P-622 Age-specific reference intervals for anti-müllerian hormone in Mexico: A population-based study. implications for Latin America

Abstract

Abstract Study question To determine the age-specific normal range of antimullerian hormone (AMH) levels in a female Latin American population. Summary answer Age-related nomograms for general population for the 3rd-97th percentiles were produced. These nomograms could provide a reference guide for clinicians to consult women with infertility. What is known already The variation of AMH levels among different races and ethnicities has been well documented (Seifer et al., 2009). Despite the wide use of AMH measurements in clinical assessment of ovarian reserve, a population-based estimate for its reference range in Latin America is not available. Study design, size, duration A longitudinal, observational, retrospective, real-world study was carried out, including all AMH measurements performed from January 2017 to December 2018 at a large clinical laboratory network in the Mexico City area, encompassing 35 locations. A total of 6444 AMH measurements were included. Participants/materials, setting, methods AMH was assayed using either the cobas or ELISA methodologies. All AMH measurements from women 25-45 years were included. The Kolmogorov-Smirnov test was used to confirm that AMH levels between patients assayed with cobas were comparable to those assayed with ELISA at every age. Main results and the role of chance In total, 6444 measurements were identified and available for analysis. Age-related normograms for the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles of AMH were produced. The overall rate of AMH decline accelerated after 40 years of age. In women 25-30 years, 11.4% (63/554) had an AMH <1.0ng/mL. In women 30-35 years, 18.6% (276/1484) had an AMH <1.0ng/mL. In women 35-40 yeras, 35.8% (830/2319) had an AMH <1.0ng/mL. In women 40-45 years, 58.0% (1120/1932) had an AMH <1.0ng/mL. Limitations, reasons for caution The lack of medical history for patients precluded identification and exclusión of patients with iatrogenically abnormal AMH levels (e.g. due to oophorectomy). Patients undergoing measurement of AMH were primarily referred through fertility clinics, limiting the potential for extrapolation to the general population. Wider implications of the findings The study reports age-specific AMH levels drawn from a large sample of women around Mexico City. The study includes the largest dataset to date. Latin American patients considering fertility preservation should be aware of the high prevalence of diminished ovarian reserve in this large cohort, including among women 35-39. Trial registration number Not Applicable