The following is a summary of “Anti-Müllerian hormone and live birth in unexplained recurrent pregnancy loss,” published in the June 2023 issue of Reproductive BioMedicine Online by Bliddal et al.

Anti-Müllerian hormone (AMH) and live birth rate (LBR) in women with recurrent pregnancy loss (RPL) without a known cause. Between 2015 and 2021, a cohort study of women with unexplained RPL attending the RPL Unit at Copenhagen University Hospital, Denmark. AMH concentration was evaluated at the time of referral, and LBR in the subsequent pregnancy. RPL was defined as three or more pregnancy losses in a row. Regression analyses accounted for age, number of previous failures, body mass index, smoking, assisted reproductive technology (ART), and RPL interventions. 

About 507 (80.6%) of the 629 women became expectant after referral. Pregnancy rates were comparable for women with low and high AMH relative to women with medium AMH (81.9%, 80.3%, and 79.7%, respectively) (low AMH: adjusted odds ratio [aOR] 1.44, 95% CI 0.84–2.47, P = 0.18; high AMH: aOR 0.98, 95% CI 0.59–1.65, P = 0.95). AMH levels were not correlated with live births. LBR was 59.5% among women with low AMH, 66.1% among women with medium AMH, and 65.1% among women with high AMH (low AMH: aOR 0.68, 95% CI 0.41–1.11, P = 0.12; high AMH: aOR 0.96, 95% CI 0.59–1.54, P = 0.87). 

Live birth was lower in ART pregnancies (aOR 0.57, 95% CI 0.33–0.97, P = 0.04) and in those with a more significant number of previous miscarriages (aOR 0.81, 95% CI 0.68–0.97, P = 0.04). In women with unexplained RPL, AMH was not associated with the likelihood of a subsequent live birth. The available evidence does not support AMH screening in all women with RPL. The low probability of live births among women with unexplained RPL who achieve pregnancy through ART must be confirmed and investigated in future research.

Source: sciencedirect.com/science/article/pii/S1472648323000664