Nomogram for the decline in serum antimüllerian hormone: a population study of 9,601 infertility patients.
OBJECTIVE
To define an optimal model for the decline in circulating antimüllerian hormone (AMH) with age and develop a validated age-related nomogram.


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


METHODS
United Kingdom infertility clinics.


METHODS
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.


METHODS
Serum AMH measurement.


METHODS
Optimal fit and age-related AMH nomogram.


RESULTS
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.


CONCLUSIONS
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.
Nelson
Scott M
SM
Reproductive and Maternal Medicine, Faculty of Medicine, University of Glasgow, Glasgow, Scotland. Scott.Nelson@glasgow.ac.uk
Messow
Martina C
MC
Wallace
A Michael
AM
Fleming
Richard
R
McConnachie
Alex
A
D000328:Adult; D000367:Age Factors; D000375:Aging / Q000097:blood; D054304:Anti-Mullerian Hormone / Q000097:blood*; D001774:Blood Chemical Analysis / Q000592:standards*; D015331:Cohort Studies; D003940:Diagnostic Techniques, Endocrine / Q000592:standards; D015536:Down-Regulation; D005260:Female; D006801:Humans; D007246:Infertility / Q000097:blood* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D049451:Nomograms; D009994:Osmolar Concentration; D012016:Reference Values
D054304:Anti-Mullerian Hormone