Frequent binge drinking associated with lower AMH in African-American women

1. Current, frequent binge drinking was linked to lower levels of the ovarian aging marker anti-Müllerian hormone (AMH) in reproductive-age African-American women.

2. A range of other drinking and smoking patterns were not associated with AMH levels.

Evidence Rating Level: 2 (Good)

Study Rundown: Excessive alcohol consumption and cigarette smoking are common behaviors among women of all ages, but especially those of reproductive age. The negative health impacts of such behaviors are widely recognized, including their effects on fertility. Previous investigations have identified that heavy alcohol consumption negatively impacts in vitro fertilization (IVF) cycle success. Other studies demonstrate that cigarette smoking is a risk factor for both short and long-term infertility. Anti-Müllerian hormone is released by preantral ovarian follicles and is a validated marker of ovarian reserve in women. To date, no studies have assessed the impact of smoking and alcohol consumption on AMH levels specifically in the African-American populations. In this study, researchers collected information on duration, frequency, amount, and pattern of alcohol and cigarette consumption to better characterize the influence of such common behaviors on AMH levels in reproductive-age African-American women.

Among women who currently drink, high-frequency current binge drinking was associated with lower anti-Müllerian hormone levels. Strengths included investigation of a highly understudied population and assessment of the impact of not only drinking and smoking exposure but also patterns including binge drinking. Limitations included the relatively small sample size of heavy smokers in the study cohort and the use of self-reported data. Future, longitudinal studies that follow changes in anti-Müllerian hormone levels over time would confirm findings and clarify whether the impact of these common lifestyle behaviors enact a transient or permanent impact on ovarian reserve.

Click to read the study in ACOG

Relevant Reading: Anti-Müllerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART)

In-Depth [cross-sectional study]: Researchers analyzed data collected at the baseline clinical visit of the Study of Environment, Lifestyle and Fibroids, an ongoing prospective cohort study following 1654 23-34 year old African-American women in Detroit, Michigan. Data collection on alcohol intake and cigarette smoking, and serum collection for AMH measurement were performed by computer questionnaire and an in-person clinical visit, respectively. The primary outcome was serum anti-Müllerian hormone level. Potential confounders including age, BMI and hormonal contraception usage were adjusted for in multivariable linear and logistic regressions.

Among reproductive-age African-American women who currently drink alcohol, binge drinking (≥4 drinks/occasion) two or more times per week was associated with 26% lower anti-Müllerian hormone levels (p < 0.04). Most women (74% of all women, n = 1168) drink alcohol, and most drinkers (74%, n = 866) report binge drinking in the last year. The minority of women (19%) currently smoke and just 4% currently consume a pack or more per day. Other alcohol consumption patterns, smoking status, and exposure to secondhand smoke were not significantly associated with anti-Müllerian hormone levels.

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