Serum anti-müllerian hormone as a biomarker of functional testicular reserve: a comparative analysis.

How do serum Anti-Müllerian hormone (AMH) levels differ among men with varying fertility statuses, and what is the relationship between AMH, spermatogenesis, and functional testicular reserve? Serum AMH levels were significantly lower in men with NOA compared to fertile controls and non-azoospermic infertile men. AMH correlated negatively with age and FSH, and positively with testicular volume and sperm concentration. After adjustment, AMH showed no independent association with sperm concentration. AMH is produced by Sertoli cells and may serve as a biomarker of spermatogenesis, yet literature lacks comprehensive comparative analyses across male fertility conditions. Cross-sectional study with 1,085 white-European non-Finnish men with confirmed fertility, primary infertility, or NOA. Men with confirmed fertility (n=116), primary infertility (n=791), and NOA (n=178) underwent comprehensive hormonal and semen analyses per WHO 2010 criteria. Kruskal-Wallis and Chi-square tests were used for group comparisons. Correlations were assessed using Spearman's rank correlation. Multivariate linear regression models identified factors associated with AMH levels and sperm concentration. AMH levels were significantly lower in non-obstructive azoospermia versus fertile men and primary infertility 3.8 (1.6-7.2) vs. 5.1 (3.6-7.0) vs. 4.9 (3.0-7.8) ng/mL; p<0.001. AMH negatively correlated with age and FSH, positively with testicular volume and sperm concentration. Age, FSH, and testicular volume independently associated with AMH; FSH and testicular volume, not AMH, independently associated with sperm concentration. Cross-sectional design limits causality. Limited ethnic generalizability. AMH reflects Sertoli cell function and testicular status rather than directly influencing spermatogenesis, potentially serving as a complementary male fertility biomarker.