L26/O-292 Body Mass Index (BMI) does not significantly impact age-adjusted Anti-Müllerian Hormone (AMH) levels: a single site analysis of 7,500 patients

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Abstract Study question Is Body Mass Index (BMI) independently associated with serum Anti-Müllerian Hormone (AMH) levels when controlling for age in a large clinical cohort? Summary answer BMI does not significantly impact age-adjusted AMH levels, suggesting that BMI-specific reference ranges for AMH are not clinically necessary. What is known already The relationship between BMI and AMH is unclear. Some studies suggest that obesity is associated with lower AMH levels due to hormonal changes that disrupt the hypothalamic-pituitary-ovarian axis. However, these studies were limited by smaller sample sizes, homogeneous patient populations, and/or failure to adequately control for the natural decline in AMH with age. Establishing whether BMI truly impacts AMH is critical for accurate fertility counseling and treatment planning in reproductive medicine. Study design, size, duration This was a retrospective cross-sectional study of 7,574 racially and ethnically heterogeneous patients who underwent infertility evaluation or received treatment at a suburban reproductive endocrinology clinic in New York, USA, between 2018 and 2024. Participants/materials, setting, methods Age, BMI, and serum AMH were collected. Outliers were removed using the global Interquartile Range (IQR) method (1.5 × IQR), resulting in an analytical cohort of 6,944 patients (23 Main results and the role of chance Age was a highly significant predictor of AMH level (F(1, 6936) = 1258.3, p < 0.001), confirming the expected age-related decline in ovarian reserve. No statistically significant interaction between age and BMI on the rate of AMH decline was noted (p = 0.354). The effect size was negligible (η²p < 0.001), and regression lines for all BMI groups were similar (Pearson’s R range: -0.34 to -0.40). Subsequent ANCOVA confirmed that BMI category had no significant independent impact on age-adjusted AMH levels (F(3, 6936) = 0.848, p = 0.468). The age-adjusted mean AMH levels were similar across all BMI cohorts: Underweight: 2.01 ng/mL (n = 142, 95% CI: 1.70–2.38) • Normal Weight: 1.79 ng/mL (n = 2912, 95% CI: 1.73–1.86) • Overweight: 1.78 ng/mL (n = 1927, 95% CI: 1.70–1.86) • Obese: 1.77 ng/mL (n = 1963, 95% CI: 1.69–1.84) Post-hoc pairwise comparisons confirmed no significant differences in age-adjusted mean AMH levels between any BMI groups. Limitations, reasons for caution This study may be limited due to selection bias of patients seeking specialized care at a reproductive endocrinology clinic. Additionally, the global outlier removal step resulted in the exclusion of patients with AMH in the upper extremes, meaning these results may not apply to patients who have polycystic ovarian syndrome. Wider implications of the findings In one of the largest studies to date, BMI was not found to significantly impact AMH levels. Clinicians may interpret AMH results without adjusting for patient weight. These findings simplify the clinical application of AMH as a robust, age-dependent marker of ovarian reserve. Trial registration number No

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