Abstract
BackgroundAnti-Müllerian hormone (AMH) and antral follicle count (AFC) age-specific reference values form the basis of infertility treatments, yet they were based upon studies performed primarily on Caucasian populations. However, they may vary across different age-matched ethnic populations. This study aimed to describe age-specific serum AMH and AFC for women native to the Arabian Peninsula.MethodsA retrospective large-scale study was performed including 2,495 women, aged 19 to 50 years, native to the Arabian Peninsula. AMH and AFC were measured as part of their fertility assessment at tertiary-care fertility centres. Age-specific values and nomograms were calculated.Results2,495 women were evaluated. Mean, standard deviation and median values were calculated for AMH and AFC by 1-year and 5-years intervals. Median age was 34.81 years, median AMH was 1.76ng/ml and median AFC was 11. From the total group, 40.60% presented with AMH levels below 1.3ng/mL. For women <45 years old, the decrease in AFC was between -0.6/-0.8 per year. Up to 36 years old, the decrease of AMH was 0.1ng/ml. However, from 36 to 40 years old, an accelerated decline of 0.23ng/ml yearly was noted. In keeping with local customs, 71.23% of women wore the hijab and 25.76% the niqab. AMH and AFC were significantly lower for niqab group compared with hijab group (p=0.02 and p=0.04, respectively).ConclusionThis is to-date the largest data set on age-specific AMH and AFC values in women from the Arabian Peninsula aiming to increase clinical awareness of the ovarian reserve in this population.
Highlights
In recent years, Anti-Müllerian hormone (AMH) and antral follicle count (AFC) have become widely used markers for baseline assessment of ovarian reserve, especially preceding assisted reproductive techniques (ART) [1]
Due to the lack of large-scale age-specific ovarian reserve parameters for women from the Arabian Peninsula and with the aim to close this gap in knowledge, this study describes age-specific AMH and AFC values from women native to the Arabian Peninsula region and evaluates them in the context of the existing sociocultural and religious habits from the Middle East
A total of 2,495 patients, native to the Arabian Peninsula with data on AMH, dress code and BMI were included for analysis
Summary
Anti-Müllerian hormone (AMH) and antral follicle count (AFC) have become widely used markers for baseline assessment of ovarian reserve, especially preceding assisted reproductive techniques (ART) [1]. Ovarian reserve declines over the reproductive lifespan and has a relevant impact on present and future fertility This is why AMH and AFC have an important influence on treatment decisions. Studies comparing patients from Middle East/North Africa (MENA) region with Caucasian patients described a reduced ovarian reserve and lower number of retrieved oocytes for the MENA population [17, 18] These findings point to significant race-dependent differences in the ovarian reserve and in ovarian ageing [19, 20]. Anti-Müllerian hormone (AMH) and antral follicle count (AFC) age-specific reference values form the basis of infertility treatments, yet they were based upon studies performed primarily on Caucasian populations. They may vary across different age-matched ethnic populations.
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