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

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 117; no. 4; pp. 798 - 804
• Main Authors: STEINER, Anne Z, HERRING, Amy H, KESNER, James S, MEADOWS, Juliana W, STANCZYK, Frank Z, HOBERMAN, Steven, BAIRD, Donna D
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.04.2011
• Subjects: Adult; Anti-Mullerian Hormone - blood; Biological and medical sciences; Biomarkers - blood; Cohort Studies; Confidence Intervals; Estradiol - blood; Female; Fertility - physiology; Follicle Stimulating Hormone - blood; Gynecology. Andrology. Obstetrics; Humans; Inhibins - blood; Maternal Age; Medical sciences; Predictive Value of Tests; Pregnancy; Pregnancy Rate; Risk Factors; Human; Antimüllerian hormone; Gynecology; Female; Predictive factor; Woman; Obstetrics
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1097/aog.0b013e3182116bc8

To generate estimates of the association between markers of ovarian aging and natural fertility in a community sample at risk for ovarian aging. 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. Diary data on menstrual cycle day and patterns of intercourse were used to calculate day-specific fecundability ratios. Sixty-three percent of participants 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 with women with higher antimüllerian hormone levels (fecundability ratio 0.38; 95% confidence interval [CI] 0.08-0.91). The day-specific fecundability for women with early-follicular phase serum FSH values greater than 10 milli-international units/mL compared with women with lower FSH levels was also reduced, although 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. Early-follicular phase antimüllerian hormone appears to be associated with natural fertility in the general population. II.