Live birth rates in IVF patients with and without polycystic ovary syndrome according to serum anti-Müllerian hormone concentrations.

RESEARCH QUESTION: Is there a relationship between serum anti-Müllerian hormone (AMH) concentration and live birth rate (LBR) in patients with and without polycystic ovary syndrome (PCOS)?

DESIGN

This retrospective study included 4631 patients aged 20-35 years who underwent their first frozen embryo transfer cycle at the First Affiliated Hospital of Zhengzhou University from June 2016 to June 2021. Participants were categorized as having or not having PCOS (PCOS group, n = 1428, and NPCOS group, n = 3203, respectively). In the two groups, AMH was categorized into subgroups 1, 2 and 3 using the 25th and 75th percentiles as cut-off lines.

RESULTS

In the NPCOS subgroups, LBR was significantly lower in NPCOS1 than in NPCOS2 and NPCOS3 (P < 0.001). In the PCOS subgroups, LBR was significantly lower in PCOS3 than in PCOS2 (P = 0.038), with no significant difference between PCOS1 and the other subgroups. In the NPCOS and PCOS groups, the preterm birth rate increased with the increase in AMH concentration in the subgroups (P = 0.018 and P = 0.016, respectively). Multivariate regression analysis revealed that AMH was an independent factor influencing the LBR and preterm birth rate in the NPCOS and PCOS groups (P < 0.05). The threshold effect analysis indicated a positive correlation between LBR and AMH in the NPCOS group at an AMH concentration of 2.98 ng/ml or less (P < 0.001), and a negative correlation in the PCOS group at an AMH concentration higher than 7.13 ng/ml (P = 0.043). Higher AMH concentrations were positively correlated with preterm birth rate in the NPCOS (P = 0.004) and PCOS (P = 0.017) groups.

CONCLUSIONS

Serum AMH concentrations could have a clinical predictive value for LBR in young patients, both with and without PCOS.