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Fertil Steril. 2011 Feb;95(2):736-41.e1-3. doi: 10.1016/j.fertnstert.2010.08.022. Epub 2010 Sep 24.

Nomogram for the decline in serum antimüllerian hormone: a population study of 9,601 infertility patients.

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  • 1Reproductive and Maternal Medicine, Faculty of Medicine, University of Glasgow, Glasgow, Scotland. Scott.Nelson@glasgow.ac.uk

Abstract

OBJECTIVE:

To define an optimal model for the decline in circulating antimüllerian hormone (AMH) with age and develop a validated age-related nomogram.

DESIGN:

Cohort study with validation of linear, biphasic linear, differential, power, and quadratic equations undertaken in two additional cohorts.

SETTING:

United Kingdom infertility clinics.

PATIENT(S):

Training cohort of 4,590 infertile women. Two separate validation cohorts; 4,588 infertile women, and 423 women with confirmed ovulation and normal pelvic ultrasound who have a male partner with severe oligospermia.

INTERVENTION(S):

Serum AMH measurement.

MAIN OUTCOME MEASURE(S):

Optimal fit and age-related AMH nomogram.

RESULT(S):

The linear model had the largest sum of absolute and squared residuals and provided a less adequate fit than the four nonlinear models. Of these, the R(2) ranged from 19.45% to 19.48% in the training dataset, from 21.30% to 21.36% in the validation dataset, and from 13.29% to 13.75% in the partners of oligospermic males. The parameters of the differential model were difficult to estimate, and the goodness-of-fit of the power model was slightly inferior to the quadratic model.

CONCLUSION(S):

Circulating AMH concentrations decline with increasing reproductive age in a manner optimally described by a quadratic equation. This validated age-related AMH nomogram will enable counseling of infertility patients regarding reproductive performance.

Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

[PubMed - indexed for MEDLINE]
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