Novel correlates between antimüllerian hormone and menstrual cycle characteristics in African-American women (23–35 years-old)

Abstract

Objective To characterize normative anti-Müllerian hormone (AMH) levels and ascertain which factors are associated with AMH in a large cohort of reproductive-aged women. Design Cross-sectional study. Setting Study of the Environment, Lifestyle and Fibroids (SELF), a longitudinal study performed by the National Institute of Environmental Health Sciences in conjunction with a major health care provider in Detroit, Michigan. Patients 1,654 African-American women (AAW) aged 23-34 at recruitment. Intervention None Main Outcome Measure Serum AMH measured using an ultrasensitive ELISA. Results The median AMH was 3.18 ng/ml, and there was a significant, but nonlinear, relationship between age and AMH, with levels peaking at age 25. As AMH was not normally distributed, log transformation was performed and used for all analyses. In a multivariable age-adjusted model, body mass index, current use of hormonal contraception, and history of a thyroid condition were inversely associated with AMH, while history of abnormal menstrual bleeding and menstrual cycles longer than 35 days were positively associated with AMH. Conclusions While age is correlated with AMH, it accounts for only a portion of the variation seen. This study adds valuable information to the existing literature on normative AMH levels in young reproductive-aged women. While our findings fill a critical data gap for ovarian reserve in AAW, the insights gained will be of benefit for all women.

Relationship between obesity and anti‐Müllerian hormone in reproductive‐aged African American women

“…Given the established relationship between age and AMH, as well as the confirmed association between age and AMH in our previous analysis of this cohort , age‐adjusted linear regression was performed to evaluate the association between obesity and its biomarkers and AMH. Age and quadratic age were both included in the model to allow for a nonlinear relationship between AMH and age.…”

Alcohol, cigarette smoking, and ovarian reserve in reproductive-age African-American women

“…AMH levels were log-transformed to account for non-normal distribution and all models were adjusted for age, BMI, and current hormonal contraception (HC), variables that were previously shown to be significantly associated with AMH levels in this cohort. 29 Recognizing the non-linear association between age and ovarian reserve, main effects models included both an age and an age quadratic term. Considering the natural, age-related decline in AMH levels occurring at 25 years, 30–31 sensitivity analyses were performed to examine interactions between age and exposure variables.…”

“…39 In our study population, AMH levels began declining at 25 years of age, in keeping with previous studies, such that that binge drinking in the late twenties might accelerate the natural decline of AMH. 29–31, 40 Considering that binge drinking is common in young women in the U.S., 7 this finding is important to examine further.…”

Ovarian Reserve Testing: A Review of the Options, Their Applications, and Their Limitations

“…Other studies have evaluated African-American women alone and observed a significant inverse effect. 21,22 Among African Americans, AMH was negatively correlated with current BMI 22 as well as current BMI, BMI at age 18, and highest lifetime BMI. 21 Though, the effect of BMI on ovarian reserve is debated, it is worth noting that race and ethnicity may have implications for the observed effects as well.…”

“…21 There have been several studies published that report no effect of obesity on AMH, as well as several that report a negative effect of obesity on AMH. 13,19,21,22 Though AFC is generally stable across menstrual cycles, it has been demonstrated to have some variability at high levels. 11 Possibly related to this, intercycle variability in AFC appears to be higher in overweight and obese women, which can limit the predictive utility in this population.…”