The impact of smoking on antimüllerian hormone levels in women aged 38 to 50 years

Abstract

Objective Smoking is associated with increased follicle-stimulating hormone levels and early menopause. Smoking may directly accelerate ovarian follicular depletion or may act indirectly by increasing the pituitary production of follicle-stimulating hormone. Antimüllerian hormone (AMH), produced by ovarian follicles, is a more direct measure of ovarian reserve. The objective of our study was to determine the extent to which smoking influences ovarian reserve, as measured by AMH levels. Methods A community sample of 284 women aged 38 to 50 years completed a self-administered questionnaire including a detailed smoking history. Serum AMH levels were measured on day 2, 3, or 4 of the menstrual cycle. The association between AMH and smoking was analyzed using linear regression, adjusting for age and body mass index. Results Participants aged 38 to 42, 43 to 45, and 46 to 50 years had geometric mean AMH values of 6.7 pM (95% CI, 5.2–8.7 pM), 2.7 pM (95% CI, 1.9–3.8 pM), and 1.3 pM (95% CI, 1.0–1.7 pM), respectively. Current smokers, but not past smokers, had 44% lower AMH values than did the reference group (participants with neither active nor former or passive smoke exposure; P = 0.04). Passive smoking had no effect on AMH values when compared with the reference group (P = 0.55). The impact of smoking on AMH values was not dose dependent based on cigarettes per day (P = 0.08) or pack-years (P = 0.22). Finally, prenatal exposure to smoking (either maternal or paternal) had no impact on AMH levels (P = 0.47 and P = 0.89, respectively). Conclusions Active smoking, but not former smoking, is associated with decreased AMH values in late-reproductive-age and perimenopausal women, suggesting a possible direct effect of smoking on the depletion of the antral but not primordial follicles. The direct impact of active smoking on AMH levels in younger women requires further investigation.

Decreased ovarian function is associated with obesity in very long-term female survivors of childhood cancer

“…Smoking is linked to ovarian aging in the general population (41). However, we did not find a significant difference in AMH levels between smokers and nonsmokers.…”

El hábito de fumar se asocia a baja concentración plasmática de hormona antimülleriana en mujeres infértiles

“…Sin embargo, este estudio, como otros 14 , falló para establecer una relación dosis respuesta al correlacionar el número de cigarrillos fumados en la semana anterior a la aplicación del cuestionario con los niveles de AMH plasmática encontrados. Resultados similares han sido reportados por Freour 15 .…”

Systematic and Meta-Analytic Review of Research Examining the Impact of Menstrual Cycle Phase and Ovarian Hormones on Smoking and Cessation

“…Smoking in women is associated with dysmenorrhea and menstrual irregularity 9,82 and altered ovarian cycle and hormone levels. 83,84 Compared to female nonsmokers, female smokers demonstrate changes in estrogen metabolism and lower circulating estrogen, 85,86 a shorter reproductive lifespan, 9,87,88 lower ovarian reserve, 89,90 and quicker entry into all stages of the menopausal transition. 91,92 Pregnancy-related smoking consequences include infertility, spontaneous abortion, preterm delivery, and perinatal mortality.…”