ANTI-MÜLLERIAN HORMONE LEVELS AS A PREDICTOR OF FEMALE GENERAL HEALTH
STATUS: A CROSS-SECTIONAL STUDY
Abstract
Objective: To assess the correlations between clinical and hormonal
parameters and comorbidity burden in Caucasian women presenting for
fertility treatment. Design: Cross-sectional study. Setting: Single
academic reproductive medicine center. Patient: Cohort of 3163
single-ethnicity women seeking medical help for fertility treatment, who
underwent centralized lab testing for fertility-related hormonal
assessment. Intervention: Complete clinical and laboratory data from the
entire cohort of patients were retrospectively analysed. Main outcome
measures: Assessment of i) the comorbidity burden scored via the
Charlson Comorbidity Index (CCI; categorized as 0 vs. 1 vs.
>2); and, ii) the potential associations between CCI and
clinical and hormonal parameters. Results: Descriptive statistics and
regression models tested the associations between clinical and
laboratory parameters and CCI. Of 3163, CCI=0, CCI=1 and
CCI>2 were found in 2977 (94.1%), 113 (3.6%) and 73
(2.3%) patients, respectively. Age, gravidity, Anti-Müllerian hormone
(AMH) and thyroid stimulating hormone (TSH) values were found to be
significantly different among CCI groups (all p≤ 0.01). At regression
models, age at presentation and AMH emerged as independent predictors of
CCI>1. Age at presentation <36 years (OR=1.742,
95% CI [1.284; 2.364]) and an AMH level <2.3 ng/ml
(OR=1.864, 95% CI [1.29; 2.69]) were the most informative cutoff
values for CCI >1. Conclusions: A younger age at
presentation and lower AMH levels are significant predictors of
decreased general health in women requiring clinical evaluation for
fertility treatment. As observed for sperm parameters in men, AMH might
serve as a proxy of women’s general health status. Key words: AMH,
comorbidities, health, infertility