Pre-pregnancy levels of anti-Müllerian hormone do not impact the perinatal outcomes in women with polycystic ovary syndrome

Yaxin Guo; Hong Chen; Luyang Zha; Dijia Bai; Lei Jin

doi:10.1016/j.fertnstert.2025.06.032

Pre-pregnancy levels of anti-Müllerian hormone do not impact the perinatal outcomes in women with polycystic ovary syndrome

Fertil Steril. 2025 Jun 25:S0015-0282(25)00537-0. doi: 10.1016/j.fertnstert.2025.06.032. Online ahead of print.

Authors

Yaxin Guo¹, Hong Chen¹, Luyang Zha¹, Dijia Bai¹, Lei Jin²

Affiliations

¹ Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 JieFang Avenue, Wuhan, 430030, People's Republic of China; National Clinical Research Center for Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
² Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 JieFang Avenue, Wuhan, 430030, People's Republic of China; National Clinical Research Center for Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: leijintongjih@qq.com.

PMID: 40578662
DOI: 10.1016/j.fertnstert.2025.06.032

Abstract

Objective: To evaluate the relationship between pre-pregnancy serum anti-Müllerian hormone (AMH) levels and perinatal outcomes in polycystic ovary syndrome (PCOS) women undergoing fresh or frozen embryo transfer cycles.

Design: Retrospective cohort study.

Subjects: The study retrospectively included 1952 women with PCOS who received fresh or frozen embryo transfer cycles and successfully achieved their first single live birth between January 2016 and June 2023.

Exposure: The levels of AMH. Patients were classified into 3 categories according to AMH levels: the low-level category (AMH ≤ 25th percentile/ 6.54 ng/mL), the average-level category (25th percentile/ 6.54 ng/mL < AMH ≤75th percentile/ 14.53 ng/mL), and the high-level category (AMH > 75th percentile/ 14.53 ng/mL). Multivariate regression analyses were performed to examine the association between AMH, treated as either a continuous or categorical variable, and perinatal outcomes after controlling for confounders. Restricted cubic spline (RCS) curve analysis was employed to assess potential nonlinear relationships. Separate analyses were conducted for fresh and frozen 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 exhibited no significant association with any perinatal outcomes after adjusting for potential confounders. RCS analysis revealed no nonlinear relationships. The distribution of AMH in preterm birth patients was similar to that of term delivery patients, 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 based on different body mass index categories and young women yielded consistent conclusions.

Conclusion: PCOS patients with high serum basal AMH still have satisfactory perinatal outcomes. IVF management decisions should rely more on established obstetric indicators rather than AMH levels alone.

Keywords: Polycystic ovary syndrome; anti-Müllerian hormone; assisted reproductive technology; perinatal outcomes.