SERUM ANTI-MULLERIAN HORMONE LEVELS ARE ASSOCIATED WITH EARLY MISCARRIAGE IN THE IVF/ICSI FRESH CYCLE

Abstract Background: Anti-Müllerian hormone (AMH) is used as a marker of ovarian reserve in assisted reproductive technology. Its role in predicting early miscarriage in fresh in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles is uncertain. In this study we aim to systematically review the association between serum AMH levels and early miscarriage in fresh IVF/ICSI cycles. Methods: A systematic review was conducted in accordance to PRISMA 2020 guidelines. Searches were performed in PubMed, Scopus, Web of Science, and Embase for studies published between 2005 and 2025. First-trimester miscarriage is the outcome reported by eligible studies. Seventeen studies met the inclusion criteria. Results: Most studies indicated association between elevated AMH levels and increased risk of early miscarriage, mainly in women with polycystic ovary syndrome (PCOS). Women with AMH ≥10.65 ng/mL experienced miscarriage rates up to twice as high as those with lower levels. Low AMH was linked to diminished ovarian response and suboptimal outcomes. A minority of studies reported no correlation. Conclusion: Elevated serum AMH levels are associated with an increased risk of early miscarriage in fresh IVF/ICSI cycles mainly in PCOS patients. AMH should be interpreted clinically to improve individualized fertility care.