Association between uterine fibroids and antimüllerian hormone concentrations among African American women

Lia A. Bernardi; Anne Waldo; Veronica J. Berrocal; Lauren A. Wise; Erica E. Marsh

doi:10.1016/j.fertnstert.2021.12.019

Association between uterine fibroids and antimüllerian hormone concentrations among African American women

Lia A. Bernardi, Anne Waldo, Veronica J. Berrocal, Lauren A. Wise, Erica E. Marsh^*

^*Corresponding author for this work

Obstetrics and Gynecology

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

Objective: To evaluate the extent to which uterine fibroids are associated with antimüllerian hormone (AMH) concentrations. Design: Cross-sectional study. Setting: Baseline data from the Study of the Environment, Lifestyle, and Fibroids, which is a 5-year longitudinal study of African American women. Patient(s): A total of 1,643 women aged 23–35 years without a known history of fibroids. Exposure: Fibroid presence. Intervention(s): None. Main Outcome Measure(s): The primary outcome was percent difference in the mean AMH concentration between participants with fibroids and those without fibroids. The secondary outcomes were percent differences in the mean AMH concentrations in participants with different numbers, sizes, types, and positions of fibroids and the percent difference in the mean AMH concentration in participants with different uterine volumes. Result(s): At least 1 fibroid was identified on ultrasound in 362 (22%) participants. There was a small difference in the mean AMH concentrations in participants with fibroids (age-adjusted model: −4.6%, 95% confidence interval (CI): −14.5% to 6.5%; multivariable model: −4.6%, 95% CI: −14.4% to 6.3%). The mean AMH concentrations were found to decrease with increasing fibroid number. Although differences in AMH concentrations were not statistically significant, compared with no fibroids, the mean percent differences in AMH concentrations for 1, 2–3, and ≥4 fibroids were −1.2% (95% CI: −13.2% to 12.5%), −7.1% (95% CI: −23.3% to 12.5%), and −17.5% (95% CI: −38.2% to 10.0%), respectively. There were no consistent associations between AMH concentrations and fibroid location, size, or uterine volume. Conclusion(s): The presence of fibroids was not materially associated with AMH concentrations. Other than a monotonic inverse relationship between fibroid number and AMH concentrations, no other fibroid characteristics were consistently or appreciably associated, although associations were imprecise.

Original language	English (US)
Pages (from-to)	832-840
Number of pages	9
Journal	Fertility and Sterility
Volume	117
Issue number	4
DOIs	https://doi.org/10.1016/j.fertnstert.2021.12.019
State	Published - Apr 2022

Funding

Supported by the National Institutes of Health ( R01HD088638 ) (to E.E.M.). We thank Patrick Sluss, Ph.D. at Ansh Labs. We also thank the SELF participants and staff. The fibroid and covariate data for this analysis was provided by Donna Baird, Ph.D. and Quaker Harmon, M.D., Ph.D. Principal Investigator and Staff Scientist for SELF. SELF was funded by the Intramural Research Program of the National Institutes of Health, National Institute of Environmental Health Sciences (ZIAES049013) and, in part, by funds allocated for health research by the American Recovery and Reinvestment Act.

Keywords

Antimüllerian hormone
ovarian reserve
uterine fibroids
uterine leiomyomas

ASJC Scopus subject areas

Reproductive Medicine
Obstetrics and Gynecology

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10.1016/j.fertnstert.2021.12.019

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title = "Association between uterine fibroids and antim{\"u}llerian hormone concentrations among African American women",

abstract = "Objective: To evaluate the extent to which uterine fibroids are associated with antim{\"u}llerian hormone (AMH) concentrations. Design: Cross-sectional study. Setting: Baseline data from the Study of the Environment, Lifestyle, and Fibroids, which is a 5-year longitudinal study of African American women. Patient(s): A total of 1,643 women aged 23–35 years without a known history of fibroids. Exposure: Fibroid presence. Intervention(s): None. Main Outcome Measure(s): The primary outcome was percent difference in the mean AMH concentration between participants with fibroids and those without fibroids. The secondary outcomes were percent differences in the mean AMH concentrations in participants with different numbers, sizes, types, and positions of fibroids and the percent difference in the mean AMH concentration in participants with different uterine volumes. Result(s): At least 1 fibroid was identified on ultrasound in 362 (22%) participants. There was a small difference in the mean AMH concentrations in participants with fibroids (age-adjusted model: −4.6%, 95% confidence interval (CI): −14.5% to 6.5%; multivariable model: −4.6%, 95% CI: −14.4% to 6.3%). The mean AMH concentrations were found to decrease with increasing fibroid number. Although differences in AMH concentrations were not statistically significant, compared with no fibroids, the mean percent differences in AMH concentrations for 1, 2–3, and ≥4 fibroids were −1.2% (95% CI: −13.2% to 12.5%), −7.1% (95% CI: −23.3% to 12.5%), and −17.5% (95% CI: −38.2% to 10.0%), respectively. There were no consistent associations between AMH concentrations and fibroid location, size, or uterine volume. Conclusion(s): The presence of fibroids was not materially associated with AMH concentrations. Other than a monotonic inverse relationship between fibroid number and AMH concentrations, no other fibroid characteristics were consistently or appreciably associated, although associations were imprecise.",

