High levels of AMH do not influence the chances of having a healthy baby in women with PCOS—this might surprise many, given how often ovarian reserve markers are considered in fertility assessments. But here’s where it gets controversial: recent research suggests that a women’s serum antimüllerian hormone (AMH) levels, despite being widely used to gauge ovarian reserve, don’t actually predict outcomes related to childbirth or perinatal health in PCOS patients.
A comprehensive retrospective study analyzing nearly two thousand women with polycystic ovary syndrome (PCOS) has shed new light on this topic. The findings reveal that AMH levels, whether high or low, do not have a significant impact on perinatal results for women undergoing either fresh or frozen embryo transfers.
So, what did this study find regarding the link between AMH and pregnancy outcomes?
The research included 1,952 women with PCOS who achieved their first live birth following embryo transfer between 2016 and 2023. These women were grouped based on their AMH levels into low, average, and high categories, determined through percentile thresholds. This classification allowed for a detailed comparison across the entire spectrum of hormonal levels, making the findings more reliable.
Importantly, after adjusting for various potential confounding factors—such as age, BMI, and other health indicators—the analysis showed no correlation between serum AMH levels and negative perinatal outcomes. These outcomes encompass a wide range of concerns, including preterm delivery, low birth weight, macrosomia (excessive birth weight), infants being small or large for their gestational age, and pregnancy-related complications. Whether AMH was analyzed as a continuous variable or categorized into groups, the results remained consistent.
Advanced statistical techniques, like restricted cubic spline modeling, also demonstrated no nonlinear relationships, further confirming that AMH levels do not meaningfully influence perinatal health outcomes. Interestingly, the distribution of AMH values was similar when comparing women who delivered preterm versus those who carried to term, reinforcing the idea that AMH is not a predictor of these outcomes.
And this is the part most people miss—evaluating embryo transfer cycles separately revealed the same lack of association for both fresh and frozen cycles. Additionally, subgroup analyses based on factors like BMI and age confirmed that this lack of correlation holds true across different patient profiles within the PCOS demographic.
So, what does this mean for women with PCOS and their fertility treatment plans? The authors emphasize that women with high AMH levels can still expect positive pregnancy and perinatal outcomes. Crucially, decisions in IVF management should be based on well-established obstetric risk factors rather than AMH alone. Since AMH primarily reflects ovarian reserve—a measure of how many eggs a woman has—rather than the quality of those eggs or the health of the pregnancy, it shouldn’t be used as a predictor of perinatal success.
In summary, this study encourages a shift in perspective: instead of overemphasizing AMH as a prognostic tool for pregnancy outcomes, clinicians should prioritize other indicators for obstetric risk assessment. This nuanced understanding supports more personalized and evidence-based approaches to fertility treatment in women with PCOS.
What do you think—should AMH be dismissed entirely in predicting pregnancy success, or does it still have some place? Share your opinions below!
Reference:
Guo Y et al. Prepregnancy levels of antimüllerian hormone do not impact the perinatal outcomes in women with polycystic ovary syndrome. Fertility and Sterility. 2025;124(5):1093-103.
