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Age-Specific Normal Reference Range for Serum Anti-Müllerian Hormone in Healthy Chinese Han Women: A nationwide Population-Based Study

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Abstract

Background

The increasing use of anti-Müllerian hormone (AMH) in clinic has raised concerns regarding the reliable reference range for this test. However, the reference range for AMH in normal Chinese female population has not been established. Furthermore, relationship between AMH and other clinical markers such as body mass index (BMI) and antral follicle counts (AFCs) and other sex-related hormones have not been examined in normal population-based women.

Objective

We aimed to determine the age-specific reference range for serum AMH in healthy Chinese women throughout reproductive age to menopause and to estimate relationship between AMH and other clinical markers in healthy women.

Study Design

In this multicenter and nationwide study, advertisements were used to recruit 2055 women, aged 20 to 55 years, from 6 different regions in China; 1590 (77.37%) women met the inclusion criteria for the reference range population. We measured the baseline serum AMH levels using new Beckman Coulter Gen II assay. Serum concentration of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), testosterone (T), prolactin (PRL), progesterone (PRG), and AFCs were also determined in the follicular phase.

Main Outcome Measures

The AMH-Age nomogram and AMH levels of different age-groups and the relationship between AMH and other clinical markers.

Results

Serum AMH concentrations declined progressively with age. A quadratic model defined as log (AMH) = (−1.970 + 0.296 × Age − 0.006 × Age2) fitted best the decline of AMH with age. The median AMH levels were 6.23, 5.65, 4.55, 3.74, 2.78, and 1.09 ng/mL for the 20 ≤ age < 25, 25 ≤ age < 30, 30 ≤ age < 33, 33 ≤ age < 37, 37 ≤ age < 40, and 40 ≤ age < 55 groups, respectively. The 5th to 95th percentiles of the AMH levels, as the reference range, were 2.06 to 12.66, 1.77 to 13.83, 1.48 to 11.45, 0.87 to 9.76, 0.56 to 9.49, and 0.08 to 5.70 ng/mL for each age-group. The AMH levels were positively correlated with AFCs and T, LH, PRL and PRG levels and negatively correlated with BMI and FSH levels and were not significantly correlated with E2 levels. The relationship between AMH and other variables remain unchanged except for PRL, which was not significantly correlated with AMH levels after controlling for both age and BMI.

Conclusions

This study determined the normal reference ranges for serum AMH levels in a large population-based sample of healthy Chinese women.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Anv, 430030, Wuhan, Hubei, China

    Xiaofang Du MD, Ting Ding PhD, Kecheng Huang MD, Song Deng MD, Lanfang Ma MD, Jun Yang PhD, Jingjing Jiang MD, Shuhong Yang PhD, Jia Huang MD, Meng Wu MD, Li Fang MD, Yunping Lu MD, Aiyue Luo PhD & Shixuan Wang PhD

  2. Reproductive Medical Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Hanwang Zhang PhD

  3. Reproductive Medical Center, Henan Provincial People’s Hospital, Zhengzhou, China

    Cuilian Zhang PhD

  4. Reproductive Medical Center, The People’s Hospital of Zhengzhou University, Zhengzhou, China

    Cuilian Zhang PhD

  5. Reproductive Medical Center, Foshan Maternal and Child Health Care Hospital, Foshan, China

    Wenmin Ma MD

  6. Reproductive Medical Center, Chengdu Jinjiang Maternal and Child Health Hospital, Chengdu, China

    Ying Zhong MD

  7. Reproductive Medical Center, Shenyang women’s and children’s hospital, Shenyang, China

    Wenyu Qu PhD

  8. Reproductive Medical Center, Maternal and Child Health Hospital of Hubei Province, Wuhan, China

    Jie Zheng MD

  9. Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Yi Liu PhD

  10. Department of Obstetrics and Gynecology, Renhe Hospital, China Three Gorges University, Yichang, China

    Zhiying Li MD

Authors
  1. Xiaofang Du MD
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  2. Ting Ding PhD
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  3. Hanwang Zhang PhD
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  4. Cuilian Zhang PhD
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  5. Wenmin Ma MD
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  6. Ying Zhong MD
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  7. Wenyu Qu PhD
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  8. Jie Zheng MD
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  11. Kecheng Huang MD
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  12. Song Deng MD
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  13. Lanfang Ma MD
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  18. Meng Wu MD
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  19. Li Fang MD
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  20. Yunping Lu MD
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  21. Aiyue Luo PhD
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Corresponding authors

Correspondence to Aiyue Luo PhD or Shixuan Wang PhD.

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Du, X., Ding, T., Zhang, H. et al. Age-Specific Normal Reference Range for Serum Anti-Müllerian Hormone in Healthy Chinese Han Women: A nationwide Population-Based Study. Reprod. Sci. 23, 1019–1027 (2016). https://doi.org/10.1177/1933719115625843

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  • DOI: https://doi.org/10.1177/1933719115625843

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