Anti-Müllerian Hormone Levels as a Predictor of Female General Health Status: A Cross-Sectional Study

Abstract

Objective: To assess the correlations between clinical and hormonal parameters and comorbidity burden in Caucasian women presenting for fertility treatment. Design: Cross-sectional study. Setting: Single academic reproductive medicine center. Patient: Cohort of 3163 single-ethnicity women seeking medical help for fertility treatment, who underwent centralized lab testing for fertility-related hormonal assessment. Intervention: Complete clinical and laboratory data from the entire cohort of patients were retrospectively analysed. Main outcome measures: Assessment of i) the comorbidity burden scored via the Charlson Comorbidity Index (CCI; categorized as 0 vs. 1 vs. >2); and, ii) the potential associations between CCI and clinical and hormonal parameters. Results: Descriptive statistics and regression models tested the associations between clinical and laboratory parameters and CCI. Of 3163, CCI=0, CCI=1 and CCI>2 were found in 2977 (94.1%), 113 (3.6%) and 73 (2.3%) patients, respectively. Age, gravidity, Anti-Müllerian hormone (AMH) and thyroid stimulating hormone (TSH) values were found to be significantly different among CCI groups (all p[?] 0.01). At regression models, age at presentation and AMH emerged as independent predictors of CCI>1. Age at presentation <36 years (OR=1.742, 95% CI [1.284; 2.364]) and an AMH level <2.3 ng/ml (OR=1.864, 95% CI [1.29; 2.69]) were the most informative cutoff values for CCI >1. Conclusions: A younger age at presentation and lower AMH levels are significant predictors of decreased general health in women requiring clinical evaluation for fertility treatment. As observed for sperm parameters in men, AMH might serve as a proxy of women's general health status.