Alkaline phosphatase, hemoglobin and hematocrit, and creatinine may vary depending on the patient's current sex hormone configuration. Several factors contribute to these differences, bone mass, muscle mass, number of myocytes, presence or lack of menstruation, and erythropoetic effect of testosterone. Many transgender men do not menstruate, and those with male-range testosterone levels will experience an erythropoetic effect. As such an amenorrheic transgender man taking testosterone, registered as female and with hemoglobin/hematocrit in the range between the male and female lower limits of normal, may be considered to have anemia, even though the lab report may not indicate so. Conversely, the lack of menstruation, and presence of exogenous testosterone make it reasonable to use the male-range upper limit of normal for hemoglobin/hematocrit. Using the male-range upper limit of normal for alkaline phosphatase and creatinine may also be appropriate for transgender men due to increased bone and muscle mass, respectively. In these cases the provider should reference the male normal ranges for their lab.
Although anti-mullerian hormone (AMH) levels appears to be associated with declining ovarian function, there is no consensus on the appropriate threshold value. An assessment by the Institute for Clinical and Health Policy (Pichon-Riviere, et al., 2009) found no clear evidence on the usefulness of AMH in the assisted reproduction program clinical practice setting. The assessment found less evidence for the utility of AMH in other clinical practice settings. Guidelines from the American Society for Reproductive Medicine (2012) concluded "There is mounting evidence to support the use of AMH as a screening test for poor ovarian response, but more data are needed. There is emerging evidence to suggest that a low AMH level (., undetectable AMH) has high specificity as a screen for poor ovarian response but insufficient evidence to suggest its use to screen for failure to conceive."
One study using MCF-7 breast cancer cells (a cell line responsive to estrogen) noted that Maca at -100ug/mL was able to induce proliferation and induced notable estrogenicity at 100-200ug/mL concentration, but was less potent than physiological concentrations of estrogen;  the potency was comparable to that of Silymarin from Milk Thistle .  Estrogenic effects have been seen in vivo when ovariectomized rats were given /kg ethanolic extract of Maca (equivalent to /kg root extract), where the measured uterine weight after 28 weeks was % of ovariectomized control but % that of non-menopausal control.  Another study using a lower dose of three variants of Maca for 4 weeks failed to establish estrogenic effects,  and estrogenic effects have also failed to be observed in other in vitro assays.