Associations Between Physical Activity and Age-Related Anti-Mullerian Hormone Decline: Insights from All of Us Research Program

Background: Anti-mullerian hormone (AMH) is used to measure ovarian reserve and female fertility levels. Physical activity is thought to influence fertility and warrants further investigation, especially using objective measures. Methods: Using the All of Us Research Program dataset, the relationship between normal age-based decline in AMH and levels of physical activity were examined. Inclusion criteria were: ≥ 1 AMH test in electronic health record, AMH level < 7 ng/ml, and ≥ 30 days of valid Fitbit data within 1 year prior to AMH test. Final dataset included 24 participants. Results: Generalized linear regression models were fitted between log transformed AMH level and daily average activity intensity minutes (sedentary, lightly active, fairly active and very active) and daily step counts. Daily average of “very active” minutes showed a trend towards a positive effect on preventing the decline of AMH levels (B = 0.02 (95% CI 0-0.04), p = 0.136), though results were not statistically significant. Conclusion: Despite its small sample size, this study is one of the first to report a positive correlation, approaching significance, between objectively measured physical activity and preserving AMH, suggesting that daily high intensity physical activity may extend ovarian reserve. Further studies, with large, diverse samples are needed to provide clearer numbers for optimal engagement in physical activity and AMH level for fertility.