Highly elevated level of antimüllerian hormone associated with preterm delivery in polycystic ovary syndrome patients who underwent ovulation induction

Kaing, Amy; Jaswa, Eleni Greenwood; Diamond, Michael P.; Legro, Richard S.; Cedars, Marcelle I.; Huddleston, Heather G.

doi:10.1016/j.fertnstert.2020.06.015

Cited by 16 publications

(15 citation statements)

References 46 publications

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“…Another retrospective cohort study performed in China including 25,165 IVF cycles showed that preterm deliveries were predominant among PCOS patients with AMH levels above the 75th percentile (9.75 ng/mL) (adjusted P<0.0001; AOR=4.0; 95% CI= 1.94-8.08)) and patients with frozen-thawed embryo transfer (FET) with AMH levels higher than the 90th percentile (10.10 ng/mL) (adjusted P<0.05; AOR=2.0; 95% CI=1.16-3.36) ( 9 ). Recently, a secondary analysis of data from two multicenter randomized clinical trials including a non-IVF PCOS population indicated that 62% of participants who delivered preterm had AMH levels above the 75th percentile (>9.3 ng/ml) ( 8 ). However, the article did not analyze different BMI groups, particularly overweight PCOS patients who may be more severely ill ( 19 , 21 ).…”

Section: Discussionmentioning

confidence: 99%

“…To our best knowledge, only three clinical studies have analyzed the relationship between the serum AMH levels and premature delivery of singleton offspring ( 8 – 10 ). One concerns a non-IVF-assisted PCOS population ( 8 ), and the others describe IVF-assisted pregnancy populations ( 9 , 10 , 21 ). This study is the first clinical study to analyze the relationship between premature delivery and serum AMH in PCOS patients with different BMIs.…”

Section: Discussionmentioning

confidence: 99%

“…To our best knowledge, only three clinical studies have analyzed the relationship between the serum AMH levels and premature delivery of singleton offspring (8)(9)(10). One concerns a non-IVF- assisted PCOS population (8), and the others describe IVFassisted pregnancy populations (9,10,21).…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…Current studies have reported that PCOS patients have increased rates of pregnancy complications, including pregnancy-induced hypertension and gestational diabetes mellitus, and an increased miscarriage rate (7). Studies have also indicated that the preterm birth (PTB) rate of PCOS patients is increased, regardless of whether pregnancy is achieved spontaneously or through IVF (8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Elevated Anti-Müllerian Hormone Is an Independent Risk Factor for Preterm Birth Among Patients With Overweight Polycystic Ovary Syndrome

Zhang

et al. 2021

Front. Endocrinol.

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ObjectiveTo explore whether elevated anti-Müllerian hormone (AMH) levels affect the rate of preterm birth (PTB) among PCOS patients with different BMIs.MethodsIn this retrospective cohort study, patients with PCOS who had undergone IVF/ICSI from January 2017 to December 2019 were included for potential evaluation. A total of 2368 singleton live births from PCOS patients were included. According to the BMI, all the PCOS patients were divided into two groups: BMI<24 kg/m2 and BMI≥24 kg/m2. In total, 1339 PCOS patients with a BMI<24 kg/m2 were grouped according to their serum AMH levels: ① <2.71 ng/ml (n=333), ② 2.71-4.08 ng/ml (n=330), ③ 4.09-6.45 ng/ml (n=351), and ④ >6.45 ng/ml (n=325). Additionally, 1029 cycles of patients with a BMI≥24 kg/m2 were grouped according to the serum AMH level: ① <2.71 ng/ml (n=255), ② 2.71-4.08 ng/ml (n=267), ③ 4.09-6.45 ng/ml (n=239), and ④ >6.45 ng/ml (n=268), with <2.71 ng/ml being considered the reference group. The grouping was based mainly on the interquartile range of serum AMH levels. The primary outcome of the study was PTB. The secondary outcomes were low birth weight (LBW), small for gestational age (SGA), macrosomia and large for gestational age (LGA).ResultsRegarding PCOS patients with a BMI<24 kg/m2, compared with the PTB rate of the AMH <2.71 ng/ml group, the PTB rates of the different groups were not significantly different (AMH 2.71-4.08, AOR (95% CI)=1.01 (0.52-2.00), P=0.99; AMH 4.09-6.45, AOR (95% CI)=0.93 (0.45-1.91), P=0.85; AMH>6.45, AOR (95% CI)=0.78 (0.35-1.73), P=0.54). Regarding PCOS patients with a BMI ≥24 kg/m2, compared with the PTB rate of the AMH <2.71 ng/ml group, the PTB rate of the AMH>6.45 ng/ml group was significantly higher (OR=2.47; 95% CI=1.34-4.55). After multiple logistic regression analysis, the risk of PTB in the AMH>6.45 ng/ml group was 2.1 times that in the AMH<2.71 ng/ml group (AOR=2.1, 95% CI=1.01-4.37, P=0.04). However, no statistically significant difference was found in the rate of SGA, LBW, macrosomia or LGA among patients in the different serum AMH groups.ConclusionFor PCOS patients, a BMI≥24 kg/m2 plus serum AMH>6.45 ng/ml (75th percentile) is an independent risk factor for PTB.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Strengths and Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Elevated Anti-Müllerian Hormone Is an Independent Risk Factor for Preterm Birth Among Patients With Overweight Polycystic Ovary Syndrome

