Relationship between anti-Müllerian hormone concentration in the peripheral blood of women and aneuploid pregnancy

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Anti-Müllerian hormone (AMH) is an effective biomarker for assessing ovarian reserve. This study evaluated ovarian reserve in women with aneuploid pregnancy history and whether serum AMH concentration is a predictive indicator of aneuploidy risk. Methods A case–control study was conducted among 82 women with aneuploid pregnancy history and 35 with healthy pregnancies at the Affiliated Hospital of Inner Mongolia Medical University between January 2018 and November 2024. Based on the history of polycystic ovary syndrome (PCOS) before pregnancy, the participants were categorised into case groups 1 (without PCOS, n = 70) and 2 (with PCOS, n = 12). Mann–Whitney U test was used to compare age and AMH levels between the case and control groups. A logistic regression model was employed to analyse the relationship between serum AMH concentration and the occurrence of aneuploidy, whereas receiver operating characteristic curve analysis was used to evaluate the predictive value of serum AMH level for aneuploidy in women. Ovarian reserve in these cases was categorised as DOR (AMH level 7 ng/mL). Results No significant differences in age and serum AMH concentration were found between the case and control groups (mean age, 32.60 and 31.97 years; mean AMH, 3.47 ng/mL and 3.22 ng/mL, respectively). Women in case group 2 (n = 12) exhibited significantly higher serum AMH concentration (mean AMH, 8.66 ± 3.09 ng/mL vs 3.22 ± 1.46 ng/mL, p = 0.001), whereas those in case group 1 demonstrated significantly lower levels than the controls (2.58 ± 1.49 ng/mL vs 3.22 ± 1.47 ng/mL, p = 0.045). Low serum AMH concentrations predicted aneuploid pregnancy (odds ratio: 0.752, 95% confidence interval: 0.570–0.991, p = 0.043), and the area under the predicted risk curve was 0.62. Among the cases, 15.85% presented with DOR. Conclusions This study indicates that low AMH concentration may be a high-risk factor for aneuploidy. However, ovarian reserve appears to remain within the normal range in most women with a history of aneuploid pregnancy. These findings provide a new perspective for understanding the occurrence of aneuploidy. anti-Müllerian hormone aneuploidy diminished ovarian reserve polycystic ovary syndrome Figures Figure 1 Figure 2 Background The mechanisms that trigger chromosomal nondisjunction remain unclear, and effective preventive and control measures against aneuploid pregnancies are currently lacking. Many studies have demonstrated that women of advanced age are more prone to aneuploid pregnancies [1,2]. Investigations on the origin of an additional chromosome in the karyotype of children with trisomy 21 revealed that over 95% of the extra chromosomes originate from the mother [3,4]. Therefore, aneuploidy may be induced by the non-separation of chromosomes in oocytes during meiosis, which is the egg formation process. The ovaries exhibit alterations in the number of follicles and egg quality in women of advanced age. Brook et al. [5] conducted animal experiments in 1984 to verify the association between a reduced follicle number and the occurrence of aneuploid pregnancies. They revealed that when one ovary was removed from the mice, the frequency of aneuploid offspring in ovariectomised mice was elevated compared with that in mice without ovariectomy. Based on this experiment, the occurrence of aneuploid pregnancies was hypothesised to be associated with follicular pool shrinkage. This hypothesis has been supported by some scholars from the following two perspectives. First, menopausal age and ovarian resection history in women with a history of aneuploid pregnancy were investigated, and the results indicated that their menopausal age was 1 year earlier than that of those with normal chromosomal pregnancies [6]. Additionally, the proportion of women with a history of ovarian surgery was substantially higher among women with aneuploid pregnancies than among those without [7]. Other studies have shown that the basal follicle-stimulating hormone (FSH) level (> 10 mIU/mL) increases in women with aneuploidy [8]. This evidence supports the relationship between aneuploid pregnancies and follicular pool shrinkage. Recently, two studies have investigated the association between diminished ovarian reserve (DOR) and embryonic aneuploidy incidence. Jaswa et al. [9] documented a significant reduction in the number of diploid blastocysts among patients with DOR, even after controlling for age-related factors. Fouks et al. [10] found that the rate of aneuploid embryo formation in women with DOR or poor ovarian response was similar to that observed in the general population after controlling for other confounding factors. Patients with polycystic ovary syndrome (PCOS) exhibit a higher number of follicles in their ovaries than do those with DOR. However, these follicles tend to be of inferior quality, leading to an increased incidence of chimeric aneuploid embryos in these patients [11,12]. Serum