Joana Simões-Pereira1, Joaquim Nunes2, Ana Aguiar2, Sandra Sousa2, Cátia Rodrigues2, Joaquim Sampaio Matias3, Carlos Calhaz-Jorge2. 1. Endocrinology Department, Insituto Português de Oncologia de Lisboa, Francisco Gentil, Lisbon, Portugal. joanasimoespereira@gmail.com. 2. Gynaecology, Obstetrics and Reproductive Medicine Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal. 3. Clinical Pathology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.
Abstract
PURPOSE: Anti-Müllerian hormone (AMH) is a useful marker of ovarian reserve. Obesity/overweight are increasing and may affect the reproductive health. Previous studies regarding the effect of body mass index (BMI) on AMH levels are discordant. Our main goal was to evaluate the influence of BMI on AMH levels in women without polycystic ovarian syndrome. METHODS: Revision of medical records of 951 women who performed AMH determinations as part of their fertility workup, between 2011 and 2016. RESULTS: Median AMH concentration was 1.75 [interquartile range (IQR) 2] ng/mL (12.9 pmol/mL) and median age at AMH determination was 35 (IQR 6) years. These women evidenced a median BMI of 23 (IQR 5) kg/m2. Caucasian women were more represented [889(89.3%)]. Smoking habits (present/past) were present in 359(36.1%), and 147(14.8%) harboured a history of ovarian surgery. On univariable analysis AMH was not correlated with BMI (r = 0.048/p = 0.135); the only factors influencing AMH were age (p < 0.001), ethnicity (p = 0.004), and previous ovarian surgery (p < 0.001). On multivariable analysis, age was the only variable significantly associated with AMH, evidencing a reduction of 6.2% for each additional year (p < 0.0001). Furthermore, we verified a trend suggesting an AMH reduction of 22% (p = 0.08) in black patients comparing with the caucasian ones, when controlling for the other variables. CONCLUSION: We report one of the largest series evaluating the influence of BMI on AMH levels and, consequently, on ovarian reserve. BMI does not seem to affect AMH levels. The reported concerns on infertility in overweight and obese women may be related to follicular development/oocyte maturation or endometrial disorders, rather than decreased ovarian reserve.
PURPOSE: Anti-Müllerian hormone (AMH) is a useful marker of ovarian reserve. Obesity/overweight are increasing and may affect the reproductive health. Previous studies regarding the effect of body mass index (BMI) on AMH levels are discordant. Our main goal was to evaluate the influence of BMI on AMH levels in women without polycystic ovarian syndrome. METHODS: Revision of medical records of 951 women who performed AMH determinations as part of their fertility workup, between 2011 and 2016. RESULTS: Median AMH concentration was 1.75 [interquartile range (IQR) 2] ng/mL (12.9 pmol/mL) and median age at AMH determination was 35 (IQR 6) years. These women evidenced a median BMI of 23 (IQR 5) kg/m2. Caucasian women were more represented [889(89.3%)]. Smoking habits (present/past) were present in 359(36.1%), and 147(14.8%) harboured a history of ovarian surgery. On univariable analysis AMH was not correlated with BMI (r = 0.048/p = 0.135); the only factors influencing AMH were age (p < 0.001), ethnicity (p = 0.004), and previous ovarian surgery (p < 0.001). On multivariable analysis, age was the only variable significantly associated with AMH, evidencing a reduction of 6.2% for each additional year (p < 0.0001). Furthermore, we verified a trend suggesting an AMH reduction of 22% (p = 0.08) in black patients comparing with the caucasian ones, when controlling for the other variables. CONCLUSION: We report one of the largest series evaluating the influence of BMI on AMH levels and, consequently, on ovarian reserve. BMI does not seem to affect AMH levels. The reported concerns on infertility in overweight and obesewomen may be related to follicular development/oocyte maturation or endometrial disorders, rather than decreased ovarian reserve.
Entities:
Keywords:
Anti-Müllerian hormone; Body mass index; Obesity; Ovarian reserve; Polycystic ovarian syndrome
Authors: Michelle A Kominiarek; Emily S Jungheim; Kathleen M Hoeger; Ann M Rogers; Scott Kahan; Julie J Kim Journal: Surg Obes Relat Dis Date: 2017-02-12 Impact factor: 4.734
Authors: Ellen W Freeman; Clarisa R Gracia; Mary D Sammel; Hui Lin; Lony Chong-Leong Lim; Jerome F Strauss Journal: Fertil Steril Date: 2006-11-15 Impact factor: 7.329
Authors: Luciano G Nardo; Dimitra Christodoulou; Della Gould; Steve A Roberts; Cheryl T Fitzgerald; Ian Laing Journal: Gynecol Endocrinol Date: 2007 Impact factor: 2.260