Role of serum anti mullerian hormone as a predictor for miscarriage


  • Urvashi Barman Singh Department of Obstetrics and Gynecology, MLN Medical College Prayagraj, Uttar Pradesh, India
  • Yashi Srivastava Department of Obstetrics and Gynecology, MLN Medical College Prayagraj, Uttar Pradesh, India
  • Meena Dayal Department of Obstetrics and Gynecology, MLN Medical College Prayagraj, Uttar Pradesh, India
  • Shakti Jain Department of Obstetrics and Gynecology, MLN Medical College Prayagraj, Uttar Pradesh, India



Ovarian reserve, Pregnancy outcomes, Recurrent miscarriage


Background: Recurrent Miscarriage is defined as three or more failed clinical pregnancies at less than 20 weeks of gestation or fetal weight less than 500 grams that ends spontaneously. Ovarian reserve demonstrates reproductive potential and includes FSH, estradiol, inhibin B, and S. AMH levels. Women with very low AMH levels may have altered folliculogenesis that may influence early implantation to increase the risk of miscarriage. This study aimed to determine the serum AMH levels in patients with recurrent miscarriage and pregnancy outcomes in low (<1 ng/ml), normal (1-3.5 ng/ml) and high (>3.5 ng/ml) AMH groups and to evaluate the role of serum ovarian biomarkers in prediction of miscarriages.

Methods: This was a case-control study conducted over a time period of 1 year, on 120 women attending the antenatal clinic in department of obstetrics and gynecology, Swaroop Rani Nehru Hospital, Prayagraj. The patients were divided into two groups, Group 1 (n=80) included women with previous history of abortions and Group 2 (n=40) included women with no history of abortions. S. AMH levels were analyzed and compared in both the groups.

Results: In the present study, a significant negative correlation was seen between S. AMH and rate of miscarriages (p <0.05). Low AMH values were observed in patients with history of previous pregnancy loss.

Conclusions: Diminished ovarian reserve contributes to recurrent pregnancy loss and should be considered part of the work-up for RPL. AMH levels in recurrent miscarriage patients were lower than those in a normal population.

Author Biography

Urvashi Barman Singh, Department of Obstetrics and Gynecology, MLN Medical College Prayagraj, Uttar Pradesh, India



Stirrat GM. Recurrent miscarriage. Lancet. 1990;336:673-5.

Tho PT, Byrd JR, McDonough PG. Etiologies and subsequent reproductive performance of 100 couples with recurrent abortion. Fertil Steril. 1979;32:389-95.

Stephenson MD, Kutteh W. Evaluation and management of recurrent early pregnancy loss. Clin Obstet Gynecol. 2007;50:132-45.

Royal College of Obstetricians and Gynecologists. Royal College of Obstetricians and Gynecologists, Scientific Advisory Committee, Guideline No. 17. The investigation and treatment of couples with recurrent miscarriage, 2011. Available at: Accessed 25th January 2016.

American College of Obstetricians and Gynecologists. ACOG practice bulletin. Management of recurrent pregnancy loss. No. 24. February 2001. Replaces technical bulletin no. 212, September 1995. Int J Gynaecol Obstet. 2002;78:179-90.

Stephenson MD. Frequency of factors associated with habitual abortion in 197 couples. Fertil Steril. 1996;66:24-9.

Jaslow CR, Carney JL, Kutteh WH. Diagnostic factors identified in 1,020 women with two versus three or more recurrent pregnancy losses. Fertil Steril. 2010;93:1234-43.

Zarek SM, Mitchella EM, Sjaardaa LA, Mumforda SL, Silverc RM, Stanfordc JB, et al. Anti-müllerian hormone and pregnancy loss from the EAGeR trial. Fertil Steril. 2016;105(4):946-52.

McCormack C, Furness D, Dekker G, Roberts C. 662: Anti Müllerian hormone (AMH) levels in recurrent miscarriage patients are lower than those in a normal population, and predict pregnancy outcomes. Am J Obstet Gynecol. 2013;208(1):S279-80.

Zamah AM, Stephenson MD. Antimüllerian hormone and miscarriage: fifty shades of gray. Fertil Steril. 2018;109(6):1008-9.

Tarasconi B, Tadros T, Ayoubi JM, Belloc S, de Ziegler D, Fanchin R. Serum antimüllerian hormone levels are independently related to miscarriage rates after in vitro fertilization-embryo transfer. Fertil Steril. 2017;108(3):518-24.

Brianna M. LyttleSchumacher, Anne Marie Z. Anne Z. Steiner, Metrics PX. Antimüllerian hormone as a risk factor for miscarriage in naturally conceived pregnancies. Fertil Steril. 2018;109(6):1065-71.

Steiner AZ, Herring AH, Kesner JS, Meadows JW, Stanczyk FZ, Hoberman S, Baird DD. Antimüllerian hormone as a predictor of natural fecundability in women aged 30-42 years. Obstet Gynecol. 2011;117(4):798-804.

Hagen CP, Vestergaard S, Juul A, Skakkebæk NE, Andersson AM, Main KM, et al. Low concentration of circulating antimüllerian hormone is not predictive of reduced fecundability in young healthy women: a prospective cohort study. Fertil Steril. 2012;98(6):1602-8.e2.

Atasever M, Soyman Z, Demirel E, Gencdal S, Kelekci S. Diminished ovarian reserve: is it a neglected cause in the assessment of recurrent miscarriage? A cohort study. Fertil Steril. 2016;105(5):1236-40.

Szafarowska M, Molinska-Glura M, Jerzak MM. Anti-Müllerian hormone concentration as a biomarker of pregnancy success or failure. Neuro Endocrinol Lett. 2014;35(4):322-6.

Gleicher N, Kushnir VA, Sen A, Darmon SK, Weghofer A, Wu YG, et al. Definition by FSH, AMH and embryo numbers of good-, intermediate- and poor-prognosis patients suggests previously unknown IVF outcome-determining factor associated with AMH. Transl Med. 2016;14(1):172.

Pereira N, Setton R, Petrini AC, Lekovich JP, Elias RT, Spandorfer SD. Is anti-Müllerian hormone associated with IVF outcomes in young patients with diminished ovarian reserve? Women Health (Lond). 2016;12(2):185-92.






Original Research Articles