Exploring the association between lifestyle factors and anti-Müllerian hormone concentration and rate of decline

RESEARCH QUESTION: How do lifestyle factors relate to level and decline rate of anti-Müllerian hormone (AMH)?

DESIGN: Longitudinal follow-up study including 2761 women of the population-based Doetinchem Cohort Study with five measurements over a 20-year period. The following lifestyle factors were assessed at follow-up visits: smoking; oral contraceptive use; coffee and tea intake; alcohol intake; physical exercise; body mass index (BMI); and waist-hip ratio (WHR). The associations between lifestyle factors and the outcome measures AMH level (ng/ml) and AMH decline rate (ng/ml/year) were studied in a multivariable linear mixed model.

RESULTS: After confounder adjustment, current oral contraceptive use was associated with 41.5% (95% CI ‒49.9 to ‒31.4%) lower AMH levels and a 0.11 ng/ml/year (95% CI 0.08 to 0.13) slower decline than never use. Current and former smokers had 20.3% (95% CI ‒29.2 to ‒10.3%) and 12.7% (‒21.2 to ‒3.2%) lower AMH levels, respectively, but the AMH decline rate did not differ from non-smokers. Women who stopped smoking, however, had temporary stagnation of their AMH decline. Women with high coffee and tea intake had 10.2% (CI 0.2 to 21.2%) higher AMH levels compared with women with low intake. No associations were found between BMI, WHR, physical exercise and alcohol consumption and AMH or AMH decline rate in the multivariable analysis.

CONCLUSIONS: These findings can be used for the interpretation of AMH levels in the context of reproductive health counselling.