Serum anti-Müllerian hormone levels are associated with perinatal outcomes in women undergoing IVF/ICSI: A multicenter retrospective cohort study

Front Endocrinol (Lausanne). 2023 Feb 21:14:1081069. doi: 10.3389/fendo.2023.1081069. eCollection 2023.

Abstract

Introduction: Anti-Müllerian hormone (AMH) level has long been considered as a serum biomarker of ovarian reserve clinically, while emerging data suggest that serum AMH level may also predict pregnancy outcomes. However, whether pregestational serum AMH levels are related to perinatal outcomes among women undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles is unknown.

Objective: To explore the association between different AMH levels and perinatal outcomes in women with live births in IVF/ICSI.

Methods: This multicenter retrospective cohort study was conducted among three different provinces in China, from January 2014 to October 2019. A total of 13,763 IVF/ICSI cycles with 5657 live-delivery pregnant women and 6797 newborns were recruited. Participants were categorized into three groups according to the <25th (low), 25 to 75th (average), and >75th (high) percentile of serum AMH concentration. Perinatal outcomes were compared among groups. Subgroup analyses were conducted based on the number of live births.

Results: Among women with singleton deliveries, low and high AMH levels increased the risk of intrahepatic cholestasis of pregnancy (ICP) (aOR1 = 6.02, 95%CI: 2.10-17.22; aOR2 = 3.65, 95%CI:1.32-10.08) and decreased the risk of macrosomia (aOR1 = 0.65, 95%CI:0.48-0.89; aOR2 = 0.72, 95%CI:0.57-0.96), while low AMH reduced the risk of large for gestational age (LGA, aOR=0.74, 95%CI:0.59-0.93) and premature rupture of membrane (PROM, aOR=0.50, 95%CI:0.31-0.79)compared with the average AMH group. In women with multiple deliveries, high AMH levels increased the risks of gestational diabetes mellitus (GDM, aOR=2.40, 95%CI:1.48-3.91) and pregnancy-induced hypertension (PIH, aOR=2.26, 95%CI:1.20-4.22) compared with the average AMH group, while low AMH levels increased the risk of ICP (aOR=14.83, 95%CI:1.92-54.30). However, there was no evidence of differences in preterm birth, congenital anomaly, and other perinatal outcomes among the three groups in both singleton and multiple deliveries.

Conclusions: Abnormal AMH levels increased the risk of ICP regardless of the number of live births for women undergoing IVF/ICSI, while high AMH levels increased the risks of GDM and PIH in multiple deliveries. However, serum AMH levels were not associated with adverse neonatal outcomes in IVF/ICSI. The underlying mechanism warrants further investigation.

Keywords: anti-Müllerian hormone; gestational diabetes mellitus; in vitro fertilization; intracytoplasmic sperm injection; intrahepatic cholestasis of pregnancy; perinatal outcomes; pregnancy-induced hypertension.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Mullerian Hormone
  • Female
  • Fertilization in Vitro
  • Humans
  • Infant, Newborn
  • Male
  • Peptide Hormones*
  • Pregnancy
  • Premature Birth*
  • Retrospective Studies
  • Semen
  • Sperm Injections, Intracytoplasmic

Substances

  • Anti-Mullerian Hormone
  • Peptide Hormones

Supplementary concepts

  • Intrahepatic Cholestasis of Pregnancy

Grants and funding

This research was supported by National Key Research and Development Program of China (2021YFC2700701, 2022YFC2703505), National Natural Science Foundation of China (8211101588, 82088102, 82171686), CAMS Innovation Fund for Medical Sciences (2019-I2M-5-064), the International Science and Technology Collaborative Fund of Shanghai (18410711800), Program of Shanghai Academic Research Leader (20XD1424100), Natural Science Foundation of Shanghai (20ZR1463100), Collaborative Innovation Program of Shanghai Municipal Health Commission (2020CXJQ01), Clinical Research Plan of Shanghai Shenkang Hospital Development Center (SHDC12018X17, SHDC2020CR1008A, SHDC12019107), Science and Technology Innovation Fund of Shanghai Jiao Tong University (YG2019GD04, YG2020YQ29), Outstanding Youth Medical Talents of Shanghai Rising Stars of Medical Talent Youth Development Program, Shanghai Clinical Research Center for Gynecological Diseases (22MC1940200), Shanghai Urogenital System Diseases Research Center (2022ZZ01012) and Shanghai Frontiers Science Research Base of Reproduction and Development.