title: Is Anti-Müllerian Hormone Associated With Fecundability? Findings From the EAGeR Trial.
abstract: OBJECTIVE
  The objective of the study was to evaluate whether anti-Müllerian hormone (AMH) is associated with fecundability among women with proven fecundity and a history of pregnancy loss.
  
  
  METHODS
  This was a prospective cohort study within a multicenter, block-randomized, double-blind, placebo-controlled clinical trial ( clinicaltrials.gov , number NCT00467363).
  
  
  METHODS
  The study was conducted at four US medical centers (2006-2012).
  
  
  METHODS
  Participating women were aged 18-40 years, with a history of one to two pregnancy losses who were actively attempting pregnancy.
  
  
  METHODS
  Time to human chorionic gonadotropin detected and clinical pregnancy were assessed using Cox proportional hazard regression models to estimate fecundability odds ratios (fecundability odds ratios with 95% confidence interval [CI]) adjusted for age, race, body mass index, income, low-dose aspirin treatment, parity, number of previous losses, and time since most recent loss. Analyses examined by preconception AMH levels: low (<1.00 ng/mL, n = 124); normal (referent 1.00-3.5 ng/mL, n = 595); and high (>3.5 ng/mL, n = 483).
  
  
  RESULTS
  Of the 1202 women with baseline AMH levels, 82 women with low AMH (66.1%) achieved an human chorionic gonadotropin detected pregnancy, compared with 383 with normal AMH (65.2%) and 315 with high AMH level (65.2%). Low or high AMH levels relative to normal AMH (referent) were not associated with fecundability (low AMH: fecundability odds ratios 1.13, 95% CI 0.85-1.49; high AMH: FOR 1.04, 95% CI 0.87-1.24).
  
