Fertility and sterility · 2025
Prepregnancy levels of antimüllerian hormone do not impact the perinatal outcomes in women with polycystic ovary syndrome.
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Guo Yaxin, Chen Hong, Zha Luyang, Bai Dijia, Jin Lei
Аннотация
OBJECTIVE: To evaluate the relationship between prepregnancy serum antimüllerian hormone (AMH) levels and perinatal outcomes in women with polycystic ovary syndrome (PCOS) undergoing fresh or frozen embryo transfer (ET) cycles.
DESIGN: Retrospective cohort study.
SUBJECTS: The study retrospectively included 1,952 women with PCOS who received fresh or frozen ET cycles and successfully achieved their first single live birth between January 2016 and June 2023.
EXPOSURE: The levels of AMH were measured. Patients were classified into three categories according to their AMH levels: the low-level category (AMH level ≤25th percentile/6.54 ng/mL), the average-level category (AMH level between >25th percentile/6.54 ng/mL and ≤75th percentile/14.53 ng/mL), and the high-level category (AMH level >75th percentile/14.53 ng/mL). Multivariate regression analyses were performed to examine the association between AMH levels, treated as either a continuous or categorical variable, and perinatal outcomes after controlling for confounders. Restricted cubic spline curve analysis was performed to assess potential nonlinear relationships. Separate analyses were conducted for fresh and frozen ET cycles.
MAIN OUTCOME MEASURES: Preterm birth, low birth weight, macrosomia, small for gestational age, large for gestational age, and pregnancy-related complications.
RESULTS: When analyzed as either a continuous or categorical variable, AMH levels exhibited no significant association with any perinatal outcomes after adjusting for potential confounders. Restricted cubic spline curve analysis revealed no nonlinear relationships. The distribution of AMH in patients with preterm birth was similar to that of patients with term delivery, confirming that the risk of preterm birth is not linked to AMH levels. Further analysis of both frozen and fresh cycles revealed no association between AMH levels and various abnormal perinatal outcomes, including preterm birth. Subgroup analyses on the basis of different body mass index categories and young women yielded consistent conclusions.
CONCLUSION: Patients with PCOS with high serum basal AMH levels still have satisfactory perinatal outcomes. In vitro fertilization management decisions should rely more on established obstetric indicators rather than AMH levels alone.
DESIGN: Retrospective cohort study.
SUBJECTS: The study retrospectively included 1,952 women with PCOS who received fresh or frozen ET cycles and successfully achieved their first single live birth between January 2016 and June 2023.
EXPOSURE: The levels of AMH were measured. Patients were classified into three categories according to their AMH levels: the low-level category (AMH level ≤25th percentile/6.54 ng/mL), the average-level category (AMH level between >25th percentile/6.54 ng/mL and ≤75th percentile/14.53 ng/mL), and the high-level category (AMH level >75th percentile/14.53 ng/mL). Multivariate regression analyses were performed to examine the association between AMH levels, treated as either a continuous or categorical variable, and perinatal outcomes after controlling for confounders. Restricted cubic spline curve analysis was performed to assess potential nonlinear relationships. Separate analyses were conducted for fresh and frozen ET cycles.
MAIN OUTCOME MEASURES: Preterm birth, low birth weight, macrosomia, small for gestational age, large for gestational age, and pregnancy-related complications.
RESULTS: When analyzed as either a continuous or categorical variable, AMH levels exhibited no significant association with any perinatal outcomes after adjusting for potential confounders. Restricted cubic spline curve analysis revealed no nonlinear relationships. The distribution of AMH in patients with preterm birth was similar to that of patients with term delivery, confirming that the risk of preterm birth is not linked to AMH levels. Further analysis of both frozen and fresh cycles revealed no association between AMH levels and various abnormal perinatal outcomes, including preterm birth. Subgroup analyses on the basis of different body mass index categories and young women yielded consistent conclusions.
CONCLUSION: Patients with PCOS with high serum basal AMH levels still have satisfactory perinatal outcomes. In vitro fertilization management decisions should rely more on established obstetric indicators rather than AMH levels alone.