Abstract
Studies of Anti-Müllerian Hormone (AMH) rely upon serum measures and clinical samples of older reproductive-aged women intended/attempting pregnancy, with known fertility issues or medical morbidities. We explored the utility of minimally invasive AMH as a measure of fecundability in population-based reproductive health research. We analyzed baseline data from 191 participants in a pilot, longitudinal cohort study, the Young Women's Stress Study. Using an integrated biosocial design, we collected interviewer-administered surveys on demographic, psychosocial, health, and method feasibility/acceptability information and finger-stick capillary dried blood spots (DBS). We used descriptive and bivariate statistics (correlation, T-tests, ANOVA) to estimate method feasibility/acceptability and unadjusted AMH mean concentrations overall and across sociodemographic, reproductive, and health covariates. AMH concentrations ranged from 1.02 to 22.23 ng/mL, with a mean of 5.66 ng/mL. AMH concentrations were associated with current hormonal contraceptive use, menstrual cycle frequency, and irregular menstrual patterns, but not with other known correlates. Most participants stated the DBS method was comfortable (81%) and would be likely to provide it again (88%). While these pilot data suggest AMH fell within normal range and our DBS methods were acceptable/feasible, the broader question of its usefulness for population reproductive health research remains unanswered. Larger, longitudinal studies are needed to validate AMH against time-to-pregnancy and gold standard measures in young healthy samples and across different sociodemographic groups. Public health and social scientists should consider the resource costs of AMH, ethical issues, and risks of (over)interpretation, with a reproductive justice and human rights frame in mind.
Highlights
Introduction and objectiveStudies of Anti-Müllerian Hormone (AMH) rely upon serum measures and clinical samples of older reproductive-aged women intended/attempting pregnancy, with known fertility issues or medical morbidities
While the proximate behavioral determinants of unintended pregnancy have been the focus of family planning research for more than three decades [1,2,3,4], the intersecting biological and social pathways leading to pregnancy during adolescence and young adulthood have been understudied [5,6]
Data are drawn from a subsample of the Young Women’s Stress Study, a community-based longitudinal cohort pilot study of 199 females aged 15-24 years recruited from a large metropolitan area in the South-eastern United States
Summary
Studies of Anti-Müllerian Hormone (AMH) rely upon serum measures and clinical samples of older reproductive-aged women intended/attempting pregnancy, with known fertility issues or medical morbidities. We explored the utility of minimally invasive AMH as a measure of fecundability in population-based reproductive health research. Landmark population-based studies that have addressed young women’s reproduction have not included biomarkers of fertility or biomarkers at all [10,11]. Research in reproductive endocrinology has long studied the fertility of women later in the reproductive life course, and various measures of infertility have been widely tested and used [12,13]. Biomarkers of fertility often relied upon in clinical studies, such as antral follicle count (ultrasonography of follicle number) and neuroendocrine steroid hormones of the hypothalamus-pituitary axis (follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estrogen), have features which limit their feasibility and utility for population research. Invasiveness, significant cost, necessary tightly controlled conditions, intensive data collection procedures, burdensome follow-up schedules, substantial inter-patient variability and intra-cycle fluctuation, and limited predictive value are among the limitations of these common fertility measures [12,13]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
