External validation of nomogram for the decline in serum anti-Müllerian hormone in women: a population study of 15,834 infertility patients

The value of anti-müllerian hormone (AMH) as a marker of the ovarian reserve is becoming clear in a range of clinical contexts. This study reports the external validation of a quadratic model-based AMH–age nomogram using a cohort of 15,834 US women. All models previously investigated for the decline in ovarian reserve (i.e. linear, bi-linear, decay curve, power and quadratic models) tended to overestimate AMH by approximately 11% versus the published nomogram, indicating some between-population heterogeneity. Bootstrapping of 1000 datasets indicated that the quadratic model provided the best fit, confirming the choice of this model in the AMH–age nomogram. This nomogram can therefore be used with confidence for the interpretation of AMH in clinical populations.