Race ethnic disparities in reproductive age An examination of ovarian reserve estimates across four race ethnic groups of healthy regularly cycling women

Capsule:
In a healthy, multiethnic sample, a significant race/ethnicity-by-age interaction was observed, suggesting African-American women may have lower AMH at younger ages but experience less of a reduction in AMH with age.

Authors:
Maria E. Bleil, Ph.D., Steven E. Gregorich, Ph.D., Nancy E. Adler, Ph.D., Barbara Sternfeld, Ph.D., Mitchell P. Rosen, M.D., Marcelle I. Cedars, M.D.

Volume 101, Issue 1, Pages 199-207, January 2014

Abstract:

Objective:
To determine whether reproductive age, as indexed by a validated marker of ovarian reserve (antimüllerian hormone [AMH]), varies among women of different race/ethnic backgrounds.

Design:
Cross-sectional study.

Setting:
Community-based sample.

Patient(s):
Multiethnic sample of 947 (277 white, 237 African American, 220 Latina, and 213 Chinese) healthy and regularly cycling premenopausal women, ages 25–45.

Intervention(s):
None.

Main Outcome Measure(s):
AMH level.

Result(s):
A multivariate model was fit examining race/ethnicity, covariates, nonlinear terms for age (age2, age3), and body mass index (BMI2, BMI3), and two-way interactions between race/ethnicity and each of the other predictor variables in relation to AMH. After backward elimination, significant effects included race/ethnicity (F = 8.45), age (F = 349.94), race/ethnicity-by-linear age interaction (F = 4.67), age2 (F = 31.61), and BMI (F = 10.69). Inspection of the significant race/ethnicity-by-linear age interaction showed AMH levels were consistently lower among Latina women compared with white women across all ages, whereas AMH levels were lower among African American and Chinese women compared with the white women at younger and middle ages, respectively. The AMH levels were higher among African American compared with Latina and Chinese women at older ages.

Conclusion(s):
Although the results must be considered preliminary, the findings are twofold: African American women may have lower AMH levels at younger ages but experience less of a reduction in AMH with advancing age, and Latina and Chinese women compared with white women may have lower AMH levels, marking a lower ovarian reserve and a possibly increased risk for earlier menopause.

  • Lauren Johnson

    Very nice study from UCSF that found significant differences in AMH
    levels between race/ethnic groups. The study population was large and included
    over 200 subjects in each of four race/ethnic groups. I appreciate the authors’
    detailed description of the statistical methods, which will be instructive for
    other investigators studying AMH. While the data are preliminary and require
    validation with longitudinal studies, the authors suggest that there may be
    differences in ovarian reserve across racial/ethnic groups. I look forward to
    seeing longitudinal data from this cohort!

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