Decreased Ovarian Reserve Predicts Inexplicability of Recurrent Miscarriage? A Retrospective Analysis

PLoS One. 2016 Sep 14;11(9):e0161606. doi: 10.1371/journal.pone.0161606. eCollection 2016.

Abstract

Objective: To evaluate anti-Mullerian hormone, basal follicle stimulating hormone, luteinizing hormone, estradiol, and female age in women with recurrent miscarriage and to compare women with explained and idiopathic recurrent miscarriage.

Design: Retrospective cohort study.

Setting: University hospital, tertiary care center.

Patients: Women with recurrent miscarriage (78 explained, 66 idiopathic).

Intervention(s): None.

Main outcome measures(s): Anti-Mullerian hormone, basal follicle stimulating hormone, luteinizing hormone, estradiol, and age.

Results: Anti-Mullerian hormone and estradiol were significantly lower in women with idiopathic recurrent miscarriage (median 1.2 ng/ml, IQR 0.6-2.1, and median 36.5 pg/ml, IQR 25.8-47.3, respectively) than in women with explained recurrent miscarriage (median 2.0 ng/ml, IQR 1.1-2.7, and median 42.5 pg/ml, IQR 32.8-59.8, respectively; p<0.05). Optimized cut-off values for the prediction of idiopathic recurrent miscarriage were <39.5 pg/ml for estradiol (sensitivity: 63.3%, 95% CI: 50.9-75.1; specificity: 56.4%, 95% CI: 44.7-67.6) and <1.90 ng/ml for anti-Mullerian hormone (sensitivity: 72.7%, 95% CI: 60.4-83.0; specificity: 52.6%, 95% CI: 40.9-64.0).

Conclusion: Idiopathic recurrent miscarriage was associated with lower basal estradiol and anti-Mullerian hormone levels compared to explained recurrent miscarriage.

MeSH terms

  • Abortion, Habitual / etiology*
  • Adult
  • Age Factors
  • Anti-Mullerian Hormone / blood
  • Estradiol / blood
  • Female
  • Follicle Stimulating Hormone / blood
  • Humans
  • Luteinizing Hormone / blood
  • Ovarian Reserve* / physiology
  • ROC Curve
  • Retrospective Studies
  • Young Adult

Substances

  • Estradiol
  • Anti-Mullerian Hormone
  • Luteinizing Hormone
  • Follicle Stimulating Hormone

Grants and funding

The authors received no specific funding for this work.