Ovarian Reserve in Women of the Moscow Metropolis: First National Centile References for Anti Müllerian Hormone
TL;DR
For the first time, AMH centile reference values have been derived in a large non‑selective Russian population and are applicable to the individual assessment of ovarian reserve in clinical practice and to informed planning of reproductive behaviour.
Abstract
Aim. To establish population‑based centile references for anti‑Müllerian hormone (AMH) in Russian women of reproductive age and to estimate the prevalence of diminished ovarian reserve in a non‑selective sample drawn from the Moscow metropolis. Design. Retrospective cross‑sectional study. Materials and methods. A retrospective cross‑sectional analysis was performed on AMH screening results of 351 185 female residents of Moscow obtained in 2024 and 2025. The cohort included women participating in the municipal “Stanu Mamoy” (“I Will Become a Mother”) programme and women over 39 years not participating in the project. Body mass index, clinical and medical history and the district of residence within Moscow were also taken into account. AMH was measured by an automated chemiluminescent immunoassay. Diminished ovarian reserve was defined as an AMH level < 1.2 ng/mL (POSEIDON criteria). Statistical analysis included the Kruskal–Wallis H‑test with η² effect size calculation, pairwise comparisons using Dunn’s test with Bonferroni correction, and Pearson’s χ² test with Cramér’s V. Results. The median AMH level in the overall sample was 2.61 [1.36; 4.46] ng/mL. Diminished ovarian reserve was documented in 75 708 (21.6%) women. Age emerged as the principal determinant of AMH variability (η² = 0.150, corresponding to a large effect size). AMH centile curves (P₅, P₁₀, P₂₅, P₅₀, P₇₅, P₉₀, P₉₅) were constructed for five age groups: 18–24, 25–29, 30–34, 35–39 and over 39 years. The most clinically relevant finding was the intersection of the P₂₅ curve with the 1.2 ng/mL threshold at approximately 33 years. Inter‑district differences across Moscow administrative districts were statistically significant but clinically negligible (η² = 0.003). Conclusion. For the first time, AMH centile reference values have been derived in a large non‑selective Russian population. These references are applicable to the individual assessment of ovarian reserve in clinical practice and to informed planning of reproductive behaviour. Keywords: anti Müllerian hormone, ovarian reserve, centile curves, population screening, reproductive ageing, delayed motherhood, “Stanu Mamoy” (“I Will Become a Mother”) programme