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

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

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

SETTING: Not applicable.

PATIENT(S): Women, ages 35-54 years at time of enrollment, with an archived serum sample and at least one intact ovary and classified as premenopausal.

INTERVENTION(S): Not applicable.

MAIN OUTCOME MEASURE(S): Serum AMH (ng/mL) levels ascertained by ultrasensitive ELISA assay.

RESULT(S): 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.

CONCLUSION(S): 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.