anti-Müllerian hormone (AMH) concentrations are significantly higher in this patient cohort than in the general population [13]. In the case group of this study, 12 patients were diagnosed with PCOS before pregnancy, accounting for 14.63% of all cases, a rate significantly higher than that observed in the general population (5–8%) [14,15]. Therefore, categorising this group distinctly is imperative. Currently, whether women with PCOS are more likely to have aneuploid foetuses has not been reported. Since only 12 patients with PCOS were included in this study and the sample size was insufficient for statistical analysis, the relationship between serum AMH concentration and aneuploidy in the PCOS group was not further investigated. Therefore, exploring the relationship between ovarian reserve and chromosome aneuploid pregnancies is essential for understanding the related factors leading to aneuploid pregnancies and preventing them. Currently, clinical approaches for evaluating ovarian reserve include detecting AMH, FSH, basal oestrogen, and statin B levels in the peripheral blood of women and measuring follicle counts in the central ovarian sinus via ultrasound. Among these strategies, detecting AMH levels in the peripheral blood of women is considered an ideal indicator of ovarian reserve [16,17,18]. AMH, a member of the transforming growth factor β superfamily, is a glycoprotein secreted by the granulosa cells of the preantral and antral follicles in the ovary. Serum AMH in females is closely linked to follicular development, with its secretion peaking during adolescence and reproductive age, followed by a gradual decline in its concentration with advancing age [19]. AMH is not influenced by the endocrine regulation of the hypothalamic–pituitary–gonadal axis, is minimally affected by the menstrual cycle, and can be measured at any time during the cycle [20]. Therefore, it is extensively used to assess ovarian reserve [21] and predict menopause time [22] and can serve as a marker of ovarian biological age [23]. Recently, researchers have investigated the association between serum AMH concentrations and embryonic aneuploidy. A retrospective study by Shim et al. [24] revealed that low AMH concentration in the peripheral blood of women could serve as a marker for predicting foetal aneuploidy. Jiang et al. [25] studied 394 patients with unexplained recurrent spontaneous abortion and revealed that low serum AMH concentrations are associated with an elevated risk of foetal aneuploidy only in women of advanced age (age ≥ 35 years). However, the proportion of women with aneuploid pregnancies who have DOR remains unknown. The extent of ovarian reserve declines may influence the likelihood of aneuploid pregnancies, raising the question of whether AMH can serve as a predictive marker for this risk. Studies on these issues are important for developing strategies to prevent aneuploidy. Various factors, including age, body mass index, and ethnicity, affect serum AMH concentration in women. No universally accepted cut-off value exists for assessing ovarian reserve based on AMH levels [26]. Therefore, this study aimed to evaluate the ovarian reserve of women with aneuploid pregnancy history using commonly accepted clinical criteria and changes in serum AMH concentrations observed in healthy women [27,28,29]. AMH concentrations of 7 ng/mL indicate DOR, good ovarian function, and PCOS tendency, respectively. Methods Study design and participants This retrospective case–control study included 82 women with a history of aneuploid pregnancy undergoing genetic counselling and 35 with healthy pregnancies at the Obstetrics and Gynaecology Department of the Affiliated Hospital of Inner Mongolia Medical University, China, between January 2018 and November 2024. The Institutional Review Board of the Inner Mongolia Medical University, China, approved the study protocol (approval number: YKD2016108). Inclusion and exclusion criteria The age range for the case and control groups was 20–45 years. Participants in the case group were categorised into case groups 1 (women without PCOS, n = 70) and 2 (those with PCOS, n = 12). The control group (n = 35) consisted of women who concurrently underwent pre-pregnancy physical examinations; had given birth to healthy children; experienced regular menstrual cycles; and had no history of adverse fertility outcomes, endocrine disorders, or ovarian surgeries. The inclusion criterion for the case group was women with aneuploid pregnancy history but without chromosomal abnormalities in them or their partner, whereas the exclusion criteria were women with foetal chromosomes with chimeric trisomy, partial deletion or duplication, or chromosomal translocation or inversion. Clinical data, which include age, menstrual history, fertility history, medical history, embryo or foetal chromosome examination results, and AMH examination results (AMH test results detected within 1 year after the embryo is diagnosed as aneuploid), were systematically obtained from the hospital's case management system at the time of each patient visit. Statistical analyses All statistical analyses were performed using SPSS Statistics for Windows, version 19.0 (SPSS Inc., Chicago, Ill, USA). Pearson chi-square test was used to compare the number of pregnancies and deliveries, as well as AMH concentration distribution, between the two groups. Age and AMH concentrations in the case and control groups were not normally distributed according to the Shapiro–Wilk test; therefore, between-group differences were assessed using the Mann–Whitney U test. Binary logistic regression analysis was conducted to evaluate whether serum AMH concentration in women was a significant risk factor for aneuploidy. