Anti-Müllerian hormone (AMH), a biomarker of ovarian reserve produced by granulosa cells of early follicles, is known to predict ovarian response and oocyte yield in assisted reproductive technology (ART). Although AMH reliably predicts ovarian response and oocyte yield and ART, its utility as an independent predictor of oocyte or embryo quality remains uncertain, especially for women of non-advanced reproductive age (non-ARA; < 35 years old). Clinically, the extremes of ovarian reserve are seen in women with polycystic ovarian syndrome (high) and with decreased ovarian reserve (low). AMH is used in conjunction with ultrasound imaging (measuring an antral follicle count (AFC)) to determine the likely response to gonadotropin stimulation during fertility treatments such as in vitro fertilization (IVF). However, its role as an independent predictor of embryo quality remains unclear, particularly in women under 35 years of age.

To date, a large amount of the existing literature is dominated by cohorts of women of advanced reproductive age (ARA), which limits its applicability to younger patients. This represents a critical gap in knowledge with direct implications for patient counseling and study design.

We are performing a retrospective cohort study of women less than 35 years of age who underwent in vitro fertilization (IVF) at the University of Oklahoma, OU Health Reproductive Medicine (OURM) from 2020 to 2024 in order to evaluate the relationship between serum AMH and embryo quality and ploidy. AMH will be categorized using Poseidon thresholds as low (< 1.2 ng/mL) and normal (≥ 1.2 ng/mL). Primary endpoints measured will be the ratio of good quality blastocyst per normally fertilized oocytes (2PN), and the euploid rate per total number of embryos biopsied for PGT-A. Embryo grading will follow the Gardner criteria, and embryo quality grouping will be based on SART (the Society of Assisted Reproductive Technology) grading. PGT-A results will be classified as euploid, aneuploid, high-level mosaic, low-level mosaic, or no result.

Of an initial query of 1,217 records, 324 cycles met the inclusion and exclusion criteria. The median patient age is 31 years of age (± 2.71), and the median patient BMI was 27.6. (± 6.92). Analysis is ongoing currently.