Elevated antimüllerian hormone levels are not associated with preterm delivery after in vitro fertilization or ovulation induction

Abstract

To investigate the association between anti-Müllerian hormone and preterm birth risk in a larger cohort of patients who underwent either in vitro fertilization or ovulation induction with intrauterine insemination at a US academic fertility center. Retrospective cohort study SUBJECTS: Live singleton births from patients who underwent in vitro fertilization or ovulation induction between 2016 and 2020 at a single academic fertility center were included in this study. Patients were excluded if they had a missing pre-pregnancy AMH level, a pregnancy using donor oocytes or a gestational carrier, multiple gestations, a delivery prior to 20 weeks gestation, or a cerclage in place. AMH level MAIN OUTCOME MEASURES: The primary outcome was proportion of preterm delivery. Secondary outcomes included rate of pregnancy-induced hypertension, gestational diabetes, and small for gestational age. In the entire cohort (n=875), 8.4% of deliveries were preterm. Mean AMH values were similar between those with term and preterm births (3.9 vs 4.2 ng/mL, p=0.29). Similar proportions of patients with term and preterm deliveries had AMH levels greater than the 75th percentile (25% vs 21%, p=0.4). The odds of preterm birth were similar by AMH quartile after adjusting for history of preterm birth. Similarly, in the PCOS cohort, there was no difference between mean AMH values of term and preterm births (n=139, 9.6 vs 10.0 ng/mL, p=0.9). The proportions of PCOS patients with AMH levels greater than the 75th percentile were similar between those with term and preterm deliveries (25% vs 22%, p=0.9). The odds of preterm birth were similar by AMH quartile after adjusting for history of preterm birth. Elevated AMH levels were not associated with an increased risk of preterm birth in patients who conceived after in vitro fertilization and ovulation induction, including PCOS patients. Although studies suggest that AMH level may help stratify risk of preterm birth in this population, our findings indicate that further studies are needed prior to clinical application.