Ethnic discordance in serum anti-Müllerian hormone in European healthy control, Indian healthy control and Indian infertile women: a population study from India and Europe

Gromski, P. S., Patil, R. S., Chougule, S. M., Bhomkar, D. A., Jirge, P. R. and Nelson, S. M. (2022) Ethnic discordance in serum anti-Müllerian hormone in European healthy control, Indian healthy control and Indian infertile women: a population study from India and Europe. Reproductive BioMedicine Online, 45(5), pp. 979-986. (doi: 10.1016/j.rbmo.2022.06.023)

Abstract

Research Question: Does AMH differ between healthy European and Indian women, and are potential ethnic differences modified by infertility diagnosis? Design: Cross-sectional analysis of three prospectively recruited cohorts (n=2,758); healthy European women (n=758), healthy community cohort from Kolhapur, India (n=400) and infertility cohort from Kolhapur, India (n=1600). AMH was determined by Elecys® AMH plus. Ethnicity, age and cause of infertility were modelled using additive quantile regression models. Results: Healthy Indian women had lower AMH than their healthy European counterparts (population estimates 20.0% lower (95% CI, 7.2-36.5)), with increasing discordance with increasing age; at 25 years AMH was 11.9% (95% CI, 9.4-14.1) lower, increasing to 40.0% (95% CI, 0-64.6) lower by age 45. Comparison of healthy and infertile Indian women revealed differences that were related to cause of infertility. Women whose male partner had severe oligoasthenoteratozoospermia (n=95) had similar AMH to controls, women with PCOS (n=220) had higher AMH, especially in those <30 years and women with a principal diagnosis of unexplained infertility (n=757) AMH was lower (median difference 22.6% lower 95% CI 9.1-37.7) than controls. Conclusions: AMH is substantially lower in healthy Indian women at all ages than their European counterparts. Infertile Indian women have variable differences in AMH from there healthy Indian controls, with the extent and direction of differences primarily reflects the underlying cause of infertility. Recognition of ethnic and cause specific differences are critical to ensure accurate contextualising of results and clinical outcomes for patients.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Nelson, Professor Scott and Gromski, Dr Piotr
• Authors: Gromski, P. S., Patil, R. S., Chougule, S. M., Bhomkar, D. A., Jirge, P. R., and Nelson, S. M.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Reproductive BioMedicine Online
• Publisher: Elsevier
• ISSN: 1472-6483
• ISSN (Online): 1472-6491
• Published Online: 30 June 2022
• Copyright Holders: Copyright © 2022 Crown Copyright
• First Published: First published in Reproductive BioMedicine Online 45(5): 979-986
• Publisher Policy: Reproduced under a Creative Commons license