Fertility in women of late reproductive age: the role of serum anti-Müllerian hormone (AMH) levels in its assessment.
BACKGROUND
Fertility is referred to the capability for having offspring and can be evaluated by fertility rate. Women's fertility is strictly dependent on individual's age. The fertility peak occurs in the early 20s, and it starts to decline in the third and fourth decades of life (falling sharply after age 35).


OBJECTIVE
The aim of this work is to review the available data concerning fertility in women of late reproductive age, especially the role of serum anti-Müllerian hormone (AMH) levels.


RESULTS
There are a lot of factors responsible for decrease of fertility in women of late reproductive age. These factors can be classified as oocyte-dependent (decrease in oocyte quantity and quality) and oocyte-independent (reproductive organs [uterus, oviducts] status and general health). Anti-Müllerian hormone (AMH) is a dimeric glycoprotein of the transforming growth factor-β (TGF-β) superfamily produced directly by the ovarian granulosa cells of secondary, preantral, and early antral follicles. It has been used as an ovarian reserve marker since 2002. Anti-Müllerian hormone seems to be the best endocrine marker for assessing the age-related decline of the ovarian pool in healthy women. Evaluation of AMH's predictive value in the naturally aging population is important for counseling women about reproductive planning as well as for treatment planning for women experiencing hormone-sensitive gynecological conditions such as endometriosis and fibroids.


CONCLUSIONS
AMH can be considered as an indicator of fertility in late reproductive age women and pregnancy outcome in assisted reproductive technology cycles. AMH can strongly predict poor response in the controlled ovarian stimulation.
Department of Gynecological Endocrinology, Poznan University of Medical Sciences, ul. Polna 33, Poznan, Poland. blazejmeczekalski@yahoo.com.
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Meczekalski
Department of Gynecological Endocrinology, Poznan University of Medical Sciences, ul. Polna 33, Poznan, Poland.
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Czyzyk
INVICTA Fertility and Reproductive Center, Gdańsk, Poland.
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Kunicki
Department of Gynecological Endocrinology, Poznan University of Medical Sciences, ul. Polna 33, Poznan, Poland.
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Podfigurna-Stopa
INVICTA Fertility and Reproductive Center, Gdańsk, Poland.
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Plociennik
INVICTA Fertility and Reproductive Center, Warsaw, Poland.|Department of Obstetrics and Gynecology, Center of Postgraduate Education, Warsaw, Poland.
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Jakiel
Department of Gynecological Endocrinology, Poznan University of Medical Sciences, ul. Polna 33, Poznan, Poland.
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Maciejewska-Jeske
INVICTA Fertility and Reproductive Center, Gdańsk, Poland.|INVICTA Fertility and Reproductive Center, Warsaw, Poland.|Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences, Medical University of Gdansk, Gdańsk, Poland.
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Lukaszuk
D000367:Age Factors; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015415:Biomarkers / Q000097:blood*; D005260:Female; D005298:Fertility / Q000502:physiology*; D006801:Humans; D011247:Pregnancy
D015415:Biomarkers; D054304:Anti-Mullerian Hormone
Anti-Müllerian hormone; Fertility; Late reproductive age; Pregnancy