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Abstract
Purpose of ReviewIn this review, we summarize ethnic/race- and age-related variation in AMH and discuss the underpinnings behind these differences.Recent findingsAnti-mullerian hormone (AMH) has become a widely used method of ovarian reserve testing over the last 15 years. Numerous studies have shown substantial ethnic/race and age-related differences. When compared to age-matched Caucasian women, AMH levels tend to be lower in black and Hispanic women. Chinese women tend to have significantly greater AMH levels prior to age 25 than Caucasian women. When considering subpopulations within ethnicities, at least one study noted lower AMH levels among Maya women compared to other Hispanic women. Age exhibits a positive trend with AMH up until at least 25 years of age with a consistent decline after 34 years of age extending to menopause.SummaryAMH levels are highly variable among ethnicities and race with higher age-matched levels typically seen in Caucasian women. Age does not exhibit a consistent linear relationship with AMH, but a consistent decline is seen starting in the third decade of life and proceeding to menopause.
Highlights
Anti-Müllerian hormone (AMH) as a marker of ovarian reserve is an essential aspect of infertility testing
AMH as a measure of ovarian reserve is more reliable due to its reduced variation within each menstrual cycle and reduced interobserver variability compared to antral follicle count (AFC) and follicle stimulating hormone (FSH) levels [7,8,9]
Phrases used in the search were suited for each individual database and included “AMH AND Caucasian quality,” “AMH AND African-American,” “AMH AND black,” “AMH AND asian,” “AMH AND race,” “AMH AND ethnicity,” “AMH AND age,” “AMH AND adolescents,” “AMH AND menopause,” “Müllerian inhibitory substance/factor” AND Caucasian,” “Müllerian inhibitory substance/factor AND African-American,” “Müllerian inhibitory substance/factor AND black,” “Müllerian inhibitory substance/factor AND Asian,” “Müllerian inhibitory substance/factor AND race,” “Müllerian inhibitory substance/factor AND ethnicity,” “Müllerian inhibitory substance/factor AND age,” “Müllerian inhibitory substance/factor AND adolescents,” and “Müllerian inhibitory substance/factor AND menopause
Summary
Anti-Müllerian hormone (AMH) as a marker of ovarian reserve is an essential aspect of infertility testing. AMH as a measure of ovarian reserve is more reliable due to its reduced variation within each menstrual cycle and reduced interobserver variability compared to antral follicle count (AFC) and follicle stimulating hormone (FSH) levels [7,8,9]. AMH demonstrates minimal cycle-to-cycle variability in comparison to AFC and FSH levels [10, 11] Given this greater consistency, AMH has become a widely used tool to assess ovarian reserve [8, 12]. The first study to demonstrate a reliable correlation between AMH and egg yield showed that AMH levels were 2.5 times higher in patients whose ART cycles yielded 11 or more oocytes compared to those that yielded 6 or less oocytes.
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