Blood anti-Müllerian hormone is a possible determinant of recurrent early miscarriage, yet not conclusive in predicting a further miscarriage

Leclercq, Estelle; Martin, Luc de Saint; Bohec, Caroline; Martelot, M.T. Le; Roche, Sylvie; Alavi, Zarrin; Mottier, Dominique; Pasquier, Elisabeth

doi:10.1016/j.rbmo.2019.04.004

Cited by 5 publications

(6 citation statements)

References 26 publications

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“…In contrast, the serum AMH level, a novel marker of OR, is a dimeric glycoprotein produced solely by the ovarian follicles and is not affected by the menstrual cycle. Recently, an increasing number of studies have verified that lower AMH levels in women with RM than in non-RM groups (9,14,15,25); Similarly, our results also showed that women with three or more previous unexplained miscarriages had lower AMH levels. However, one study by Prakash et al (26) suggested that AMH levels were not significantly different between RM and non-RM groups.…”

Section: Discussionsupporting

confidence: 83%

“…As maternal age was identified as a prominent confounding factor affecting AMH levels and AFC, we further compared the PM0 and PM3 groups after stratification by age (Table 3). Among participants aged <35 years, AMH and AFC levels were both significantly higher in the PM0 group (median 4.96 ng/ml, IQR [2.99-8.00] and median 11 number, IQR [8][9][10][11][12][13][14][15], respectively) than in the PM3 group (median 3.62 ng/ml, IQR [1.71-5.49], P =…”

Section: The Relationship Between the Pm0 And Pm3 Groups And Ormentioning

confidence: 99%

“…Recent studies have documented an association between RM and decreased OR, using AMH levels and AFCs as markers of OR (9,14,15). In addition, many of these studies showed that the proportion of DOR patients in the RM group was significantly higher than that in the control group (9,14).…”

Section: Introductionmentioning

confidence: 99%

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Decreased Ovarian Reserves With an Increasing Number of Previous Early Miscarriages: A Retrospective Analysis

Tan

Jiang

et al. 2022

Front. Endocrinol.

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The fact of ovarian reserve (OR) decreased in women with recurrent miscarriage has been well known. However, Whether OR would decrease with increasing numbers of previous miscarriages (PMs) is still unclear. To address this, OR parameters of following four groups’ patients were evaluated: 99 women with one previous miscarriage (PM1), 46 women with two previous miscarriages (PM2) and 35 women with three or more previous miscarriages (PM3). The control group included 213 women without a history of miscarriage (PM0). The correlation of OR parameters and the proportion of diminished ovarian reserve (DOR) patients between the four groups were analyzed using Kendall’s Tau-B coefficients. The results showed the median anti-Müllerian hormone (AMH) levels were 4.04, 3.40, 3.14 and 2.55 respectively in the PM0, PM1, PM2 and PM3 groups, respectively (H=15.99, P = 0.001); the median antral follicle counts (AFCs) were 10, 8, 8 and 6, respectively (H=24.53, P < 0.001); and the proportions of DOR patients were 10.8%, 15.2%, 23.9% and 31.4% (χ2 = 13.01, P = 0.005). In addition, AMH level and AFC correlated negatively with the number of PMs (correlation coefficients -0.154, P < 0.001; -0.205, P < 0.001 respectively), the proportion of DOR patients correlated positively with the number of PMs (correlation coefficients 0.156, P = 0.001). After stratification by age, AMH and AFC levels were still significantly lower in the PM3 group than the PM0 group (P < 0.05). The proportion of DOR patients between the PM0 and PM3 groups was statistically significant (P < 0.001). This study showed that AMH levels and AFCs decreased as well as the proportion of DOR patients increased significantly as the number of PMs increased. In conclusion, our study indicates decreased AMH levels and AFCs might be one of the factors contributing to early miscarriage.

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Section: Discussionsupporting

confidence: 83%

Section: The Relationship Between the Pm0 And Pm3 Groups And Ormentioning

confidence: 99%

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Decreased Ovarian Reserves With an Increasing Number of Previous Early Miscarriages: A Retrospective Analysis

Tan

Jiang

et al. 2022

Front. Endocrinol.

