Neighborhood poverty may contribute to lower ovarian reserve over time

Key takeaways:

• Women had progressively lower ovarian reserve over time as poverty level increased.
• Younger women exposed to high and medium vs. low poverty levels had higher anti-Müllerian hormone levels.

Greater neighborhood disadvantage was related to lower ovarian reserve, with initially higher anti-Müllerian hormone levels leading to greater ovarian follicle loss over time, researchers reported in Menopause.

“Growing evidence shows that neighborhood-level disadvantage has detrimental impacts on women’s health more generally, possibly through health-related behaviors, resource availability and environmental toxicants,” Anwesha Pan, MA, graduate student in the department of anthropology at the University of Washington, Seattle, and colleagues wrote. “These same exposures have implications for women’s reproductive health, yet few studies have explored links between neighborhood-level socioeconomic status and ovarian reserve specifically.”

Utilizing data from the Ovarian Aging Study (OVA), a community-based cross-sectional investigation of ovarian aging with a single in-person research visit from 2006 to 2011, researchers evaluated aggregate neighborhood poverty exposure in relation to ovarian reserve biomarkers. Researchers evaluated the interaction between age and neighborhood poverty exposure to determine whether declines in anti-Müllerian hormone and antral follicle count were greater for women exposed to higher neighborhood poverty levels. Researchers analyzed neighborhood poverty levels through geocoding and linking adulthood residential addresses to U.S. Census data.

Overall, 1,018 healthy premenopausal women (mean age, 35.2 years; no college degree, 42.5%; annual household income < $75,000, 68.3%) from OVA were included in the study. On average, anti-Müllerian hormone values were 3.2 ng/mL and antral follicular count values were 15.1. Aggregate neighborhood poverty exposure showed that, on average, 17.5% of families live below the poverty line.

Over time, women exposed to low, medium and high neighborhood poverty levels had steady ovarian reserve reductions, as measured by anti-Müllerian hormone. Associations between age and anti-Müllerian hormone levels varied by neighborhood poverty exposure in adulthood (P < .05). In addition, older age was associated with lower anti-Müllerian hormone levels (P < .0001).

Compared with low neighborhood poverty levels, women aged 25 years who were exposed to high (P < .01) and medium (P < .05) levels had higher anti-Müllerian hormone levels. By age 35 years, higher neighborhood poverty levels were associated with lower anti-Müllerian hormone levels, but this association did not reach statistical significance.

Researchers observed no significant variation in the effect of age on antral follicle count related to neighborhood poverty exposure.

“More research is needed to move this area forward by using longitudinal study designs, expanding on the neighborhood measurement and assessing potential mechanisms of neighborhood impacts such as relevant environmental toxicants,” the researchers wrote.