Age-related decline in AMH and gonadotropin patterns in Syrian women: Preliminary population-based estimates

BackgroundAnti-Müllerian hormone (AMH) is a key biomarker of ovarian reserve, yet population-specific reference values remain limited for Middle Eastern women.ObjectivesEstablishing preliminary age-specific population estimates of AMH and gonadotropin is essential for improving clinical interpretation in this demographic.DesignCross-sectional, population-based exploratory study conducted between March 2025 and February 2026.Methods90 healthy women aged 19-47 years were recruited. Serum AMH, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) were measured on cycle day 3. Age-specific distributions were summarized as preliminary population-based estimates, given the modest sample size within each age stratum. Linear regression models were used to assess whether AMH independently predicted FSH, LH, or the LH/FSH ratio after adjusting for age.ResultsAMH showed a strong inverse correlation with age (r=-0.54). ROC analysis demonstrated that lower AMH levels were strongly associated with being older than 35 years, with an AMH value of 1.8 ng/mL (AUC≈0.80; sensitivity 0.94; specificity 0.61), indicating high sensitivity but limited specificity. FSH increased progressively with age (r=0.29), while LH remained relatively stable, resulting in a declining LH/FSH ratio. Regression analysis showed that AMH was independently associated with the LH/FSH ratio (β = 0.100, p < 0.001), but not FSH or LH after adjusting for age.ConclusionThis study provides the first preliminary age-specific population estimates of AMH and gonadotropins in Syrian women, demonstrating patterns consistent with global ovarian-aging trajectories. However, the absence of data on BMI, smoking, and lifestyle factors, along with the modest sample size, may limit the precision and generalizability of these estimates.