Antimüllerian hormone and pregnancy loss from the Effects of Aspirin in Gestation and Reproduction trial

Capsule:
Lower and higher antimullerian hormone levels are not associated with human chorionic gonadotropin- detected or clinical pregnancy loss in unassisted conceptions in women with a history of pregnancy loss.

Authors:
Shvetha M. Zarek, Emily M. Mitchell, Ph.D., Lindsey A. Sjaarda, Ph.D., Sunni L. Mumford, Ph.D., Robert M. Silver, M.D., Joseph B. Stanford, M.D., M.S.P.H., Noya Galai, Karen C. Schliep, Ph.D., Rose G. Radin, Ph.D., Torie C. Plowden, M.D., Alan H. DeCherney, M.D., Enrique F. Schisterman, Ph.D.

Volume 105, Issue 4, Pages 946-952

Abstract:

Objective:
To evaluate if antimüllerian hormone (AMH) is associated with pregnancy loss.

Design:
Prospective cohort study within a block-randomized, double-blind, placebo-controlled trial of low-dose aspirin.

Setting:
Not applicable.

Patient(s):
Women (n = 1,228) were of ages 18–40 years with a history of one to two pregnancy losses and were actively attempting pregnancy without fertility treatment.

Intervention(s):
None.

Main Outcome Measure(s):
Pregnancy loss.

Result(s):
Relative risks (and 95% confidence interval [CIs]) of hCG-detected and clinical pregnancy loss were assessed with the use of log binomial models with robust variance and inverse probability weights adjusted for age, race, body mass index, income, trial treatment assignment, parity, number of previous losses, and time since most recent loss. AMH levels were defined as: low (<1.00 ng/mL; n = 124), normal (referent; 1.00–3.5 ng/mL; n = 595), and high (>3.5 ng/mL; n = 483). Of the 1,202 women with baseline AMH data, 19 (17.3%) with low AMH experienced a clinical loss, compared with 61 (11.4%) with normal AMH and 50 (11.8%) with high AMH levels. Low or high AMH levels, compared with normal AMH, were not associated with clinical loss. Results for hCG-detected pregnancy loss mirrored those of clinical loss.

Conclusion(s):
AMH values were not associated with hCG-detected or clinical pregnancy loss in unassisted conceptions in women with a history of one to two previous losses. Our data do not support routine AMH testing for prediction of pregnancy loss.

Clinical Trial Registration Number:
ClinicalTrials.gov NCT00467363.

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