Volume 109, Issue 6, Pages 1065–1071.e1

Authors:

Brianna M. Lyttle Schumacher, M.D., Anne Marie Z. Jukic, Ph.D., Anne Z. Steiner, M.D., M.P.H.

Abstract:

Objective

To determine the association between antimüllerian hormone (AMH), a measure of ovarian reserve, and miscarriage among naturally conceived pregnancies.

Design

Prospective cohort study.

Setting

Not applicable.

Patient(s)

Women (n = 533), between 30 and 44 years of age with no known history of infertility, polycystic ovarian syndrome, or endometriosis who conceived naturally.

Intervention(s)

None.

Main Outcome Measure(s)

Miscarriage, defined as an intrauterine pregnancy loss before 20 weeks’ gestation.

Result(s)

After adjusting for maternal age, race, history of recurrent miscarriage, and obesity, risk of miscarriage decreased as AMH increased (risk ratio per unit increase in natural log of AMH = 0.83; 95% confidence interval [CI], 0.73, 0.94). Women with severely diminished ovarian reserve (AMH ≤ 0.4 ng/mL) miscarried at over twice the rate of women with an AMH ≥ 1 ng/mL (hazard ratio, 2.3; 95% CI, 1.3, 4.3).

Conclusion(s)

AMH levels are inversely associated with the risk of miscarriage. Women with severely diminished ovarian reserve are at an increased risk of miscarriage.

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