Impact of age and menopausal stage on serum anti-Müllerian hormone levels in middle-aged women

Abstract

Objective

This study aimed to evaluate the association between age, menopausal stage and serum anti-Müllerian hormone (AMH) levels in middle-aged women.

Methods

In this cross-sectional study, the serum AMH levels of 288 healthy women aged 40–55 years (divided into age groups: 40–44, 45–49 and 50–55 years) were evaluated. Stages of Reproductive Aging Workshop + 10 criteria were used to categorize these women into menopausal stages: late reproductive, menopausal transition and early postmenopausal stages. The impact of age, menopausal stage and hormone replacement therapy on serum AMH levels was analyzed using multi-factor analysis of variance. Effects of body mass index, smoking status and oral contraceptive use were simultaneously considered.

Results

The median AMH level was 0.140 ng/ml. Log-AMH levels varied according to age group (variance = 20.113, F = 88.538, p < 0.001) and menopausal stage (variance = 5.543, F = 24.501, p < 0.001). An exponential model defined as AMH = 227,421.757 × e^{(−0.301 × age)} was fit to describe the decline in AMH level with age. The 5th–95th percentiles of the AMH levels ranged from less than 0.020 to 3.150, less than 0.020 to 1.944 and less than 0.020 to 0.030 ng/ml in the aforementioned menopausal stages, respectively.

Conclusion

Age and menopausal stage were associated with AMH levels; age had a greater impact on AMH than menopausal stage in middle-aged women.

年龄和绝经分期对中年女性血清抗苗勒管激素水平的影响 摘要

目标：本研究旨在评价中年女性的年龄、绝经分期与血清抗苗勒管激素( AMH )水平的相关性。

方法：本横断面研究对288名40-55岁健康女性(按年龄分组:40-44岁、45-49岁和50-55岁)的血清AMH水平进行了评估。采用STRAW+10分期系统将这些女性分为：育龄期晚期、绝经过渡期和绝经后期。采用多因素方差分析的方法, 分析了年龄、绝经分期、激素替代治疗对血清AMH水平的影响。同时考虑了体重指数、吸烟状况和口服避孕药的影响。

结果：AMH水平中位数为0.140ng/ml。Log-AMH水平随年龄(方差=20.113,F=88.538,p< 0.001)和绝经分期(方差=5.543,F=24.501,p<0.001)而变化。随着年龄的增长, AMH 水平下降的趋势符合指数模型AMH=227, 421.757×e ^{(-0.301×age)}描述。对于上述绝经分期, AMH 水平的第5-95百分位值分别为0.020-3.150,0.020-1.944和0.020-0.030 ng/ml。

结论： AMH 水平与年龄和绝经分期有关, 年龄对 AMH 的影响大于绝经分期。

Keywords:

• Anti-Müllerian hormone
• age factor
• reproductive aging
• ovarian reserve
• menopause

Potential conflict of interest

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Beijing Municipal Administration of Hospitals Incubating Program [grant number PX2018031]; Youth Fund of Beijing Shijitan Hospital [grant number 2019-q03]; Beijing Natural Science Foundation [grant number 7202075].