Racial/ethnic differences in AMH and potential underlying mechanisms

Accumulating evidence suggests that reproductive potential and function may be different across racial and ethnic groups. Racial differences have been demonstrated in pubertal timing, incidence of several gynecologic diseases, infertility, outcomes after assisted reproductive technology (ART) treatment and reproductive aging. Recently, racial differences have also been described in serum anti-Müllerian hormone (AMH), a sensitive biomarker of ovarian reserve, supporting the notion that ovarian reserve differs between racial/ethnic groups. The existence of such racial/ethnic differences in ovarian reserve, as reflected by AMH, may have important clinical implications for reproductive endocrinologists. However, the mechanisms which may underlie such racial differences in ovarian reserve are unclear. Various genetic factors, and environmental factors such as obesity, smoking and vitamin D deficiency which have been shown to correlate with serum AMH levels and also display significant racial/ethnic variations are discussed in this chapter. Improving our understanding of racial differences in AMH and reproductive aging may lead to better counseling of women regarding their reproductive planning, individualization of infertility treatments and improved outcomes, as well as timely interventions which may prolong reproductive lifespan in these women.