Age-stratified anti-Müllerian hormone (AMH) nomogram: a comprehensive cohort study including 22.920 women.
Level 3 - non-randomized controlled study
Retrospective cohort study analyzing clinical database records
PubMed 40620793 · doi:10.3389/fendo.2025.1612194
What was done
This retrospective cohort study evaluated anti-Müllerian hormone (AMH) test results from a tertiary university hospital database collected between April 2015 and June 2024. Women aged 18 to 45 years with complete records were included across multiple clinical departments. Investigators calculated age-specific median AMH concentrations, interquartile ranges, and the prevalence of diminished ovarian reserve (DOR, defined as AMH < 1.2 ng/mL), comparing distributions across clinical subgroups.
What was found
Across 22,920 AMH measurements, more than half came from women aged 24 to 33 years. AMH exhibited a significant negative correlation with age, with median AMH dropping below 1.2 ng/mL by age 36. The prevalence of DOR rose from 15.9% at age 18 to 96% at age 45. Women evaluated in the Endometriosis Unit had significantly lower median AMH levels (1.6 ng/mL) compared to other hospital departments (2.03 ng/mL). The overall age-stratified distribution remained consistent after excluding patients from assisted reproduction, reproductive endocrinology, and endometriosis units.
Why it matters
This study provides an empirical, age-stratified AMH nomogram based on a large dataset, identifying age 36 as the transition point where median AMH falls into the diminished ovarian reserve range.
Limits
The study is retrospective and limited to a single tertiary hospital population rather than an unselected community cohort, creating risk of referral bias. The abstract does not specify assay standardization methods across the 2015–2024 collection period or account for potential confounders such as oral contraceptive use, body mass index, or longitudinal reproductive outcomes.
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.