Usefulness of Anti-Müllerian Hormone to Predict Outcomes of Threatened Miscarriage in Naturally Conceived Pregnancies

Abstract

Background: Anti-Müllerian hormone (AMH) levels fluctuate in a complicated and not always one-way fashion in the early stages of pregnancy. An abundance of research has looked at how AMH levels correlate with various pregnancy problems. Objective: To determine the association between AMH and miscarriage among women naturally conceived pregnancy. Methods: Total of 40 pregnant women at gestational age ranged between 6-8 weeks who had first trimester threatened miscarriage while they were trying for naturally conceive were included in our prospective cohort study at Obstetrics and Gynecology Department at Fetomaternal Unit in Zagazig University Hospital. All patients were subjected to assay serum AMH. Results: Anti-Mϋllerian hormone (AMH) among the studied cases ranged from 0.8 to 4 ng/ml with mean 2.41 ng/ml and median 2.55 ng/ml. Statistical analysis revealed a negative connection between AMH and age and statistical +ve significant correlation between AMH and gestational sac size, crown lump length, yolk sac size and fetal heart rate among the studied cases. There was a statistically significant decrease in AMH among cases had aborted before 20 weeks compared to cases completed pregnancy. AMH at cut off <1.9 ng/ml had sensitivity 85.7%, specificity 87.9% and accuracy 87.5% in prediction of early pregnancy loss among the studied cases. Conclusion: Ovarian reserve may be accurately measured by measuring anti-Müllerian hormone levels in the blood. However, findings on the significance of AMH level in making pregnancy predictions are inconsistent. The likelihood of having a miscarriage is inversely related to AMH levels. Miscarriages are more common among women who have substantially decreased ovarian reserve.