Antimüllerian hormone as a predictor of natural fecundability in women aged 30-42 years

Obstet Gynecol. 2011 Apr;117(4):798-804. doi: 10.1097/AOG.0b013e3182116bc8.


Objective: To generate estimates of the association between markers of ovarian aging and natural fertility in a community sample at risk for ovarian aging.

Methods: Women aged 30-44 years with no history of infertility who had been trying to conceive for less than 3 months provided early-follicular phase serum and urine (N=100). Subsequently, these women kept a diary to record menstrual bleeding and intercourse and conducted standardized pregnancy testing for up to 6 months. Serum was analyzed for estradiol, follicle-stimulating hormone (FSH), antimüllerian hormone, and inhibin B. Urine was analyzed for FSH and estrone 3-glucuronide. Diary data on menstrual cycle day and patterns of intercourse were used to calculate day-specific fecundability ratios.

Results: Sixty-three percent of participants conceived within 6 months. After adjusting for age, 18 women (18%) with serum antimüllerian hormone levels of 0.7 ng/mL or less had significantly reduced fecundability given intercourse on a fertile day compared with women with higher antimüllerian hormone levels (fecundability ratio 0.38; 95% confidence interval [CI] 0.08-0.91). The day-specific fecundability for women with early-follicular phase serum FSH values greater than 10 milli-international units/mL compared with women with lower FSH levels was also reduced, although nonsignificantly (11% of women affected; fecundability ratio 0.44; 95% CI 0.08-1.10). The association with urinary FSH was weaker (27% women affected; fecundability ratio 0.61; 95% CI 0.26-1.26), and the associations for the other markers were weaker still.

Conclusion: Early-follicular phase antimüllerian hormone appears to be associated with natural fertility in the general population.

Level of evidence: II.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Anti-Mullerian Hormone / blood*
  • Biomarkers / blood
  • Cohort Studies
  • Confidence Intervals
  • Estradiol / blood*
  • Female
  • Fertility / physiology
  • Follicle Stimulating Hormone / blood*
  • Humans
  • Inhibins / blood*
  • Maternal Age*
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Rate
  • Risk Factors


  • Biomarkers
  • inhibin B
  • Estradiol
  • Inhibins
  • Anti-Mullerian Hormone
  • Follicle Stimulating Hormone