Anti-Müllerian hormone levels and antral follicle count in women enrolled inin vitrofertilization cycles: Relationship to lifestyle factors, chronological age and reproductive history

Abstract

The aims of this prospective study were to investigate the relationship between anti-Müllerian hormone (AMH) and antral follicle count (AFC), and to determine whether these markers of ovarian reserve correlate with lifestyle factors, ethnicity, chronological age and reproductive history. Participants were 136 normo-ovulatory women undergoing infertility work-up within 3 months of their first ovarian stimulation cycle for in vitro fertilization. On day 3 of a spontaneous menstrual cycle, a blood sample for measurement of plasma AMH levels was taken and a transvaginal ultrasound scan to determine the AFC (follicles measuring 2-5 mm in diameter) was performed. Information about smoking, body mass index, alcohol consumption, ethnic origin, chronological age, age at menarche, years since menarche and gravidity were recorded using a case report form. The main outcome measures were plasma AMH concentrations and total number of small antral follicles (AFC). Median plasma levels of AMH were 2.0 ng/ml (interquartile range 1.1-3.6) and AFC was 10 (interquartile range 7-15). A positive correlation between AMH and AFC (r = 0.54, p < 0.0001) was found. AMH and AFC correlated negatively with age (r = -0.30, p < 0.001 and r = -0.27, p = 0.001 respectively) and number of years since menarche (r = -0.23, p = 0.007 and r = -0.21, p = 0.015 respectively), but not with any of the other measures. Circulating AMH levels and AFC correlated with each other and declined significantly with age. There were only weak, non-significant, correlations with lifestyle factors and reproductive history. These putative markers could be used individually or together to assess the age-related decline of ovarian function in normo-ovulatory candidates for IVF.

Differences of the association of anti-Müllerian hormone with clinical or biochemical characteristics between women with and without polycystic ovary syndrome

“…Furthermore, AMH was not statistically different with respect to obesity but rather associated with PCOS status. Some studies have reported results similar to ours [9,25,28], and also support the hypothesis that AMH increases due to an enhanced granulosa cell activity in vivo, which may not be body weightrelated [9]. However, the small number of subjects in this study, differences in study populations and clinical setting must all be taken into consideration.…”

Biochemical Parameters Serving As Prognostic Indicators of Ovarian Reserve in Females with Unexplained Sub-Fertility

“…10 TSH is included as hypothyroidism is now-a-days common in female and one cause of subfertility. 11,12 In our study, no relationship was found between AMH and BMI, confirming earlier observations in a group of subfertile subjects (Nardo et al, 2007) although this was in contrast to other studies (Freeman et al, 2007;Chen et al, 2008). 13,14 Pigny and colleagues (2003) also found that BMI did not influence the circulating AMH.…”

“…11,12 In our study, no relationship was found between AMH and BMI, confirming earlier observations in a group of subfertile subjects (Nardo et al, 2007) although this was in contrast to other studies (Freeman et al, 2007;Chen et al, 2008). 13,14 Pigny and colleagues (2003) also found that BMI did not influence the circulating AMH. 15,16 Differences in study populations, clinical setting have to be borne in mind to explain discrepancies between the studies.…”

Serum anti‐müllerian hormone concentrations in reproductive age women with and without polycystic ovary syndrome: the influence of body mass index

“…In these studies, the evaluation of the relationship between AMH concentrations and BMI generally showed contradictory results. In some studies [14,15] a significant inverse association between AMH levels and BMI was found, whereas some others [16][17][18][19] found no relationship between AMH and BMI.…”