Age-specific random day serum antimüllerian hormone reference values for women of reproductive age in the general population: a large Chinese nationwide population-based survey.
Level 4 - case-series / case-control
Cross-sectional nationwide population survey
PubMed 35934115 · doi:10.1016/j.ajog.2022.07.029
What was done
A nationwide population-based cross-sectional survey was conducted in 15 provinces and municipalities across mainland China between May 2019 and April 2021. A multistage stratified sampling design selected 10,053 women aged 20 to 49 years. Women who were pregnant, had prior ovarian surgery, used hormone medications within the past 3 months, or had outlier values were excluded. Serum antimüllerian hormone (AMH) was measured on a random day using ultrasensitive two-site ELISA. Generalized additive models for location scale and shape were used to fit age-specific percentile curves for 9,112 eligible women aged 21 to 49 years.
What was found
Fitted 50th (2.5th–97.5th) percentiles of serum AMH (ng/mL) across ages were: - Age 21: 4.83 (0.79 to 18.41) - Age 25: 4.47 (0.72 to 16.58) - Age 30: 3.67 (0.50 to 13.82) - Age 35: 2.59 (0.24 to 10.35) - Age 40: 1.35 (0.05 to 6.68) - Age 45: 0.33 (<0.01 to 3.40) - Age 49: 0.04 (<0.01 to 1.77) The rate of AMH decline accelerated with increasing age, particularly beyond age 35, with a steeper decline observed in the 25th percentile curve compared to the 75th percentile curve.
Why it matters
This study provides large-scale, population-based age-specific AMH percentile reference curves for reproductive-aged Chinese women to assist clinical evaluation of ovarian reserve.
Limits
The study is cross-sectional, inferring longitudinal trajectories from age-group differences rather than serial individual measurements. Values were obtained using a single ELISA platform (Ansh Lab), which may not directly generalize to other automated commercial AMH assays. The population was restricted to mainland China, limiting generalizability to other ethnic populations.
Cited by
- supports A normal AMH level for women in their 20s and 30s is up to 6 ng/mL, whereas for women in their 40s it is typically less than 1 ng/mL.