Nomogram for the decline in serum antimüllerian hormone: a population study of 9,601 infertility patients

Fertil Steril. 2011 Feb;95(2):736-41.e1-3. doi: 10.1016/j.fertnstert.2010.08.022. Epub 2010 Sep 24.


Objective: To define an optimal model for the decline in circulating antimüllerian hormone (AMH) with age and develop a validated age-related nomogram.

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

Setting: United Kingdom infertility clinics.

Patient(s): 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.

Intervention(s): Serum AMH measurement.

Main outcome measure(s): Optimal fit and age-related AMH nomogram.

Result(s): 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.

Conclusion(s): 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.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Age Factors
  • Aging / blood
  • Anti-Mullerian Hormone / blood*
  • Blood Chemical Analysis / standards*
  • Cohort Studies
  • Diagnostic Techniques, Endocrine / standards
  • Down-Regulation
  • Female
  • Humans
  • Infertility / blood*
  • Infertility / diagnosis
  • Male
  • Middle Aged
  • Nomograms*
  • Osmolar Concentration
  • Reference Values


  • Anti-Mullerian Hormone