Antimüllerian hormone in relation to tobacco and marijuana use and sources of indoor heating/cooking

Fertil Steril. 2016 Sep 1;106(3):723-30. doi: 10.1016/j.fertnstert.2016.05.015. Epub 2016 May 27.


Objective: To evaluate exposure to tobacco, marijuana, and indoor heating/cooking sources in relation to antimüllerian hormone (AMH) levels.

Design: Cross-sectional analysis in a sample of premenopausal women (n = 913) enrolled in the Sister Study cohort (n = 50,884).

Setting: Not applicable.

Patient(s): Women, ages 35-54 years at time of enrollment, with an archived serum sample and at least one intact ovary and classified as premenopausal.

Intervention(s): Not applicable.

Main outcome measure(s): Serum AMH (ng/mL) levels ascertained by ultrasensitive ELISA assay.

Result(s): Lower AMH levels were associated with sources of indoor heating, including burning wood (-36.0%; 95% confidence interval [CI], -55.7%, -7.8%) or artificial fire logs (-45.8%; 95% CI, -67.2%, -10.4%) at least 10 times/year in a residential indoor stove/fireplace. Lower AMH levels were also observed in women who were current smokers of ≥20 cigarettes/day relative to nonsmokers (-56.2%; 95% CI, -80.3%, -2.8%) and in women with 10+ years of adult environmental tobacco smoke (ETS) exposure (-31.3%; 95% CI, -51.3%, -3.1%), but no associations were observed for marijuana use.

Conclusion(s): We confirmed previously reported findings of lower AMH levels in current heavy smokers and also found associations for long-term ETS exposure and indoor burning of wood or artificial fire logs. These findings suggest that combustion by-products from common exposures can have toxic effects on the human ovary.

Keywords: Anti-Müllerian Hormone; Tobacco; breast cancer; environmental tobacco smoke; indoor air pollution.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Air Pollution, Indoor / adverse effects*
  • Anti-Mullerian Hormone / blood*
  • Biomarkers / blood
  • Cooking*
  • Cross-Sectional Studies
  • Female
  • Heating / adverse effects*
  • Housing*
  • Humans
  • Marijuana Abuse / blood
  • Marijuana Abuse / complications*
  • Marijuana Smoking / adverse effects*
  • Marijuana Smoking / blood
  • Middle Aged
  • Puerto Rico
  • Risk Assessment
  • Risk Factors
  • Siblings
  • Smoking / adverse effects*
  • Smoking / blood
  • Tobacco Smoke Pollution / adverse effects*
  • United States
  • Women's Health


  • Biomarkers
  • Tobacco Smoke Pollution
  • Anti-Mullerian Hormone