Is Anti-Müllerian Hormone Associated With Fecundability? Findings From the EAGeR Trial

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This prospective cohort study found that low or high anti-Müllerian hormone levels were not associated with fecundability in women with a history of pregnancy loss attempting unassisted conception.

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Abstract

OBJECTIVE: The objective of the study was to evaluate whether anti-Müllerian hormone (AMH) is associated with fecundability among women with proven fecundity and a history of pregnancy loss. DESIGN: This was a prospective cohort study within a multicenter, block-randomized, double-blind, placebo-controlled clinical trial ( clinicaltrials.gov , number NCT00467363). SETTING: The study was conducted at four US medical centers (2006-2012). PARTICIPANTS: Participating women were aged 18-40 years, with a history of one to two pregnancy losses who were actively attempting pregnancy. MAIN OUTCOME MEASURES: Time to human chorionic gonadotropin detected and clinical pregnancy were assessed using Cox proportional hazard regression models to estimate fecundability odds ratios (fecundability odds ratios with 95% confidence interval [CI]) adjusted for age, race, body mass index, income, low-dose aspirin treatment, parity, number of previous losses, and time since most recent loss. Analyses examined by preconception AMH levels: low (3.5 ng/mL, n = 483). RESULTS: Of the 1202 women with baseline AMH levels, 82 women with low AMH (66.1%) achieved an human chorionic gonadotropin detected pregnancy, compared with 383 with normal AMH (65.2%) and 315 with high AMH level (65.2%). Low or high AMH levels relative to normal AMH (referent) were not associated with fecundability (low AMH: fecundability odds ratios 1.13, 95% CI 0.85-1.49; high AMH: FOR 1.04, 95% CI 0.87-1.24). CONCLUSIONS: Lower and higher AMH values were not associated with fecundability in unassisted conceptions in a cohort of fecund women with a history of one or two prior losses. Our data do not support routine AMH testing for preconception counseling in young, fecund women.

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MeSH descriptors

Anti-Mullerian Hormone Fertility Abortion, Spontaneous Abortion, Spontaneous Abortion, Spontaneous Adolescent Adult Anti-Mullerian Hormone Biomarkers Biomarkers Cohort Studies Double-Blind Method Female Fertility Humans Predictive Value of Tests Pregnancy Prospective Studies Socioeconomic Factors Treatment Outcome

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