High levels of serum anti-Müllerian hormone (AMH) are associated with increased risk for preterm delivery in women with polycystic ovary syndrome (PCOS), according to study results published in Fertility and Sterility.

Women with PCOS are more likely to experience poor outcomes during pregnancy, including preterm delivery. However, there are currently very few identifiable markers that can be used to help determine which patients are at increased risk for complications. Because women with PCOS have higher serum AMH levels during pregnancy than women without PCOS, the researchers aimed to identify the association between serum AMH levels and preterm delivery in PCOS in a retrospective cohort study of women who underwent in vitro fertilization at Peking University Third Hospital in Beijing, China.

A total of 3743 deliveries (281 preterm) were analyzed from patients who received both fresh and frozen embryo transfer. Although patients with PCOS were more common in the preterm delivery group than in the term delivery group, the difference was not significant (16.0% vs 12.2%; P =.06), and there was no difference observed in serum AMH levels between groups (4.1 vs 3.8 ng/mL; P =.28).

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In patients with PCOS (n=468), however, serum AMH levels were significantly higher in the preterm delivery group than the term delivery group (9.3 vs 6.9 ng/mL; P <.01). Patients with PCOS and high serum AMH levels (in the 75th percentile) were more common in the preterm delivery group as well (adjusted odds ratio, 4.0; 95% CI, 1.94-8.08; P <.0001). There was no significant difference observed for patients with the highest serum AMH levels (in the 90th percentile).

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In women who underwent fresh embryo transfer, there was no difference observed in the distribution of preterm and term births among patients in the 75th and 90th percentiles for AMH concentrations. However, in women with PCOS who underwent frozen embryo transfer, patients with high serum AMH levels were more likely to be in the preterm delivery group (adjusted odds ratio, 4.5; 95% CI, 1.93-10.49; P <.0001). No significant difference was observed for patients in the 90th percentile for AMH levels.

“In conclusion, in the present study, we show that high AMH levels are associated with an increased risk of preterm delivery in PCOS patients and in patients with [frozen embryo transfers],” the study investigators concluded. “Our results will guide clinicians to better manage the process of pregnancy in these patients.”


Hu KL, Liu FT, Xu H, Li R, Qiao J. High antimüllerian hormone levels are associated with preterm delivery in patients with polycystic ovary syndrome [published online January 20, 2020]. Fertil Steril. doi:10.1016/j.fertnstert.2019.09.039