  
  CONCLUSIONS
  Lower and higher AMH values were not associated with fecundability in unassisted conceptions in a cohort of fecund women with a history of one or two prior losses. Our data do not support routine AMH testing for preconception counseling in young, fecund women.
authors.affiliation: Epidemiology Branch (S.M.Z., E.M.M., L.A.S., S.L.M., K.C.S., E.F.S.), Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland 20854; Program in Reproductive and Adult Endocrinology (S.M.Z., A.H.D.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland 20982; Department of Obstetrics and Gynecology (R.M.S., J.B.S.), University of Utah and Intermountain HealthCare, Salt Lake City, Utah 84111; Department of Statistics (N.G.), University of Haifa, Haifa 3498838, Israel; and Department of Family, Community, and Rural Health (M.V.W.), The Commonwealth Medical College, Scranton, Pennsylvania 18509.
authors.forename: Shvetha M
authors.initials: SM
authors.lastname: Zarek
authors.affiliation: Epidemiology Branch (S.M.Z., E.M.M., L.A.S., S.L.M., K.C.S., E.F.S.), Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland 20854; Program in Reproductive and Adult Endocrinology (S.M.Z., A.H.D.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland 20982; Department of Obstetrics and Gynecology (R.M.S., J.B.S.), University of Utah and Intermountain HealthCare, Salt Lake City, Utah 84111; Department of Statistics (N.G.), University of Haifa, Haifa 3498838, Israel; and Department of Family, Community, and Rural Health (M.V.W.), The Commonwealth Medical College, Scranton, Pennsylvania 18509.
authors.forename: Emily M
authors.initials: EM
authors.lastname: Mitchell
authors.affiliation: Epidemiology Branch (S.M.Z., E.M.M., L.A.S., S.L.M., K.C.S., E.F.S.), Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland 20854; Program in Reproductive and Adult Endocrinology (S.M.Z., A.H.D.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland 20982; Department of Obstetrics and Gynecology (R.M.S., J.B.S.), University of Utah and Intermountain HealthCare, Salt Lake City, Utah 84111; Department of Statistics (N.G.), University of Haifa, Haifa 3498838, Israel; and Department of Family, Community, and Rural Health (M.V.W.), The Commonwealth Medical College, Scranton, Pennsylvania 18509.
authors.forename: Lindsey A
authors.initials: LA
authors.lastname: Sjaarda
authors.affiliation: Epidemiology Branch (S.M.Z., E.M.M., L.A.S., S.L.M., K.C.S., E.F.S.), Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland 20854; Program in Reproductive and Adult Endocrinology (S.M.Z., A.H.D.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland 20982; Department of Obstetrics and Gynecology (R.M.S., J.B.S.), University of Utah and Intermountain HealthCare, Salt Lake City, Utah 84111; Department of Statistics (N.G.), University of Haifa, Haifa 3498838, Israel; and Department of Family, Community, and Rural Health (M.V.W.), The Commonwealth Medical College, Scranton, Pennsylvania 18509.
authors.forename: Sunni L
authors.initials: SL
authors.lastname: Mumford
authors.affiliation: Epidemiology Branch (S.M.Z., E.M.M., L.A.S., S.L.M., K.C.S., E.F.S.), Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland 20854; Program in Reproductive and Adult Endocrinology (S.M.Z., A.H.D.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland 20982; Department of Obstetrics and Gynecology (R.M.S., J.B.S.), University of Utah and Intermountain HealthCare, Salt Lake City, Utah 84111; Department of Statistics (N.G.), University of Haifa, Haifa 3498838, Israel; and Department of Family, Community, and Rural Health (M.V.W.), The Commonwealth Medical College, Scranton, Pennsylvania 18509.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Silver
authors.affiliation: Epidemiology Branch (S.M.Z., E.M.M., L.A.S., S.L.M., K.C.S., E.F.S.), Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland 20854; Program in Reproductive and Adult Endocrinology (S.M.Z., A.H.D.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland 20982; Department of Obstetrics and Gynecology (R.M.S., J.B.S.), University of Utah and Intermountain HealthCare, Salt Lake City, Utah 84111; Department of Statistics (N.G.), University of Haifa, Haifa 3498838, Israel; and Department of Family, Community, and Rural Health (M.V.W.), The Commonwealth Medical College, Scranton, Pennsylvania 18509.
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Stanford
authors.affiliation: Epidemiology Branch (S.M.Z., E.M.M., L.A.S., S.L.M., K.C.S., E.F.S.), Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland 20854; Program in Reproductive and Adult Endocrinology (S.M.Z., A.H.D.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland 20982; Department of Obstetrics and Gynecology (R.M.S., J.B.S.), University of Utah and Intermountain HealthCare, Salt Lake City, Utah 84111; Department of Statistics (N.G.), University of Haifa, Haifa 3498838, Israel; and Department of Family, Community, and Rural Health (M.V.W.), The Commonwealth Medical College, Scranton, Pennsylvania 18509.
authors.forename: Noya
authors.initials: N
authors.lastname: Galai
authors.affiliation: Epidemiology Branch (S.M.Z., E.M.M., L.A.S., S.L.M., K.C.S., E.F.S.), Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland 20854; Program in Reproductive and Adult Endocrinology (S.M.Z., A.H.D.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland 20982; Department of Obstetrics and Gynecology (R.M.S., J.B.S.), University of Utah and Intermountain HealthCare, Salt Lake City, Utah 84111; Department of Statistics (N.G.), University of Haifa, Haifa 3498838, Israel; and Department of Family, Community, and Rural Health (M.V.W.), The Commonwealth Medical College, Scranton, Pennsylvania 18509.
authors.forename: Mark V
authors.initials: MV
authors.lastname: White
authors.affiliation: Epidemiology Branch (S.M.Z., E.M.M., L.A.S., S.L.M., K.C.S., E.F.S.), Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland 20854; Program in Reproductive and Adult Endocrinology (S.M.Z., A.H.D.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland 20982; Department of Obstetrics and Gynecology (R.M.S., J.B.S.), University of Utah and Intermountain HealthCare, Salt Lake City, Utah 84111; Department of Statistics (N.G.), University of Haifa, Haifa 3498838, Israel; and Department of Family, Community, and Rural Health (M.V.W.), The Commonwealth Medical College, Scranton, Pennsylvania 18509.
authors.forename: Karen C
authors.initials: KC
authors.lastname: Schliep
authors.affiliation: Epidemiology Branch (S.M.Z., E.M.M., L.A.S., S.L.M., K.C.S., E.F.S.), Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland 20854; Program in Reproductive and Adult Endocrinology (S.M.Z., A.H.D.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland 20982; Department of Obstetrics and Gynecology (R.M.S., J.B.S.), University of Utah and Intermountain HealthCare, Salt Lake City, Utah 84111; Department of Statistics (N.G.), University of Haifa, Haifa 3498838, Israel; and Department of Family, Community, and Rural Health (M.V.W.), The Commonwealth Medical College, Scranton, Pennsylvania 18509.
authors.forename: Alan H
authors.initials: AH
authors.lastname: DeCherney
authors.affiliation: Epidemiology Branch (S.M.Z., E.M.M., L.A.S., S.L.M., K.C.S., E.F.S.), Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland 20854; Program in Reproductive and Adult Endocrinology (S.M.Z., A.H.D.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland 20982; Department of Obstetrics and Gynecology (R.M.S., J.B.S.), University of Utah and Intermountain HealthCare, Salt Lake City, Utah 84111; Department of Statistics (N.G.), University of Haifa, Haifa 3498838, Israel; and Department of Family, Community, and Rural Health (M.V.W.), The Commonwealth Medical College, Scranton, Pennsylvania 18509.
authors.forename: Enrique F
authors.initials: EF
authors.lastname: Schisterman
mesh_terms: D000022:Abortion, Spontaneous / Q000097:blood / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D004311:Double-Blind Method; D005260:Female; D005298:Fertility / Q000502:physiology*; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D054304:Anti-Mullerian Hormone