Serum anti-Müllerian hormone levels among female undergoing premarital and preconception examinations
LI Wei1, WAN Huiqing1, HAN Haiyan1, YU Jiqi1, HUANG Yizhou2, WANG Feixue3, ZHOU Jianhong2
1. Women and Children's Health Center of Gongshu District, Hangzhou, Zhejiang 310005, China; 2. Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang 310006, China; 3. Zhejiang Provincial Center for Maternal and Child Health & Reproductive Health Care, Hangzhou, Zhejiang 310012, China
Abstract:Objective To analyze serum anti-Müllerian hormone (AMH) level and its influencing factors among female undergoing premarital and preconception examinations, so as to provide the evidence for optimizing reproductive health management measures. Methods Female who received free premarital and preconception examinations and voluntarily underwent serum AMH testing at Women and Children's Health Center of Gongshu District, Hangzhou City from January 2022 to April 2025 were selected as study subjects. Demographic information and reproductive history were collected through questionnaire survey. Venous blood was collected to detect thyroid-stimulating hormone (TSH), alanine aminotransferase, hemoglobin (Hb), and AMH levels. The original AMH values did not follow a normal distribution, but followed a normal distribution after natural logarithm transformation, recorded as ln (AMH). Pearson correlation analysis was used to analyze the correlation between variables, and multiple linear regression model was used to analyze the influencing factors for ln (AMH) levels among female undergoing premarital and preconception examinations. Results A total of 1 073 females undergoing premarital and preconception examinations were surveyed, with a mean age of (29.43±3.30) years. There were 959 females without pregnancy (89.38%) and 1 042 females without full-term live birth history (97.11%). The median AMH level was 3.85 (interquartile range, 3.63) ng/mL, and the mean ln (AMH) level was 1.27±0.75. The ln (AMH) levels were higher in females without pregnancy and without full-term live birth history (both P<0.05). The ln (AMH) level was negatively correlated with age (r=-0.260) and TSH (r=-0.093), and positively correlated with Hb (r=-0.260, -0.093, and 0.073, all P<0.05). Multiple linear regression analysis showed that age (β′=-0.253) and TSH (β′=-0.103) were statistically associated with ln (AMH) levels among female undergoing premarital and preconception examinations (both P<0.05). The associations of other variables with ln (AMH) levels were not statistically significant (all P>0.05). Conclusions Age and TSH level are influencing factors for AMH levels among female undergoing premarital and preconception examinations. AMH levels among female undergoing premarital and preconception examinations decrease with increasing age and increasing TSH level.
[1] 顾宝昌,侯佳伟,吴楠.中国总和生育率为何如此低?——推延和补偿的博弈[J].人口与经济,2020(1):49-62. [2] 周灿权,古芳.重视高龄女性生殖健康[J].中国实用妇科与产科杂志,2017,33(1):59-63. [3] 杨玉清,李旭丽,李伟娥.备孕夫妇生育储备功能现状及影响因素研究[J].宁夏医学杂志,2025,47(7):599-603. [4] Practice Committee of the American Society for Reproductive Medicine.Testing and interpreting measures of ovarian reserve:a committee opinion[J].Fertil Steril,2020,114(6):1151-1157. [5] CEDARS M I.Evaluation of female fertility-AMH and ovarian reserve testing[J].J Clin Endocrinol Metab,2022,107(6):1510-1519. [6] MOOLHUIJSEN L M E,VISSER J A.Anti-Müllerian hormone and ovarian reserve:update on assessing ovarian function[J].J Clin Endocrinol Metab,2020,105(11):3361-3373. [7] SONG J W,GAO S K,ZHAO L X,et al.Distribution and related influencing factors of AMH level in family-planning women of childbearing age:a cross-sectional study from Beijing,China[J].Int J Womens Health,2025,17:99-107. [8] CUI L L,QIN Y Y,GAO X,et al.Antimüllerian hormone:correlation with age and androgenic and metabolic factors in women from birth to postmenopause[J].Fertil Steril,2016,105(2):481-485. [9] American College of Obstetricians and Gynecologists Committee on Gynecologic Practice and Practice Committee.Female age-related fertility decline.Committee Opinion No.589[J].Fertil Steril,2014,101(3):633-634. [10] AL RISI E,ZADJALI F,MULA-ABED W S.Reference ranges of serum anti-müllerian hormone in healthy reproductive-aged Omani women[J/OL].Oman Med J,2023,38(3)[2026-01-26].https://doi.org/10.5001/omj.2023.79. [11] HU L L,YANG H Y,LUO H N,et al.Age-specific reference ranges and variation of anti-mülerian hormone in healthy Chinese women of reproductive and perimenopausal age:a nationwide population-based prospective multicenter cross-sectional study[J/OL].Gynecol Endocrinol,2025,41(1)[2026-01-26].https://doi.org/10.1080/09513590.2024.2431230. [12] 钱靖,钱东林,朱国祥.不孕症患者血清AMH和E2水平对卵巢储备功能、治疗后卵巢反应及妊娠结局的预测价值[J].中国性科学,2024,33(10):56-60. [13] 高丽虹,蔡文伟,朱琴,等.抗苗勒管激素与年龄的关系及其预测卵巢衰老的临床研究[J].中华妇产科杂志,2015,50(5):352-355. [14] ZHANG J,WANG X,REN Z,et al.Impact of age and menopausal stage on serum anti-Müllerian hormone levels in middle-aged women[J].Climacteric,2021,24(6):618-623. [15] HIRAOKA T,WADA-HIRAIKE O,HIROTA Y,et al.The impact of elevated thyroid stimulating hormone on female subfertility[J].Reprod Med Biol,2015,15(2):121-126. [16] LI S Y,ZHANG L N,LI W Q,et al.Adult-onset hypothyroidism induces granulosa cell apoptosis and affects ovarian follicle development in rats[J/OL].Front Cell Dev Biol,2025,13[2026-01-26].https://doi.org/10.3389/fcell.2025.1610694. [17] ZHANG H Z,QIU H,LIU Z Q,et al.Subclinical/overt hypothyroidism may be associated with diminished ovarian reserve in infertile women independent of thyroid autoimmunity[J/OL].Front Endocrinol,2024,15[2026-01-26].https://doi.org/10.3389/fendo.2024.1477665.