Longitudinal changes in maternal serum concentrations of antimüllerian hormone in individual women during conception cycles and early pregnancy.

OBJECTIVE

To study antimüllerian hormone (AMH) from gestation week 0-7.

DESIGN

Longitudinal study of 85 pregnant women with AMH and reproductive hormones sampled during conception cycle and early pregnancy until week 7.

SETTING

Fertility clinic.

PATIENT(S): Of 85 pregnant women, 69 had a singleton pregnancy, 1 a twin pregnancy, and 15 had a nonviable pregnancy (3 chemical pregnancies, 11 miscarriages, and 1 blighted ovum).

INTERVENTION(S): None.

MAIN OUTCOME MEASURE(S): Relationship between AMH and gestation week, woman's age, body mass index (BMI), FSH dose, treatment modality, reproductive hormones, viability of pregnancies, and fetal gender.

RESULT(S): During the conception cycle, 86.1% of women had their maximum AMH at or before ovulation. The AMH level did not remain constant in viable pregnancies, but moved significantly away from baseline pregnancy level. In natural pregnancies the overall trend was for decreasing AMH level. In treatment pregnancies AMH level either consistently increased or decreased from gestation week 4 (time of first positive hCG) through to week 7. In contrast, the AMH level in nonviable pregnancies showed sporadic changes, both increasing and decreasing in the same individual from gestation weeks 4-7. The AMH level was negatively correlated with patient's age (r = -0.507) and P level (r = -0.220), but no other associations were observed with BMI, FSH dose, treatment modality, or fetal gender.

CONCLUSION(S): The AMH level peaked at or before ovulation in most women, trended down with natural pregnancies, and consistently increased or decreased in women with a viable pregnancy after therapy. Nonviable pregnancies showed erratic AMH patterns. Factors responsible for these different responses in pregnancy remain to be identified.