BACKGROUND Anti-Müllerian hormone (AMH) is an important determinant of ovarian reserve in fertility workups in many clinical settings. Thus, we investigated the age dependent decline in AMH specific to the Egyptian population and sought to establish an age dependent reference interval parametrically. METHODS Serum samples were collected from 841 apparently healthy women. AMH was measured using an electro-chemiluminescent technique. Box-Cox power transformation was used to make the AMH distribution Gaussian for parametric derivation of reference intervals. RESULTS Power of 0.4 was found optimal for Gaussian transformation of AMH reference values. We demonstrate the strong negative relation between circulating AMH and female age with Spearman's correlation coefficient of rS = -0.528. Age-specific reference interval was determined for every 5 years of age from 16 to 49, and nomogram was constructed by smoothing the lines connecting adjacent lower and upper reference limits. CONCLUSION The age-specific reference intervals and the age-AMH nomogram could be valuable in the clinical practice of in reproductive medicine. To our knowledge, this is the first study to confirm AMH levels in Egyptian females. We were able to explore age-related AMH levels specific to Egyptian females in the fertile age group and to treat skewed AMH data in a multi-step scheme using power transformation. Thus, a more accurate nomogram was constructed accommodating a profile delineated for a wide age range and a rescaled AMH axis improving its usability.

中文翻译：

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健康埃及女性年龄特异性抗苗勒氏管激素水平列线图。

背景抗苗勒管激素（AMH）是许多临床环境中生育检查中卵巢储备的重要决定因素。因此，我们研究了埃及人群特有的 AMH 年龄依赖性下降，并试图建立一个年龄依赖性参数参考区间。方法 从 841 名表面健康的女性身上采集血清样本。使用电化学发光技术测量 AMH。使用 Box-Cox 幂变换使 AMH 分布呈高斯分布，以进行参考区间的参数推导。结果发现 0.4 的功效对于 AMH 参考值的高斯变换是最佳的。我们证明循环 AMH 与女性年龄之间存在很强的负相关关系，Spearman 相关系数 rS = -0.528。从16岁到49岁，每5岁确定年龄特定参考区间，并通过平滑连接相邻参考下限和上限的线来构建列线图。结论年龄特异性参考区间和年龄-AMH列线图在生殖医学的临床实践中具有重要价值。据我们所知，这是第一项确认埃及女性 AMH 水平的研究。我们能够探索埃及生育年龄组女性特有的与年龄相关的 AMH 水平，并使用幂变换以多步骤方案处理倾斜的 AMH 数据。因此，构建了更准确的列线图，以适应广泛年龄范围的轮廓和重新调整的 AMH 轴，提高了其可用性。