Fertil Steril. 2025 Aug 22:S0015-0282(25)01837-0. doi: 10.1016/j.fertnstert.2025.08.013. Online ahead of print.
ABSTRACT
OBJECTIVE: To study the association between anti-Müllerian hormone (AMH) and antral follicle count (AFC) with embryo euploidy rates in patients undergoing in vitro fertilization (IVF) with preimplantation genetic testing for aneuploidy (PGT-A), independent of maternal age and other confounding factors.
DESIGN: Retrospective cohort study.
SUBJECTS: A total of 11,473 women who underwent 13,451 IVF cycles with PGT-A between October 2016 and August 2024 across a large national network of infertility clinics in the United States.
EXPOSURE(S): AMH and AFC values recorded within six months of oocyte retrieval. AMH and AFC were categorized based on Bologna criteria for diminished ovarian reserve: AMH 4.0 ng/mL; AFC 16.
MAIN OUTCOME MEASURE(S): Adjusted relative risk (RR) of embryo euploidy based on AMH and AFC levels, with secondary outcomes including live birth, clinical pregnancy, and implantation rates.
RESULTS: Euploidy rates were comparable across AMH categories (56.9%, 54.0%, and 55.8% for AMH 4.0 ng/mL, respectively) and AFC categories (56.3%, 54.8%, and 54.9% for AFC 16, respectively). After adjustment, euploidy was modestly higher in the lowest AMH category (RR: 1.08; 95% CI: 1.05, 1.11) but similar in the highest AMH category (RR: 1.00; 95% CI: 0.98, 1.02). Euploidy rates were comparable among AFC 16 (RR: 0.96; 95% CI: 0.95, 0.98). AMH and AFC levels were not significantly associated with live birth, clinical pregnancy, or implantation rates.
CONCLUSIONS: Contrary to recent studies, lower AMH and AFC levels were not associated with a clinically significant decrease in embryo euploidy or live birth outcomes. These findings suggest that while AMH and AFC are useful for assessing ovarian reserve, they may have limited value in predicting embryo euploidy when considered independently of other factors, such as maternal age.
PMID:40850506 | DOI:10.1016/j.fertnstert.2025.08.013