Zhang

et al. 2021

Front. Endocrinol.

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“…Other studies have also shown that high levels of AMH are also associated with an increased risk of preterm delivery in patients with PCOS (K.‐L. Hu et al, 2020; Kaing et al, 2021). As mentioned in previous sections, increased levels of AMH are associated with impaired folliculogenesis and gonadotropin dysregulation in PCOS (Dewailly et al, 2020).…”

Section: Pregnancy and Offspring Outcomes In Pcosmentioning

confidence: 96%

Hyperandrogenism and Polycystic ovary syndrome: Effects in pregnancy and offspring development

Abruzzese

Silva

Velázquez

et al. 2022

WIREs Mechanisms of Disease

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Polycystic ovary syndrome (PCOS) is one of the major endocrine disorders affecting women of reproductive age. Its etiology remains unclear. It is suggested that environmental factors, and particularly the intrauterine environment, play key roles in PCOS development. Besides the role of androgens in PCOS pathogenesis, exposure to endocrine disruptors, as is Bisphenol A, could also contribute to its development. Although PCOS is considered one of the leading causes of ovarian infertility, many PCOS patients can get pregnant. Some of them by natural conception and others by assisted reproductive technique treatments. As hyperandrogenism (one of PCOS main features) affects ovarian and uterine functions, PCOS women, despite reaching pregnancy, could present high-risk pregnancies, including implantation failure, an increased risk of gestational diabetes, preeclampsia, and preterm birth. Moreover, hyperandrogenism may also be maintained in these women during pregnancy. Therefore, as an altered uterine milieu, including hormonal imbalance, could affect the developing organisms, monitoring these patients throughout pregnancy and their offspring development is highly relevant. The present review focuses on the impact of androgenism and PCOS on fertility issues and pregnancy-related outcomes and offspring development. The evidence suggests that the increased risk of pregnancy complications and adverse offspring outcomes of PCOS women would be due to the factors involved in the syndrome pathogenesis and the related co-morbidities. A better understanding of the involved mechanisms is still needed and could contribute to a better management of these women and their offspring.

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Antimüllerian hormone and spontaneous preterm birth: more research is needed before we can change clinical guidelines

Poromaa

2021

Fertility and Sterility

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Highly elevated level of antimüllerian hormone associated with preterm delivery in polycystic ovary syndrome patients who underwent ovulation induction

Cited by 16 publications

References 46 publications

Elevated Anti-Müllerian Hormone Is an Independent Risk Factor for Preterm Birth Among Patients With Overweight Polycystic Ovary Syndrome

Elevated Anti-Müllerian Hormone Is an Independent Risk Factor for Preterm Birth Among Patients With Overweight Polycystic Ovary Syndrome

Hyperandrogenism and Polycystic ovary syndrome: Effects in pregnancy and offspring development

Antimüllerian hormone and spontaneous preterm birth: more research is needed before we can change clinical guidelines

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