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“…Low AMH has been previously associated with recurrent pregnancy loss (RPL) [ 21 ]. This finding persisted even after excluding women with PCOS.…”

Section: Discussionmentioning

confidence: 99%

AMH predicts miscarriage in non-PCOS but not in PCOS related infertility ART cycles

Arkfeld

Han

Tal

et al. 2023

Reprod Biol Endocrinol

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Background To study whether AMH levels were associated with miscarriage rates in index ART cycles undergoing fresh autologous transfers in PCOS and non-PCOS related infertility. Methods In the SART CORS database 66,793 index cycles underwent fresh autologous embryo transfers with AMH values reported within the last 1-year between 2014 and 2016. Cycles that resulted in ectopic or heterotopic pregnancies, or were performed for embryo/oocyte banking were excluded. Data were analyzed using Graphpad Prism-9. Odds ratios (OR) were calculated with 95% confidence intervals (CI) along with multivariate regression analysis adjusting for age, body mass index (BMI), and number of embryos transferred. Miscarriage rates were calculated as miscarriage per clinical pregnancies. Results Of the total 66,793 cycles, the mean AMH was 3.2 ng/ml and were not associated with increased miscarriage rates for AMH < 1 ng/ml (OR 1.1, CI 0.9–1.4, p = 0.3). Of the 8,490 PCOS patients, the mean AMH was 6.1 ng/ml and were not associated with increased miscarriage rates for AMH < 1 ng/ml (OR 0.8, CI 0.5–1.1, p = 0.2). Of the 58,303 non-PCOS patients, the mean AMH was 2.8 ng/ml and there was a significant difference in miscarriage rates for AMH < 1 ng/ml (OR 1.2, CI 1.1–1.3, p < 0.01). All findings were independent of age, BMI and number of embryos transferred. This statistical significance did not persist at higher thresholds of AMH. The overall miscarriage rate for all cycles, and cycles with and without PCOS were each 16%. Discussion The clinical utility of AMH continues to increase as more studies investigate its predictive abilities regarding reproductive outcomes. This study adds clarity to the mixed findings of prior studies that have examined the relationship between AMH and miscarriage in ART cycles. AMH values of the PCOS population are higher than the non-PCOS. The elevated AMH associated with PCOS decreases its utility in predicting miscarriages in IVF cycles as it may be representing the number of developing follicles rather than oocyte quality in the PCOS patient population. The elevated AMH associated with PCOS may have skewed the data; removing this sub-population may have unmasked significance within the non-PCOS associated infertility. Conclusions AMH < 1 ng/mL is an independent predictor of increased miscarriage rate in patients with non-PCOS infertility.

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“…B9, B12, and D). In a large incident case-control study of couples, we investigated some possible determinants of REM such as factor V Leiden or mutation G20210A of the prothrombin in both parents (Pasquier et al, 2009), skewed-X chromosome inactivation in the female cases (Pasquier et al, 2007) and, blood anti-Müllerian hormone concentration (Leclercq et al, 2019). Additional studies from other groups suggest that a family history of miscarriage is a risk factor for unexplained REM (Zhang et al, 2010;Woolner et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Whole exome sequencing, a hypothesis-free approach to investigate recurrent early miscarriage

Gourhant

Bocher

Martin

et al. 2021

Reproductive BioMedicine Online

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Blood anti-Müllerian hormone is a possible determinant of recurrent early miscarriage, yet not conclusive in predicting a further miscarriage

Cited by 5 publications

References 26 publications

Decreased Ovarian Reserves With an Increasing Number of Previous Early Miscarriages: A Retrospective Analysis

Decreased Ovarian Reserves With an Increasing Number of Previous Early Miscarriages: A Retrospective Analysis

AMH predicts miscarriage in non-PCOS but not in PCOS related infertility ART cycles

Whole exome sequencing, a hypothesis-free approach to investigate recurrent early miscarriage

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