Relationship Between Different Nutritional Status and Specific Hormone Levels in Sub Fertile Women in a Selected Tertiary Level Hospital in Dhaka, Bangladesh

Author(s): Prof. Dr. Tripti Rani Das, Dr. Sabiha Islam, Dr. Dipika Majumder, Dr. Iffat Rahman, Dr. Shah Noor Sharmin, Dr. Jinat Fatema, Dr. Bidisha Chakma, Dr. Tanzina Iveen Chowdhury

Background:

Subfertility is a growing reproductive health concern globally, with obesity increasingly recognized as a contributing factor affecting ovarian reserve. Anti-Mullerian Hormone (AMH) serves as a reliable marker of ovarian reserve, and its relationship with body mass index (BMI) remains a subject of clinical significance.

Aim of the Study:

To find out the association between BMI categories and serum AMH levels in sub fertile women.

Methods:

A cross-sectional analytical study was conducted at the Department of Obstetrics and Gynaecology, Bangladesh Medical University (BMU), Dhaka, over 18 months. A total of 148 sub-fertile women aged 15-44 years were enrolled using convenient sampling technique. After applying exclusion criteria, data on sociodemographic, reproductive, and clinical factors were collected through a semi-structured questionnaire. BMI was calculated from measured height and weight. Serum AMH levels were measured using Chemiluminescent Magnetic Microparticle Immunoassay (CMIA). Data was analyzed using Statistical Package for the Social Sciences (SPSS) version 26, applying independent sample t-test and regression analysis, with p<0.05 considered statistically significant.

Results:

A total of 148 sub-fertile women were included in the study. The majority 48.6% were aged between 25-34 years, and 36.5% had completed graduate-level education or higher. About 64.9% belonged to the lowermiddle- income group with monthly family incomes between BDT 30,000 and 50,000. A substantial proportion of 86.5% had experienced subfertility for one year or more, and 62.2% were nulliparous. Polycystic Ovary Syndrome (PCOS) was present in 39.2% of participants, thyroid dysfunction in 32.4%, and diabetes mellitus in 18.2%. A significant association was observed between PCOS and sedentary lifestyle (p = 0.000; OR = 2.250, 95% CI: 1.786–2.835). PCOS was also significantly associated with subfertility status (t = –6.836, p = 0.000). Multinomial logistic regression revealed that both serum AMH levels (B = 0.380, p = 0.000) and BMI (B = 0.583, p = 0.000) were significant predictors of sub-fertility, explaining 56.4% of the variance (R² = 0.564, adjusted R² = 0.558).

Conclusion:

The study was found that lower AMH and non-optimal BMI predict subfertility in women. Sedentary behavior was linked to higher PCOS risk, which was associated with subfertility. Assessing ovarian reserve and BMI is crucial for managing subfertility; promoting physical activity may be beneficial.