Antimüllerian hormone in relation to tobacco and marijuana use and sources of indoor heating/cooking

In premenopausal women, we found lower antimullerian hormone levels associated with sources of indoor heating and in women who were heavy current smokers or had long-term exposure to environmental tobacco smoke.

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Volume 106, Issue 3, Pages 723-730


Alexandra J. White, Ph.D., Dale P. Sandler, Ph.D., Aimee A. D'Aloisio, Ph.D., Frank Stanczyk, Ph.D., Kristina W. Whitworth, Ph.D., Donna D. Baird, Ph.D., Hazel B. Nichols, Ph.D.



To evaluate exposure to tobacco, marijuana, and indoor heating/cooking sources in relation to antimüllerian hormone (AMH) levels.


Cross-sectional analysis in a sample of premenopausal women (n = 913) enrolled in the Sister Study cohort (n = 50,884).


Not applicable.


Women, ages 35–54 years at time of enrollment, with an archived serum sample and at least one intact ovary and classified as premenopausal.


Not applicable.

Main Outcome Measure(s)

Serum AMH (ng/mL) levels ascertained by ultrasensitive ELISA assay.


Lower AMH levels were associated with sources of indoor heating, including burning wood (−36.0%; 95% confidence interval [CI], −55.7%, −7.8%) or artificial fire logs (−45.8%; 95% CI, −67.2%, −10.4%) at least 10 times/year in a residential indoor stove/fireplace. Lower AMH levels were also observed in women who were current smokers of ≥20 cigarettes/day relative to nonsmokers (−56.2%; 95% CI, −80.3%, −2.8%) and in women with 10+ years of adult environmental tobacco smoke (ETS) exposure (−31.3%; 95% CI, −51.3%, −3.1%), but no associations were observed for marijuana use.


We confirmed previously reported findings of lower AMH levels in current heavy smokers and also found associations for long-term ETS exposure and indoor burning of wood or artificial fire logs. These findings suggest that combustion by-products from common exposures can have toxic effects on the human ovary.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.