Antimullerian hormone is a predictor of live birth in patients with recurrent pregnancy loss.

Background: Ovarian reserve testing is not routinely performed in the evaluation of recurrent pregnancy loss (RPL). The objective of this study was to determine if AMH levels are predictive of live birth rate in RPL patients pursuing expectant management (EM).

Methods: Retrospective cohort study of RPL patients. Patients tried to conceive spontaneously for 12 calendar months or until they achieved a live birth, whichever occurred first. All patients with the intent to conceive were included regardless of final outcome.

Results: One hundred fifty-five RPL patients treated from 2009 to 2017 were included. In a univariate logistic regression, AMH < 1 ng/mL was associated with decreased likelihood of live birth (OR 0.38; CI 0.16-0.87, p = 0.03) and increasing age (OR 0.91; CI 0.83-0.99, p = 0.04). Likelihood of live birth was not significantly associated with BMI (OR 1.21; CI 0.83-1.77, p = 0.31), three or four or more prior pregnancy losses (OR 0.93; CI 0.40-2.22, p = 0.87 and OR 0.52; CI 0.19-1.42, p = 0.20, respectively) and prior live births (OR 1.00; CI 0.48-2.08, p = 0.99). AMH < 1 ng/mL was shown to be a stronger predictor of live birth than age using a multivariate model adjusting for age, AMH, and time to conception.

Conclusions: AMH < 1 ng/mL is associated with decreased likelihood of live birth among RPL patients pursuing EM, and may be a stronger predictor of live birth than age in this population.