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Fertil Steril. 2018 Jun;109(6):1065-1071.e1. doi: 10.1016/j.fertnstert.2018.01.039. Epub 2018 Jun 2.

Antimüllerian hormone as a risk factor for miscarriage in naturally conceived pregnancies.

Author information

1
Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina. Electronic address: blyttle@med.unc.edu.
2
Yale School of Public Health, New Haven, Connecticut.
3
Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina.

Abstract

OBJECTIVE:

To determine the association between antimüllerian hormone (AMH), a measure of ovarian reserve, and miscarriage among naturally conceived pregnancies.

DESIGN:

Prospective cohort study.

SETTING:

Not applicable.

PATIENT(S):

Women (n = 533), between 30 and 44 years of age with no known history of infertility, polycystic ovarian syndrome, or endometriosis who conceived naturally.

INTERVENTION(S):

None.

MAIN OUTCOME MEASURE(S):

Miscarriage, defined as an intrauterine pregnancy loss before 20 weeks' gestation.

RESULT(S):

After adjusting for maternal age, race, history of recurrent miscarriage, and obesity, risk of miscarriage decreased as AMH increased (risk ratio per unit increase in natural log of AMH = 0.83; 95% confidence interval [CI], 0.73, 0.94). Women with severely diminished ovarian reserve (AMH ≤ 0.4 ng/mL) miscarried at over twice the rate of women with an AMH ≥ 1 ng/mL (hazard ratio, 2.3; 95% CI, 1.3, 4.3).

CONCLUSION(S):

AMH levels are inversely associated with the risk of miscarriage. Women with severely diminished ovarian reserve are at an increased risk of miscarriage.

KEYWORDS:

Antimüllerian hormone; diminished ovarian reserve; miscarriage; pregnancy loss

PMID:
29871793
PMCID:
PMC6063511
DOI:
10.1016/j.fertnstert.2018.01.039
[Indexed for MEDLINE]
Free PMC Article

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