Age-specific anti-Müllerian hormone values determined for US women of reproductive age who present to fertility centers
From ages 24 to 50 years, anti-Müllerian hormone levels steadily diminish. Researchers for a new study have suggested that although a normal range of reference values have been available for women of reproductive age, age-specific values could potentially be of greater clinical use.
“What has been used in clinical practice has been a range of normal values for women in general without any reference to age,” researcher David B. Seifer, MD, of Genesis Fertility and Reproductive Medicine at Maimonides Medical Center and New York University School of Medicine, told Endocrine Today.
Between 2007 and 2010, Seifer and colleagues determined single-year interval median and mean anti-Müllerian hormone values for 17,120 unselected women aged 24 to 50 years. All women presented to US fertility clinics in 37 states.
The researchers used single-year intervals to evaluate median and mean anti-Müllerian hormone levels. Results demonstrated a continual linear decrease as women’s ages increased, with the average annual decline in median serum anti-Müllerian hormone values reaching 0.2 ng/mL by age 35 years. This number, however, stabilized at 0.1 ng/mL for each year thereafter. Additionally, the yearly rate of decrease in mean anti-Müllerian hormone levels was 0.2 ng/mL until age 40 years before subsequently decreasing to 0.1 ng/mL.
“Given the increasing utility and frequency of use of [anti-Müllerian hormone] in clinical evaluations of fertility, trends in age-specific reference values for [anti-Müllerian hormone] may provide added perspective for clinicians and couples who are considering fertility treatment options,” the researchers wrote in the study.
Most studies investigating anti-Müllerian hormone levels historically come from Europe because anti-Müllerian hormone levels are used more frequently outside of the United States, according to Seifer.
“The value of this study lies in its design because it yields useful information on age-specific anti-Müllerian hormone levels in US women,” he said.
The researchers said the anti-Müllerian hormone reference values “cannot be used in isolation to provide counseling about a woman’s chance for a successful ovulation induction or ability to have a child.” They noted, however, that anti-Müllerian hormone reference values may be used as one component during evaluation of reproductive potential and treatment options to conceive. Results of this study may further aid patients and physicians in determining which treatment options may be preferred. For example, if a woman’s anti-Müllerian hormone level is much lower than anticipated for her age, she and her physician may want to approach treatment more aggressively, Seifer said.
The data provide greater insight intoa woman’s remaining egg supply at a specific age, he added.
“Clinical scenarios where age-specific anti-Müllerian hormone values may be informative include women presenting with a history of infertility trying to decide between different therapeutic options; women with newly diagnosed cancer who will to assess their options for fertility preservation prior to undergoing chemotherapy or to assess the return of ovarian function after receiving chemotherapy; and women who may be questioning the timing of the onset of menopause,” he said. – by Melissa Foster
Disclosure: Dr. Seifer receives royalties from a licensing agreement between UMDNJ/MGH and Beckman Coulter for the use of anti-Müllerian hormone to determine ovarian reserve.
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