Antimüllerian Hormone as a Predictor of Natural Fecundability in Women Aged 30–42 Years

Abstract

Objective To generate estimates of the association between markers of ovarian aging and natural fertility in a community sample at risk for ovarian aging. Methods Women aged 30–44 years with no history of infertility who had been trying to conceive for less than 3 months provided early-follicular phase serum and urine (N=100). Subsequently, these women kept a diary to record menstrual bleeding and intercourse and conducted standardized pregnancy testing for up to 6 months. Serum was analyzed for estradiol, follicle-stimulating hormone (FSH), antimüllerian hormone, and inhibin B. Urine was analyzed for FSH and estrone 3-glucuronide (E13G). Diary data on menstrual cycle day and patterns of intercourse were used to calculate day-specific fecundability ratios. Results Sixty-three percent of subjects conceived within 6 months. After adjusting for age, 18 women (18%) with serum antimüllerian hormone levels of 0.7 ng/ml or less had significantly reduced fecundability given intercourse on a fertile day compared to women with higher antimüllerian hormone levels (fecundability ratio 0.38, 95% CI:0.08–0.91). The day-specific fecundability for women with early-follicular phase serum FSH values greater than 10 mIU/ml compared to women with lower FSH levels was also reduced, though nonsignificantly (11% of women affected; fecundability ratio 0.44, 95% CI: 0.08, 1.10). The association with urinary FSH was weaker (27% women affected; fecundability ratio 0.61, 95% CI: 0.26, 1.26), and the associations for the other markers were weaker still. Conclusions Early-follicular phase antimüllerian hormone appears to be associated with natural fertility in the general population.

Antimüllerian Hormone Levels Are Strongly Associated With Live-Birth Rates After Assisted Reproduction

“…Thus, two different markers of ovarian reserve both seem to have an association with the qualitative aspect of the remaining oocyte pool. Also supporting this are the findings of a recent study on higher fecundability (the probability of a natural conception in a menstrual cycle) among women with high AMH levels compared with those with low AMH levels after adjustment for age (37). However, we need to await thorough genetic analyses for a definite conclusion on this probable relationship between ovarian reserve markers and oocyte quality.…”

Anti‐Müllerian hormone as a marker of ovarian reserve: What have we learned, and what should we know?

“…Two recent prospective studies have shown conflicting results. There was a good correlation between AMH levels and natural conception in women 30-44 years of age during a 6-month observation period [42], but low AMH levels in a group of women in their twenties did not necessarily result in compromised fecundability [43]. These conflicting results may be due to the different ages of the study participants and to the small sizes of the study populations.…”

High levels of anti-Müllerian hormone: what does this mean for IVF treatment?

“…This finding, shown also for AFC [18], suggests that AMH (and AFC) captures not only a quantity aspect but also, to some extent, a quality aspect of the remaining oocytes. In support of this interpretation, are data showing an association between fecundability and AMH levels in natural procreation [20].…”