A pilot study for exploring blood spot anti-mullerian hormone for population-based adolescent reproductive health research.

Introduction and objective: Studies of Anti-Müllerian Hormone (AMH) rely upon serum measures and clinical samples of older reproductive-aged women intended/attempting pregnancy, with known fertility issues or medical morbidities. We explored the utility of minimally invasive AMH as a measure of fecundability in population-based reproductive health research.

Methods: We analyzed baseline data from 191 participants in a pilot, longitudinal cohort study, the Young Women's Stress Study. Using an integrated biosocial design, we collected interviewer-administered surveys on demographic, psychosocial, health, and method feasibility/acceptability information and finger-stick capillary dried blood spots (DBS). We used descriptive and bivariate statistics (correlation, T-tests, ANOVA) to estimate method feasibility/acceptability and unadjusted AMH mean concentrations overall and across sociodemographic, reproductive, and health covariates.

Results: AMH concentrations ranged from 1.02 to 22.23 ng/mL, with a mean of 5.66 ng/mL. AMH concentrations were associated with current hormonal contraceptive use, menstrual cycle frequency, and irregular menstrual patterns, but not with other known correlates. Most participants stated the DBS method was comfortable (81%) and would be likely to provide it again (88%).

Conclusions: While these pilot data suggest AMH fell within normal range and our DBS methods were acceptable/feasible, the broader question of its usefulness for population reproductive health research remains unanswered. Larger, longitudinal studies are needed to validate AMH against time-to-pregnancy and gold standard measures in young healthy samples and across different sociodemographic groups. Public health and social scientists should consider the resource costs of AMH, ethical issues, and risks of (over)interpretation, with a reproductive justice and human rights frame in mind.