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

ObjectiveTo evaluate exposure to tobacco, marijuana, and indoor heating/cooking sources in relation to antimüllerian hormone (AMH) levels.DesignCross-sectional analysis in a sample of premenopausal women (n = 913) enrolled in the Sister Study cohort (n = 50,884).SettingNot 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.