keywords = "Antim{\"u}llerian hormone, ovarian reserve, uterine fibroids, uterine leiomyomas",

author = "Bernardi, {Lia A.} and Anne Waldo and Berrocal, {Veronica J.} and Wise, {Lauren A.} and Marsh, {Erica E.}",

note = "Publisher Copyright: {\textcopyright} 2021 American Society for Reproductive Medicine",

year = "2022",

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doi = "10.1016/j.fertnstert.2021.12.019",

language = "English (US)",

volume = "117",

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T1 - Association between uterine fibroids and antimüllerian hormone concentrations among African American women

AU - Bernardi, Lia A.

AU - Waldo, Anne

AU - Berrocal, Veronica J.

AU - Wise, Lauren A.

AU - Marsh, Erica E.

PY - 2022/4

Y1 - 2022/4

N2 - Objective: To evaluate the extent to which uterine fibroids are associated with antimüllerian hormone (AMH) concentrations. Design: Cross-sectional study. Setting: Baseline data from the Study of the Environment, Lifestyle, and Fibroids, which is a 5-year longitudinal study of African American women. Patient(s): A total of 1,643 women aged 23–35 years without a known history of fibroids. Exposure: Fibroid presence. Intervention(s): None. Main Outcome Measure(s): The primary outcome was percent difference in the mean AMH concentration between participants with fibroids and those without fibroids. The secondary outcomes were percent differences in the mean AMH concentrations in participants with different numbers, sizes, types, and positions of fibroids and the percent difference in the mean AMH concentration in participants with different uterine volumes. Result(s): At least 1 fibroid was identified on ultrasound in 362 (22%) participants. There was a small difference in the mean AMH concentrations in participants with fibroids (age-adjusted model: −4.6%, 95% confidence interval (CI): −14.5% to 6.5%; multivariable model: −4.6%, 95% CI: −14.4% to 6.3%). The mean AMH concentrations were found to decrease with increasing fibroid number. Although differences in AMH concentrations were not statistically significant, compared with no fibroids, the mean percent differences in AMH concentrations for 1, 2–3, and ≥4 fibroids were −1.2% (95% CI: −13.2% to 12.5%), −7.1% (95% CI: −23.3% to 12.5%), and −17.5% (95% CI: −38.2% to 10.0%), respectively. There were no consistent associations between AMH concentrations and fibroid location, size, or uterine volume. Conclusion(s): The presence of fibroids was not materially associated with AMH concentrations. Other than a monotonic inverse relationship between fibroid number and AMH concentrations, no other fibroid characteristics were consistently or appreciably associated, although associations were imprecise.

AB - Objective: To evaluate the extent to which uterine fibroids are associated with antimüllerian hormone (AMH) concentrations. Design: Cross-sectional study. Setting: Baseline data from the Study of the Environment, Lifestyle, and Fibroids, which is a 5-year longitudinal study of African American women. Patient(s): A total of 1,643 women aged 23–35 years without a known history of fibroids. Exposure: Fibroid presence. Intervention(s): None. Main Outcome Measure(s): The primary outcome was percent difference in the mean AMH concentration between participants with fibroids and those without fibroids. The secondary outcomes were percent differences in the mean AMH concentrations in participants with different numbers, sizes, types, and positions of fibroids and the percent difference in the mean AMH concentration in participants with different uterine volumes. Result(s): At least 1 fibroid was identified on ultrasound in 362 (22%) participants. There was a small difference in the mean AMH concentrations in participants with fibroids (age-adjusted model: −4.6%, 95% confidence interval (CI): −14.5% to 6.5%; multivariable model: −4.6%, 95% CI: −14.4% to 6.3%). The mean AMH concentrations were found to decrease with increasing fibroid number. Although differences in AMH concentrations were not statistically significant, compared with no fibroids, the mean percent differences in AMH concentrations for 1, 2–3, and ≥4 fibroids were −1.2% (95% CI: −13.2% to 12.5%), −7.1% (95% CI: −23.3% to 12.5%), and −17.5% (95% CI: −38.2% to 10.0%), respectively. There were no consistent associations between AMH concentrations and fibroid location, size, or uterine volume. Conclusion(s): The presence of fibroids was not materially associated with AMH concentrations. Other than a monotonic inverse relationship between fibroid number and AMH concentrations, no other fibroid characteristics were consistently or appreciably associated, although associations were imprecise.

KW - Antimüllerian hormone

KW - ovarian reserve

KW - uterine fibroids

KW - uterine leiomyomas

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Association between uterine fibroids and antimüllerian hormone concentrations among African American women

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