Association of testosterone and antimüllerian hormone with time to pregnancy and pregnancy loss in fecund women attempting pregnancy

To examine whether higher T and/or antimüllerian hormone (AMH) was associated with anovulation, time to pregnancy (TTP), or pregnancy loss risk among healthy, fecund women without diagnosed polycystic ovary syndrome. Prospective cohort study conducted as a secondary analysis from the Effects of Aspi...

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Bibliographic Details
Published in:	Fertility and sterility 2018-03, Vol.109 (3), p.540-548.e1
Main Authors:	Sjaarda, Lindsey A., Mumford, Sunni L., Kuhr, Daniel L., Holland, Tiffany L., Silver, Robert M., Plowden, Torie C., Perkins, Neil J., Schisterman, Enrique F.
Format:	Article
Language:	eng
Subjects:	Abortion, Spontaneous - blood Abortion, Spontaneous - epidemiology Abortion, Spontaneous - physiopathology Academic Medical Centers Adult Androgen Anovulation - blood Anovulation - epidemiology Anovulation - physiopathology Anti-Mullerian Hormone - blood Biomarkers - blood Female Fertility Humans Incidence menstrual cycle polycystic ovary syndrome Pregnancy Prospective Studies Risk Factors testosterone Testosterone - blood Time Factors Time-to-Pregnancy United States Young Adult
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Summary:	To examine whether higher T and/or antimüllerian hormone (AMH) was associated with anovulation, time to pregnancy (TTP), or pregnancy loss risk among healthy, fecund women without diagnosed polycystic ovary syndrome. Prospective cohort study conducted as a secondary analysis from the Effects of Aspirin in Gestation and Reproduction randomized trial. University medical centers. A total of 1,198 healthy, eumenorrheic women aged 18–40 years attempting spontaneous pregnancy with one to two prior pregnancy losses were included. Women were categorized by baseline antimüllerian hormone (AMH), as a surrogate marker of antral follicle count, and T concentrations; the highest quartile for each was “high,” and below the top quartile (i.e., lower 75% of values) was “norm,” forming four groups: norm T/norm AMH (n = 742), norm T/high AMH (n = 156), high T/norm AMH (n = 157), and high T/high AMH (n = 143). Not applicable. Anovulation, pregnancy incidence, TTP, and pregnancy loss incidence. Women with high T/high AMH had a greater anovulation risk (risk ratio 1.58, 95% confidence interval 1.13–2.22) compared with women with norm T/norm AMH, but with imprecise differences in incidence of pregnancy, TTP, or pregnancy loss. Women with higher T and AMH had more frequent anovulatory cycles but with marginal impacts on TTP or pregnancy loss. A continuum of mild inefficiency in reproductive function may be related to higher T and AMH, including in fecund women with normal menstrual cycles and no clinical diagnosis of polycystic ovary syndrome, but with unclear effects on fecundability and pregnancy loss. NCT00467363.
ISSN:	0015-0282 1556-5653