High antimullerian hormone levels are associated with preterm delivery in patients with polycystic ovary syndrome

Context: Antimullerian hormone (AMH) levels are higher in patients with polycystic ovary syndrome (PCOS). Accumulating evidence indicates that AMH has an impact on the physiology of the female reproductive system. Objective: To investigate the association of AMH levels with the risk of preterm delivery in PCOS patients. Design: Retrospective cohort study. Setting: Academic fertility center. Patients: Women who underwent in vitro fertilization between January 2017 and July 2018 (25,165 cycles). Interventions: None. Main Outcome Measures: The primary outcome was preterm delivery. Results: Serum AMH levels were not different between the term delivery and preterm delivery groups in the entire cohort (3.8 vs. 4.1 ng/mL, P>.05). In patients diagnosed with PCOS, those with preterm delivery had higher AMH levels than were found in patients with term delivery (9.3 vs. 6.9 ng/mL, P<.01). Pretermdeliveries predominated in PCOS patients with AMH levels above the 75th percentile (9.75 ng/mL) (adjusted P<.0001, adjusted odds ratio [OR] 4.0, 95% confidence interval [CI] 1.94, 8.08)) and frozen-thawed embryo transfer (FET) patients with AMH levels higher than the 90th percentile (10.10 ng/mL) (adjusted P<.05, adjusted OR 2.0, 95% CI 1.16, 3.36). Conclusion: Serum AMH levels higher than 75th percentile were associated with an increased risk of preterm delivery in patients with PCOS, and serum AMH levels higher than the 90th percentile were associated with an increased risk of preterm delivery in FET patients. (C) 2019 by American Society for Reproductive Medicine.