Xiaofang Du1, Ting Ding1, Hanwang Zhang2, Cuilian Zhang3, Wenmin Ma4, Ying Zhong5, Wenyu Qu6, Jie Zheng7, Yi Liu8, Zhiying Li9, Kecheng Huang1, Song Deng1, Lanfang Ma1, Jun Yang1, Jingjing Jiang1, Shuhong Yang1, Jia Huang1, Meng Wu1, Li Fang1, Yunping Lu1, Aiyue Luo10, Shixuan Wang10. 1. Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 2. Reproductive Medical Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 3. Reproductive Medical Center, Henan Provincial People's Hospital, Zhengzhou, China Reproductive Medical Center, the People's Hospital of Zhengzhou University, Zhengzhou, China. 4. Reproductive Medical Center, Foshan Maternal and Child Health Care Hospital, Foshan, China. 5. Reproductive Medical Center, Chengdu Jinjiang Maternal and Child Health Hospital, Chengdu, China. 6. Reproductive Medical Center, Shenyang women's and children's hospital, Shenyang, China. 7. Reproductive Medical Center, Maternal and Child Health Hospital of Hubei Province, Wuhan, China. 8. Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 9. Department of Obstetrics and Gynecology, Renhe Hospital, China Three Gorges University, Yichang, China. 10. Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China sxwang2012@163.com aiyueluoluck@163.com.
Abstract
BACKGROUND: The increasing use of anti-Müllerian hormone (AMH) in clinic has raised concerns regarding the reliable reference range for this test. However, the reference range for AMH in normal Chinese female population has not been established. Furthermore, relationship between AMH and other clinical markers such as body mass index (BMI) and antral follicle counts (AFCs) and other sex-related hormones have not been examined in normal population-based women. OBJECTIVE: We aimed to determine the age-specific reference range for serum AMH in healthy Chinese women throughout reproductive age to menopause and to estimate relationship between AMH and other clinical markers in healthy women. STUDY DESIGN: In this multicenter and nationwide study, advertisements were used to recruit 2055 women, aged 20 to 55 years, from 6 different regions in China; 1590 (77.37%) women met the inclusion criteria for the reference range population. We measured the baseline serum AMH levels using new Beckman Coulter Gen II assay. Serum concentration of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), testosterone (T), prolactin (PRL), progesterone (PRG), and AFCs were also determined in the follicular phase. MAIN OUTCOME MEASURES: The AMH-Age nomogram and AMH levels of different age-groups and the relationship between AMH and other clinical markers. RESULTS: Serum AMH concentrations declined progressively with age. A quadratic model defined as log (AMH) = (-1.970 + 0.296 × Age - 0.006 × Age(2)) fitted best the decline of AMH with age. The median AMH levels were 6.23, 5.65, 4.55, 3.74, 2.78, and 1.09 ng/mL for the 20 ≤ age < 25, 25 ≤ age < 30, 30 ≤ age < 33, 33 ≤ age < 37, 37 ≤ age < 40, and 40 ≤ age < 55 groups, respectively. The 5th to 95th percentiles of the AMH levels, as the reference range, were 2.06 to 12.66, 1.77 to 13.83, 1.48 to 11.45, 0.87 to 9.76, 0.56 to 9.49, and 0.08 to 5.70 ng/mL for each age-group. The AMH levels were positively correlated with AFCs and T, LH, PRL and PRG levels and negatively correlated with BMI and FSH levels and were not significantly correlated with E2 levels. The relationship between AMH and other variables remain unchanged except for PRL, which was not significantly correlated with AMH levels after controlling for both age and BMI. CONCLUSIONS: This study determined the normal reference ranges for serum AMH levels in a large population-based sample of healthy Chinese women.
BACKGROUND: The increasing use of anti-Müllerian hormone (AMH) in clinic has raised concerns regarding the reliable reference range for this test. However, the reference range for AMH in normal Chinese female population has not been established. Furthermore, relationship between AMH and other clinical markers such as body mass index (BMI) and antral follicle counts (AFCs) and other sex-related hormones have not been examined in normal population-based women. OBJECTIVE: We aimed to determine the age-specific reference range for serum AMH in healthy Chinese women throughout reproductive age to menopause and to estimate relationship between AMH and other clinical markers in healthy women. STUDY DESIGN: In this multicenter and nationwide study, advertisements were used to recruit 2055 women, aged 20 to 55 years, from 6 different regions in China; 1590 (77.37%) women met the inclusion criteria for the reference range population. We measured the baseline serum AMH levels using new Beckman Coulter Gen II assay. Serum concentration of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), testosterone (T), prolactin (PRL), progesterone (PRG), and AFCs were also determined in the follicular phase. MAIN OUTCOME MEASURES: The AMH-Age nomogram and AMH levels of different age-groups and the relationship between AMH and other clinical markers. RESULTS: Serum AMH concentrations declined progressively with age. A quadratic model defined as log (AMH) = (-1.970 + 0.296 × Age - 0.006 × Age(2)) fitted best the decline of AMH with age. The median AMH levels were 6.23, 5.65, 4.55, 3.74, 2.78, and 1.09 ng/mL for the 20 ≤ age < 25, 25 ≤ age < 30, 30 ≤ age < 33, 33 ≤ age < 37, 37 ≤ age < 40, and 40 ≤ age < 55 groups, respectively. The 5th to 95th percentiles of the AMH levels, as the reference range, were 2.06 to 12.66, 1.77 to 13.83, 1.48 to 11.45, 0.87 to 9.76, 0.56 to 9.49, and 0.08 to 5.70 ng/mL for each age-group. The AMH levels were positively correlated with AFCs and T, LH, PRL and PRG levels and negatively correlated with BMI and FSH levels and were not significantly correlated with E2 levels. The relationship between AMH and other variables remain unchanged except for PRL, which was not significantly correlated with AMH levels after controlling for both age and BMI. CONCLUSIONS: This study determined the normal reference ranges for serum AMH levels in a large population-based sample of healthy Chinese women.
Authors: Seungyoun Jung; Naomi Allen; Alan A Arslan; Laura Baglietto; Louise A Brinton; Brian L Egleston; Roni Falk; Renée T Fortner; Kathy J Helzlsouer; Annika Idahl; Rudolph Kaaks; Eva Lundin; Melissa Merritt; Charlotte Onland-Moret; Sabina Rinaldi; María-José Sánchez; Sabina Sieri; Helena Schock; Xiao-Ou Shu; Patrick M Sluss; Paul N Staats; Ruth C Travis; Anne Tjønneland; Antonia Trichopoulou; Shelley Tworoger; Kala Visvanathan; Vittorio Krogh; Elisabete Weiderpass; Anne Zeleniuch-Jacquotte; Wei Zheng; Joanne F Dorgan Journal: Fertil Steril Date: 2017-04 Impact factor: 7.329
Authors: Tess V Clendenen; Wenzhen Ge; Karen L Koenig; Yelena Afanasyeva; Claudia Agnoli; Elizabeth Bertone-Johnson; Louise A Brinton; Farbod Darvishian; Joanne F Dorgan; A Heather Eliassen; Roni T Falk; Göran Hallmans; Susan E Hankinson; Judith Hoffman-Bolton; Timothy J Key; Vittorio Krogh; Hazel B Nichols; Dale P Sandler; Minouk J Schoemaker; Patrick M Sluss; Malin Sund; Anthony J Swerdlow; Kala Visvanathan; Mengling Liu; Anne Zeleniuch-Jacquotte Journal: J Clin Endocrinol Metab Date: 2021-10-21 Impact factor: 6.134