Ovarian Antral Follicle Subclasses and Anti-Müllerian Hormone During Normal Reproductive Aging

Context: The interindividual variation in the age-related decline of ovarian follicles is wide. Hence, it is important to identify reliable, sensitive, and specific markers to assess the ovarian reserve of the individual woman. Objective: The aim of this study was to characterize the relation between age and ovarian reserve parameters in a population of healthy women with regular menstrual cycle. Design and Setting: We conducted a prospective, population-based, cross-sectional study. Participants: A total of 366 health care workers aged 21–41 years employed at a University Hospital were included. Interventions: There were no interventions. Main Outcome Measures: Serum anti-Mullerian hormone (AMH) concentration, antral follicle count (AFC), antral follicle size categories (small: 2–4 mm; intermediate: 5–7 mm; and large: 8–10 mm), and ovarian volume were measured. Results: Serum AMH level declined by 5.6% per year (95% confidence interval 3.7–7.4%, P < .001), AFC (2–10 mm) declined by 4.4% per year (3.2–5.7...