Smoking, alcohol and caffeine in relation to two hormonal indicators of ovarian age during the reproductive years

Objective: To examine whether or not cigarette smoking, alcohol and caffeine intake are related to two indicators of ovarian age-anti-Mullerian hormone (AMH) and follicle stimulating hormone (FSH). Study design: Cross-sectional study of 477 women with a recent index spontaneous abortion (SA) (105 trisomic, 93 non-trisomic) or livebirth (LB) (279) with hormones measured on days 2-4 of an apparently normal menstrual cycle after the index pregnancy. Results: Current smoking is associated with about a 15% increase in median FSH (beta for ln(FSH) = 0.14, 95% CI 0.03,0.25). It is not significantly related to AMH (beta for ln(AMH) = -0.25, 95% CI -0.56,0.06). Neither alcohol 2-7 days per week nor caffeine 122-<553 mg per day is independently related to AMH or FSH. Conclusions: The observation that current smoking is associated with FSH, but not with AMH, suggests that current smoking either impairs the development of antral follicles or dysregulates the hypothalamic-pituitary-ovarian axis. The absence of an association with AMH argues against mechanisms related to accelerated follicle atresia. (C) 2016 Elsevier Ireland Ltd. All rights reserved.