Ethnic Differences in Anti-mullerian Hormone and Ovarian Reserve Retrospective Analysis of Indian and Ethiopian Women

Abstract

Background: There is a growing trend amongst many women of the reproductive age group to delay childbearing, and interest in assisted reproductive technologies (ART). Ethnic variations in anti-Mullerian hormone (AMH) levels may influence fertility and ART outcomes. Aims: To determine the prevalence of low AMH levels and poor ovarian reserve in Indian and Ethiopian women and identify ethnic differences in AMH in these populations. Settings and Design: Retrospective analysis of records of patients undergoing In-Vitro fertilization (IVF) at a fertility clinic in North India from January 2018 to March 2020. Materials and Methods: This study included 120 Indian and 86 Ethiopian women undergoing IVF due to female cause of infertility. Cases of polycystic ovarian syndrome, endometriosis, previous adnexal surgery or pelvic inflammatory disease were excluded. Serum AMH levels were estimated using a chemiluminescent immunoassay (CLIA). AMH levels = 2ng/ mL were considered to signify poor ovarian reserve. Statistical Analysis Used: Comparison of groups was done using a Mann-Whitney U test. Spearman correlation coefficients were calculated for two continuous variables. Categorical variables were compared using a Chi-Square test. Results: AMH levels were significantly higher amongst Indianscompared to Ethiopians. AMH levels declined with age overall, though the negative correlation of AMH with age was stronger in Ethiopians. Conclusions: This study demonstrates that significant differences exist between Indians and Ethiopians in serum AMH level, an ovarian reserve marker. Ethnicity may play a role in ovarian reserve and should be considered during patient counselling and may be useful for personalizing treatment.