Endocrine Abstracts

Introduction: Anti-Müllerian Hormone (AMH) is a useful marker of ovarian reserve (OR), since it remains stable inter/intra-cycles and presents a good correlation with ultrasonographic antral follicular count. Obesity/overweight are increasing and may affect the reproductive health. However, previous studies regarding the effect of body mass index (BMI) on AMH levels are discordant. Our main goal was to evaluate the influence of BMI in AMH levels in women with infertility.

Methods: Revision of medical records of 995 women who performed AMH determinations as part of their fertility workup, between 2011–2016. Women diagnosed with polycystic ovarian syndrome (Rotterdam criteria) were excluded. We analysed the influence of BMI, age, ethnicity, smoking and previous ovarian surgery on AMH levels.

Results: Median AMH concentration was 1.75(0–26)ng/dL and median age at AMH determination was 35(19–40)years. These women evidenced a median BMI of 23(15–39) kg/m² and had been struggling with infertility for 60(7–432) months. The majority [700(70.4%)] presented primary infertility. Caucasian women were more represented [889(89.3%)]. Smoking habits (present/past) were present in 359(36.1%), and 147(14.8%) harboured a history of ovarian surgery. On univariable analysis AMH was not correlated with BMI (r=0.52/P=0.10); the only factors influencing AMH were age (P<0.001), ethnicity (P=0.005) and previous surgery (P<0.001). On multivariable analysis, age was the only variable significantly associated with AMH, evidencing a reduction of 6.2% for each additional year (P<0.0001). Furthermore, we verified a trend suggesting an AMH reduction of 22% (P=0.08) in melanodermic patients comparing with the caucasian ones, when controlling for the other variables.

Conclusion: We report one of the largest series evaluating the influence of BMI on AMH levels and, consequently, on OR. BMI does not seem to affect AMH levels. The reported concerns on infertility in overweight/obese women may be related to follicular development/endometrial disorders, rather than decreased OR.