Correlation between AMH levels and embryonic aneuploidy rate in PGT-A patients: a retrospective study

The association between anti-Müllerian hormone (AMH) levels and embryonic aneuploidy rates was investigated by analyzing clinical and embryo laboratory data from patients with preimplantation genetic testing for aneuploidy (PGT-A). However, the nonlinear relationship and threshold effect of AMH on aneuploidy risk remain poorly understood.

This retrospective study analyzed the clinical data of 819 PGT-A cycles performed between January 2018 and August 2024 at the General Hospital of Northern Theater Command. We used restricted cubic spline (RCS) to investigate the dose-response relationship between the AMH levels and aneuploidy rate, adjusting for potential confounders.

Significant differences were observed in normal fertilization rates, day 3 high-quality embryo rates, blastocyst formation rates, euploidy embryo rates, aneuploid embryo rates, and mosaic embryo rates among the three AMH groups (P < 0.05). A statistically significant nonlinear relationship between AMH levels and aneuploidy rate was identified (P < 0.05). RCS and threshold effect analyses revealed that the risk of a positive (≥ 50%) aneuploidy rate increased by 40% for each 1-unit decrease in AMH when AMH ≤ 2.54 ng/mL.

In the PGT-A population, advanced maternal age (AMA), recurrent spontaneous abortion (RSA), or recurrent implantation failure (RIF) have been identified as contributing factors. After adjusting for potential confounders such as female age, AMH remains a significant risk factor for embryonic aneuploidy rates. The findings suggested that lower AMH levels are associated with a higher risk of embryonic aneuploidy, indicating that ovarian reserve function may be correlated with oocyte quality. These results provide new insights for individualized decision-making in assisted reproduction. Trial registration ChiCTR2500099710 (03/27/2025).