Neighborhood disadvantage is associated with decreased ovarian reserve in women with overweight and obesity

Objective(s): To evaluate the association between neighborhood disadvantage and ovarian reserve stratified by body mass index (BMI).

Design: Cross-sectional cohort study.

Setting: Single academic medical center.

Patient(s): A total of 193 healthy reproductive-age women with regular menstrual cycles in the St. Louis, Missouri metropolitan area.

Intervention(s): Residence in a disadvantaged neighborhood.

Main outcome measure(s): Ovarian reserve as assessed by ovarian antral follicle count (AFC) and serum anti-Müllerian hormone (AMH) concentration.

Result(s): Women (n = 193) ranged from 20 to 44 years. The majority had overweight or obesity (59%, n = 117) with mean BMI of 28±7 kg/m². Forty-eight women lived in the most disadvantaged neighborhood quartile, of which 75% had overweight or obesity, compared with 54% of the 145 women living in the 3 less disadvantaged neighborhood quartiles. When controlling for age, race, and smoking status, women with overweight or obesity living in the most disadvantaged neighborhoods had significantly lower AMH compared with those living in the less disadvantaged neighborhoods. Antral follicle count did not differ among women with overweight or obesity by neighborhood of residence. Neighborhood disadvantage was not associated with ovarian reserve by AFC or AMH in women with normal weight or underweight status.

Conclusion(s): Living in a socioeconomically deprived area is associated with lower markers of ovarian reserve among women with an elevated BMI.