Anti-Mullerian Hormone As A Predictor Of Live Birth For Patients With Unexplained Recurrent Pregnancy Loss.

Abstract

Objective: To determine whether anti-mullerian hormone (AMH) levels were associated with live birth and miscarriage rates following the first euploid frozen embryo transfer (FET) cycle for patients with unexplained recurrent pregnancy loss (URPL).

Methods: This retrospective cohort study included all patients (n=63) at an academic medical center in New York undergoing their first euploid FET with a sole diagnosis of URPL between October 2019 and October 2023. URPL was defined as a history of two or more spontaneous abortions (SAB) after a pregnancy (defined as a positive home pregnancy test or serum hCG > 2mIU/mL) and before 20 weeks of gestation without a known cause. Patient demographic data was obtained, and the primary outcomes of live birth and miscarriage were assessed while controlling for relevant clinical variables (obesity, prior number of spontaneous abortions, and aneuploidy). Significance was set at p<0.05.

Results: Lower AMH (<1 ng/mL) was associated with having fewer total blastocysts from prior IVF cycles (p=0.02). Patients with lower AMH also had fewer euploid blastocysts from prior IVF cycles, although this difference was not statistically significant (p=0.08). There were no significant differences based on AMH, and the overall miscarriage rate was 21.3%. Adjusting for obesity and prior number of SABs, AMH was not associated with live birth (aOR 1.12 (95% CI 0.93-1.35), p=0.23) or miscarriage (aOR 0.88 (95% CI 0.64-1.19), p=0.40).

Conclusions: These results suggest that once a euploid embryo is created, AMH is not associated with subsequent transfer outcomes among women with URPL.