Anti mülleran hormone levels and associated factors among adult females in Kampala

Abstract

Anti Mülleran Hormone (AMH), a type of glycoprotein, is found in both men and women. It is produced exclusively in the gonads and is involved in the regulation of follicular growth and development. AMH has over the years emerged as one the best markers for ovarian reserve among females due to its stability regardless of the menstrual cycle. However, there is limited data on AMH reference ranges among women in Uganda despite the various immunoassays that are available for its testing. Similarly, there are discrepancies in the factors affecting AMH levels among females. The aim of this study was to determine the mean and reference serum AMH levels and associated factors among adult females in Kampala, Uganda. It was a cross-sectional study among adult females at MBN Clinical Laboratories, Kampala. This study involved collecting blood samples from 161 consecutively sampled adult females for serum AMH testing. Other relevant data from these study participants were obtained using an interviewer administered questionnaire. The 5th and 95th percentiles were computed to give AMH reference ranges. Linear regression, in STATA was used to determine the factors associated with AMH levels. The median (inter quartile range) age for the participants was 31 years (IQR 25,40). Most participants (72.7%) had given birth, 64.0% had regular menses, 96.9% did not work night shifts and 31.1% used hormonal contraceptives. The mean ± SD AMH concentrations (ng/mL) were; 2.82±2.60 for 18 - 29 years, 1.19±1.33 for 30 - 39 years and 0.25±0.41 for 40 - 50 years. The AMH reference ranges (ng/mL) were; 0.31 - 7.4 for 18 – 29 years, 0.13 - 3.83 for 30 - 39 years, and < years, 0.13 - 3.83 for 30 - 39 years, and The factors associated with AMH levels were; age (β=-0.12, 95% CI=-0.15 - -0.08, p< 0.001), hormonal contraceptive use (β=0.94, 95% CI=0.28 - 1.61, p=0.006), waist to hip circumference ratio (β=-5.27, 95% CI=-10.14 - -0.40, p=0.034), and working night shifts (β=1.90, 95% CI=0.19 - 3.60, p=0.029). This study determined mean ± SD AMH concentrations (ng/mL) as; 2.82±2.60 for 18 - 29 years, 1.19±1.33 for 30 - 39 years and 0.25±0.41 for 40 - 50 years. The AMH reference ranges (ng/mL) were; 0.31 - 7.4 for 18 - 29 years, 0.13 - 3.83 for 30 - 39 years, and <1.03 for 40 - 50 years. Age, hormonal contraceptive use, and waist to hip circumference ratio were all negatively associated with serum anti-Müllerian hormone