Pre-pregnancy AMH level and risk of preeclampsia in IVF patients

Abstract

The objective was to examine the association with pre-pregnancy anti-mullerian hormone values in IVF patients and development of preeclampsia. A nested case control study in a cohort of 346 patients and 368 IVF cycles between 2016 and 2020 that subsequently resulted in a live birth. Cases of preeclampsia were identified and matched to normotensive controls by age, BMI, number of fetuses and type of oocytes. Pre-pregnancy data including demographics, AMH levels, and IVF cycle details as well as pregnancy outcomes, including the occurrence of preeclampsia, pregnancy/delivery complications and gestational age at delivery, were analyzed. Primary outcome of interest is occurrence of preeclampsia. Log transformed levels of AMH were compared between the two groups using student t test. To determine the impact of AMH levels on the main outcome while controlling for other confounders, logistic regression was used. Out of 368 IVF cycles or 346 patients, 279 patients delivered in the system of University of Louisville or Norton. Among them 33 had preeclampsia, 20 patients had gestational hypertension, 14 had chronic hypertension and the remaining 212 had normotensive pregnancies. Patients with preeclampsia had elevated pre-pregnancy AMH levels, compared to normotensive controls (mean 5.2 vs 3.3) (p< 0.05). AMH level was decreased in 35% of patients with chronic HTN, 17% of normotensive and patients with gestational hypertension and in 5% of patients with severe preeclampsia. Elevated pre-pregnancy AMH level may be a marker of increased preeclampsia risk in IVF pregnancies.View Large Image Figure ViewerDownload Hi-res image Download (PPT)