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- Title
Is Anti-Müllerian Hormone Associated With Fecundability? Findings From the EAGeR Trial.
- Authors
Zarek, Shvetha M; Mitchell, Emily M; Sjaarda, Lindsey A; Mumford, Sunni L; Silver, Robert M; Stanford, Joseph B; Galai, Noya; White, Mark V; Schliep, Karen C; DeCherney, Alan H; Schisterman, Enrique F
- Abstract
<bold>Objective: </bold>The objective of the study was to evaluate whether anti-Müllerian hormone (AMH) is associated with fecundability among women with proven fecundity and a history of pregnancy loss.<bold>Design: </bold>This was a prospective cohort study within a multicenter, block-randomized, double-blind, placebo-controlled clinical trial ( clinicaltrials.gov , number NCT00467363).<bold>Setting: </bold>The study was conducted at four US medical centers (2006-2012).<bold>Participants: </bold>Participating women were aged 18-40 years, with a history of one to two pregnancy losses who were actively attempting pregnancy.<bold>Main Outcome Measures: </bold>Time to human chorionic gonadotropin detected and clinical pregnancy were assessed using Cox proportional hazard regression models to estimate fecundability odds ratios (fecundability odds ratios with 95% confidence interval [CI]) adjusted for age, race, body mass index, income, low-dose aspirin treatment, parity, number of previous losses, and time since most recent loss. Analyses examined by preconception AMH levels: 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).<bold>Results: </bold>Of the 1202 women with baseline AMH levels, 82 women with low AMH (66.1%) achieved an human chorionic gonadotropin detected pregnancy, compared with 383 with normal AMH (65.2%) and 315 with high AMH level (65.2%). Low or high AMH levels relative to normal AMH (referent) were not associated with fecundability (low AMH: fecundability odds ratios 1.13, 95% CI 0.85-1.49; high AMH: FOR 1.04, 95% CI 0.87-1.24).<bold>Conclusions: </bold>Lower and higher AMH values were not associated with fecundability in unassisted conceptions in a cohort of fecund women with a history of one or two prior losses. Our data do not support routine AMH testing for preconception counseling in young, fecund women.
- Subjects
COMPARATIVE studies; FERTILITY; SEX hormones; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; MISCARRIAGE; RESEARCH; RESEARCH funding; SOCIOECONOMIC factors; EVALUATION research; RANDOMIZED controlled trials; TREATMENT effectiveness; PREDICTIVE tests; BLIND experiment
- Publication
Journal of Clinical Endocrinology & Metabolism, 2015, Vol 100, Issue 11, p4215
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/jc.2015-2474