Factors affecting the distribution of serum anti-müllerian hormone levels among infertile Asian women: a multi-nation, multi-centre, and multi-ethnicity prospective cohort study

Tzeng CR 1 , Huang Z 2 , Asada Y 3 , Zhang C 4 , Ho MT 5 , Li RHW 6 Show all authors , Kim JH 7 , Govindarajan M 8 , Vuyavanich T 9 , Sini I 10 , Wong PS 11 , Singh S 12 , Lin WY 13 , Ho NT 1

Affiliations 

  • 1 Taipei Fertility Centre, Taipei, Taiwan
  • 2 National University Hospital, Singapore, Singapore
  • 3 Asada Ladies Clinic, Nagoya, Aichi, Japan
  • 4 Henan Provincial People Hospital, Zhengzhou, Henan, China
  • 5 My Duc Hospital, Ho Chi Minh City, Vietnam
  • 6 Queen Mary Hospital, Hong Kong, SAR
  • 7 CHA Bundang Medical Centre, Seongnam, Gyeonggi-do, Republic of Korea
  • 8 Womens Centre and Hospitals, Coimbatore, India
  • 9 Chiang Mai University, Chiang Mai, Thailand
  • 10 Morula IVF Centre, Jakarta, Indonesia
  • 11 Sunfert International Fertility Centre, Kuala Lumpur, Malaysia
  • 12 Tropicana Medical Centre, Selangor, Malaysia
  • 13 National Taiwan University, Taipei, Taiwan
Hum Reprod, 2023 Jul 05;38(7):1368-1378.
PMID: 37105234 DOI: 10.1093/humrep/dead081

Abstract

STUDY QUESTION: How do age, ethnicity, and other characteristics affect serum anti-mullerian hormone (AMH) levels in Asian women undergoing fertility treatment?

SUMMARY ANSWER: Age, ethnicity, obesity (BMI ≥ 30 kg/m2), and polycystic ovarian syndrome (PCOS) significantly impacted serum AMH levels, with the rate of decrease accelerating as age increased; a concentration of 4.0 ng/ml was the optimal cut-off for diagnosis of PCOS.

WHAT IS KNOWN ALREADY: There are significant differences in ovarian reserve among women from different races and ethnicities, and Asian women often have poorer reproductive outcomes during assisted reproductive treatment cycles.

STUDY DESIGN, SIZE, DURATION: A population-based multi-nation, multi-centre, multi-ethnicity prospective cohort study of 4613 women was conducted from January 2020 to May 2021. Infertile women of 20-43 years of age were enrolled. The exclusion criteria included: age <20 or >43, non-Asian ethnicity, and missing critical data.

PARTICIPANTS/MATERIALS, SETTING, METHODS: Participants were Asian women of Chinese, Japanese, Korean, Thai, Vietnamese, Malay, Indian, and Indonesian ethnicities from 12 IVF centres across Asia. These women were all naïve to ovarian stimulation cycles and attended IVF centres for fertility assessment. The AMH measurement was performed using an AMH automated assay on a clinically validated platform.

MAIN RESULTS AND THE ROLE OF CHANCE: A total of 4556 infertile Asian women were included in the final analyses. The mean ± SD for serum AMH concentrations (ng/ml) across specific age groups were: overall, 3.44 ± 2.93; age <30, 4.58 ± 3.16; 30-31, 4.23 ± 3.23; 32-33, 3.90 ± 3.06; 34-35, 3.21 ± 2.65; 36-37, 2.74 ± 2.44; 38-39, 2.30 ± 1.91; 40 and above, 1.67 ± 2.00. The rate of AMH decrease was ∼0.13 ng/ml/year in patients aged 25-33 and 0.31 ng/ml/year in women aged 33-43. The highest rates of PCOS were found in Indians (18.6%), Malays (18.9%), and Vietnamese (17.7%). Age (P 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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