Arch Gynecol Obstet (2010) 282:215–219 DOI 10.1007/s00404-010-1425-1 123 REPRODUCTIVE MEDICINE Smoking and AMH levels in women with normal reproductive history Alexandros Dafopoulos · Konstantinos Dafopoulos · Panagiotis Georgoulias · Georgios Galazios · Vassilios Limberis · Panagiotis Tsikouras · Nikolleta Koutlaki · Georgios Maroulis Received: 7 December 2009 / Accepted: 2 March 2010 / Published online: 23 March 2010  Springer-Verlag 2010 Abstract Purpose To investigate the eVect of age and smoking on the AMH levels in normal cycling healthy women with nor- mal reproductive history. Materials and methods In 137 women, blood samples were taken on day 3 of a spontaneous cycle. Serum FSH, LH, E2, progesterone and AMH were measured in all blood samples. For the statistical analysis of the data, t test, Pearson’s correlation and linear regression analysis were performed. Results Of 137 women (43%), 59 were smokers. Age was positively correlated with serum FSH and LH levels (r = 0.584, P < 0.001 and r = 0.330, P < 0.001, respec- tively) and negatively correlated with serum AMH levels (r = ¡0.882, P < 0.001). There were no signiWcant diVer- ences in FSH, LH, E2, progesterone and AMH levels between smokers and non-smokers. Multiple stepwise lin- ear regression analysis showed that in both smokers and non-smokers, age was the most signiWcant determinant of AMH levels (r = ¡0.889, P < 0.001 and r = ¡0.944, P < 0.001, respectively), while smoking was not related to AMH levels. Conclusions Aging signiWcantly decreases AMH levels in women with normal cycles and normal reproductive his- tory, while smoking does not seem to have signiWcant eVects on AMH levels. Keywords FSH · AMH · Age · Smoking · Premenopausal women Introduction Anti-Müllerian hormone (AMH), a glycoprotein, is a mem- ber of the TGF- (transforming growth factor-) superfamily of growth and diVerentiation factors [1]. During sex diVer- entiation, AMH is secreted from the Sertoli cells of the fetal testis and is responsible for the regression of the Müllerian ducts [2]. In women, AMH is produced by the ovarian granulosa cells from preantral and small antral follicles. Physiologi- cally, AMH is involved in initial follicular development, exhibiting inhibitory eVects on the initial recruitment of pri- mary follicles from the resting primordial follicle pool and on the sensitivity of antral follicles to FSH [3]. AMH is secreted by the ovary into the circulation, and serum AMH levels correlate signiWcantly with the number of antral follicles, reXecting therefore the ovarian follicular pool [4]. In the context of controlled ovarian stimulation and in vitro fertilization, AMH levels have been suggested as a novel clinical marker of ovarian reserve and can pre- dict the response to gonadotrophin. AMH has recently been found to have similar accuracy and clinical value for the prediction of poor response and non-pregnancy as the antral follicle count (AFC) [5]. Many studies suggest that cigarette smoking is a repro- ductive hazard to women. Smoking has been associated A. Dafopoulos · G. Galazios · V. Limberis · P. Tsikouras · N. Koutlaki · G. Maroulis Department of Obstetrics and Gynecology, Democritus University of Thrace, Alexandroupolis, Greece K. Dafopoulos (&) Department of Obstetrics and Gynecology, University Hospital of Larissa, University of Thessalia, 41110 Larissa, Greece e-mail: kdafop@med.uth.gr P. Georgoulias Department of Nuclear Medicine, University of Thessalia, Larissa, Greece