of participants, Risk of Other Results for Analytical Outcome Inconsistency Indirectness Results for AMH testing Importance no. of studies and bias comparator test validity study design QoE Analytical n=30 0 NA -1 -1 No There was a 40-fold difference NA Important ⨁⨀⨀⨀ validity of AMH in level of detectable AMH k=1 Low risk No evidence Only Very low (to know if tests compared between the two AMH tests. of bias of incremental one quality different Case series with clinical Predictably, more samples had value of AMH small AMH assays reference undetectable levels with the was provided study are standard less sensitive EIA AMH/MIS comparable) assay (53 samples) compared with the pico-AMH ELISA (33 samples). AUC of AMH to n=56 0 NA -1 -1 No AUC of AMH ≤ 25 pg/ml was Comparator AUCs: Not important ⨁⨀⨀⨀ discriminate 0.71 (unknown k=1 Low risk No evidence Only AFC (total 2–10 mm) Very low between women how to use of bias of incremental one <1: 0.82 quality Case series with and without this evidence value of AMH small FSH ≥40IU/L: 0.72 menses in clinical was provided study Inhibin B ≤5 pg/ml: 0.63 practice) AFC <1 + AMH ≤25 pg/ml: 0.87 AFC <1 + FSH ≥40IU/L: 0.87 AMH ≤25 pg/ml + FSH ≥40IU/L: 0.74 Sensitivity of n=56 0 NA -1 -1 No Sensitivity AMH ≤ 25 pg/mL Sensitivities Not important ⨁⨀⨀⨀ AMH compared 76%. comparators: (unknown k=1 Low risk No evidence Only Very low to other ovarian how to use of bias of incremental one AFC (total 2–10 mm) < quality Case series reserve tests in this evidence value of AMH small 1: 79% distinguishing in clinical was provided study,
D Table 88 Evidence profile table for the analytical validity of AMH testing for girls or women undergoing gonadotoxic treatment Outcome No. of participants, no. of studies and study design Risk of bias Inconsistency Indirectness Other Results for AMH testing Results for comparator test Analytical validity QoE Importance Analytical validity of AMH tests compared with clinical reference standard n=30 k=1 Case series 0 Low risk of bias NA -1 No evidence of incremental value of AMH was provided -1 Only one small study No There was a 40-fold difference in level of detectable AMH between the two AMH tests. Predictably, more samples had undetectable levels with the less sensitive EIA AMH/MIS assay (53 samples) compared with the pico-AMH ELISA (33 samples). NA ⨁⨀⨀⨀ Very low quality Important (to know if different AMH assays are comparable) AUC of AMH to discriminate between women with and without menses n=56 k=1 Case series 0 Low risk of bias NA -1 No evidence of incremental value of AMH was provided -1 Only one small study No AUC of AMH ≤ 25 pg/ml was 0.71 Comparator AUCs: AFC (total 2–10 mm) <1: 0.82 FSH ≥40IU/L: 0.72 Inhibin B ≤5 pg/ml: 0.63 AFC <1 + AMH ≤25 pg/ml: 0.87 AFC <1 + FSH ≥40IU/L: 0.87 AMH ≤25 pg/ml + FSH ≥40IU/L: 0.74 ⨁⨀⨀⨀ Very low quality Not important (unknown how to use this evidence in clinical practice) Sensitivity of AMH compared to other ovarian reserve tests in distinguishing n=56 k=1 Case series 0 Low risk of bias NA -1 No evidence of incremental value of AMH was provided -1 Only one small study, No Sensitivity AMH ≤ 25 pg/mL 76%. Sensitivities comparators: AFC (total 2–10 mm) < 1: 79% ⨁⨀⨀⨀ Very low quality Not important (unknown how to use this evidence in clinical
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