Please use this identifier to cite or link to this item: https://doi.org/10.1371/journal.pone.0189830
Title: Age-related nomograms for antral follicle count and anti-Mullerian hormone for subfertile Chinese women in Singapore
Authors: Loy S.L. 
Cheung Y.B. 
Fortier M.V. 
Ong C.L. 
Tan H.H.
Nadarajah S.
Chan J.K.Y. 
Viardot-Foucault V. 
Keywords: Muellerian inhibiting factor
Muellerian inhibiting factor
adult
age
antral follicle count
Article
Chinese
female
female subfertility
human
major clinical study
nomogram
observational study
reference value
retrospective study
screening
Singapore
adolescent
age
blood
China
ethnology
female infertility
ovary follicle
pathology
young adult
Adolescent
Age Factors
Anti-Mullerian Hormone
China
Female
Humans
Infertility, Female
Ovarian Follicle
Singapore
Young Adult
Issue Date: 2017
Citation: Loy S.L., Cheung Y.B., Fortier M.V., Ong C.L., Tan H.H., Nadarajah S., Chan J.K.Y., Viardot-Foucault V. (2017). Age-related nomograms for antral follicle count and anti-Mullerian hormone for subfertile Chinese women in Singapore. PLoS ONE 12 (12) : e0189830. ScholarBank@NUS Repository. https://doi.org/10.1371/journal.pone.0189830
Abstract: Background Antral follicle count (AFC) and anti-Mullerian hormone (AMH) are known as the most reliable markers of a woman’s ovarian reserve and are related to age. There is currently no specific local age-related centile charts for AFC and AMH. Therefore, we aim to examine the relationship between AFC and AMH with age and construct age-related nomograms among a subfertile Asian population. Methods This is a study involving Chinese women who had their AFC and AMH measured as part of their subfertility screening from December 2010 until November 2014 in KK Women’s and Children’s Hospital, Singapore. Ordinary least squares regression analysis was used to estimate the relationship of AFC and AMH with age, while age-related AFC and AMH nomograms for the 3rd, 10th, 25th, 50th, 75th, 90th and 97th percentiles were produced using the lambda-mu-sigma method. Results A total of 1,009 women, aged 26 to 44 year-old, were included. On average, the AFC and AMH decreased respectively by 0.79 follicle (95% confidence interval -0.93, -0.64) and 0.38 ng/mL (95% confidence interval -0.43, -0.32) per year of age. The age-related nomograms of AFC showed an approximately linear pattern, inversely correlated with age, regardless of the percentile. For AMH, the pattern is linear for the 75th percentile and below but shows a slightly accelerating decline for the 90th and 97th percentile. Overall, there were large inter-individual variations in AFC and AMH up to about 40 year-old. Conclusion The declines of AFC and AMH over age are mostly linear among subfertile Chinese women in Singapore. The age-related AFC and AMH nomograms could be used as a reference chart by fertility practitioners. However, future validation with longitudinal data is required. © 2017 Loy et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Source Title: PLoS ONE
URI: https://scholarbank.nus.edu.sg/handle/10635/161244
ISSN: 19326203
DOI: 10.1371/journal.pone.0189830
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