Environmental heavy metal exposure and altering anti-Mullerian hormone levels in women.

Background: Serum levels of anti-Mullerian hormone (AMH), a key indicator of ovarian aging, decrease with age. This decline may be accelerated by genetic and environmental factors. Accordingly, the present study investigates the relationship between serum AMH concentrations and exposure to heavy metals.

Methods: This cohort study was conducted on 220 women with a median age of 42 years (Range: 37-45). Participants were reproductive-age women from the Tehran Lipid and Glucose Study (TLGS) that met our inclusion criteria. Serum concentration of heavy metals - including lead (Pb), cadmium (Cd), copper (Cu), aluminum (Al) and chromium (Cr) - as well as AMH levels, were measured using stored samples from the second and fifth follow-up visits with a time interval of approximately 10 years. A multivariate linear regression model was used to assess the relationship between AMH and heavy metals, adjusting for age, body mass index (BMI), smoking, physical activity, age at menarche, education, marital status and parity.

Results: The results indicated that serum AMH concentration in women classified within the fourth and third quartiles of Cu was reduced by -0.43 (95%CI: -0.73, -0.13) ng/ml and - 0.34 (95%CI: -0.65, -0.03) ng/ml, respectively. No statistically significant associations were observed between AMH levels and other heavy metals, including Pb, Al, and Cr (P > 0.05).

Conclusion: These findings suggest a possible link between elevated Cu levels and diminished AMH concentrations in reproductive-age women. However, further research is needed to confirm these findings and to elucidate the underlying factors, particularly in younger age groups.