Correlation between antral follicle count and anti-Mullerian hormone in infertile Indian women

Abstract

Background: Antral follicle count (AFC) and anti-Mullerian hormone (AMH) have been used as indicators of ovarian reserve in infertile women. There still exists a debate about the association between the two parameters. Objective: The objective of the study was to find out the relationship between AFC and AMH in infertile women. Methods: This was a prospective, hospital-based, cross-sectional study, in which 1083 infertile women (aged 20–40 years) with primary infertility were included. They were divided into four age groups, i.e., Group I (20–24 years), Group II (25–29 years), Group III (30–34 years), and Group IV (35–40 years). AMH and AFC were measured on 3rd day of menstrual cycle. Pearson correlation and linear regression analysis were done to find out the relationship between age, AFC, and AMH. Statistical analysis was done using IBM SPSS Statistics for Windows, version 20 (IBM Corp., Armonk, N.Y., USA). A P < 0.05 was considered statistically significant. Results: There was modest negative correlation of AFC with age (r = −0.476, P < 0.001). AMH showed strong negative correlation with age (r = −0.844, P < 0.001) and modest positive correlation with AFC (r = 0.400, P < 0.001). For separate age groups also, statistically significant correlations (P < 0.05–P < 0.001) were noted between age, AFC, and AMH. Age explained 22.7% variation in AFC and 71.2% variation in AMH. Conclusion: There was a significant correlation between AMH and AFC in infertile women. AFC showed a continuous decline with increasing age. However, AMH increased with age till third decade of life and showed negative correlation with AFC. Thereafter, AMH started decreasing with age and showed positive correlation with AFC.