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of serum AMH levels for aneuploidy in women. Statistical significance was set at p < 0.05. Results Comparative analysis of general information between the case and control groups and evaluation of ovarian reserve function in women with aneuploid pregnancy history Significant differences were observed in the number of pregnancies and births between the case (n = 82) and control (n = 35) groups but not in age and AMH concentrations (Table 1 ). The diagnostic criteria for ovarian reserve based on AMH concentrations were applied. Both groups were subdivided into three categories for comparative analysis, revealing significant differences among these subgroups. In the case group, 12 women had been diagnosed with PCOS before pregnancy. Three patients had undergone pelvic surgery: two for removal of endometriomas and one for salpingectomy. Additionally, three other patients had histories of endocrine disorders, including hypothyroidism, diabetes, and pituitary microadenoma. Seventeen women reported irregular menstrual cycles in the case group. Table 1 Comparative analysis of general information between the case and control groups Participants, n Case group Control group χ 2 /z p - value 82 35 Age, median (range) (years) 32.60 (26–45) 31.97 (26–40) -1.008 0.314 Irregular menstruation, n (%) 17 (20.73) Serum AMH, mean ± SD (ng/mL) 3.47 ± 3.02 3.22 ± 1.46 -0.616 0.538 < 1.2 ng/mL, n (%) 13 (15.85) 7 (20.00) Irregular menstruation, n (%) 3 (23.08) 0 ≥ 1.2, < 7.0 ng/mL, n (%) 61 (74.39) 28 (80) Irregular menstruation, n (%) 7 (11.48) 0 ≥ 7.0 ng/mL, n (%) 8 (9.76) 0 Irregular menstruation, n (%) 7 (87.50) 0 Number of pregnancies 1.90 (1–6) 1.34 (1–3) 88.966 0.001 Number of births 0.17 (0–2) 1.03 (1–2) Polycystic ovary syndrome 12 (14.46) 0 History of ovarian surgery 3 (3.66) 0 Other endocrine history 3 (3.66) 0 AMH, anti-Müllerian hormone; SD, standard deviation Ovarian reserve assessment in 82 cases based on serum AMH concentrations is shown in Fig. 1 . Specifically, 15.85% exhibited an AMH concentration of 7 ng/mL, indicative of DOR function and PCOS tendency, respectively. The remaining 74.39% had AMH levels within the normal range, reflecting normal ovarian reserve function. Distribution of chromosomal abnormalities in 82 foetuses in the case group The results of chromosomal abnormalities in 82 foetuses are shown in Fig. 2 ., among which trisomy 21 accounted for 26.83%, followed by trisomy 16 at 14.63%. Comparison of AMH concentrations between 70 women with aneuploidy history without PCOS and a control group and evaluation of AMH as a predictor of aneuploidy risk The patients were categorised into case groups 1 (without a history of PCOS) and 2 (with a history of PCOS). These groups were compared against the control group. No statistically significant difference was found in age across the three groups. However, significant differences were observed in AMH concentrations between both case groups and the control group (Table 2 ). Table 2 Comparison of age and serum AMH levels between the two case groups and the control group Age (years) Case group 1 (n = 70) Control group (n = 35) z p-value 32.90 ± 4.23 31.97 ± 4.31 -1.283 0.199 AMH (ng/mL) 2.58 ± 1.49 3.22 ± 1.47 -2.002 0.045 Case group 2 (n = 12) Control group (n = 35) Age (years) 30.83 ± 3.09 31.97 ± 4.31 -0.480 0.631 AMH (ng/mL) 8.66 ± 4.37 3.22 ± 1.47 -4.660 0.001 AMH, anti-Müllerian hormone Logistic regression analysis revealed that a lower AMH concentration is a significant risk factor for aneuploidy. Table 3 presents the results of the ROC curve analysis. The AMH concentration demonstrated a predictive accuracy of 62% for aneuploidy risk, which is marginally superior to the predictive accuracy based on age alone. Table 3 ROC curves for women's age and serum AMH concentration in assessing aneuploidy risk 95% CI AUC S.T. p-value Lower Upper Age 0.577 0.062 0.201 0.455 0.699 AMH 0.62 0.057 0.045 0.509 0.731 AMH, anti-Müllerian hormone; CI, confidence interval; AUC, area under the predicted risk curve; ROC, receiver operating characteristic; S.T., Standard error Discussion A lower serum AMH concentration in women with aneuploidy without a history of PCOS is a risk factor for aneuploidy. Based on ovarian reserve assessment using AMH, approximately 15% of women with aneuploid pregnancy history exhibited DOR. To further explore the ovarian reserve of women with aneuploid pregnancy history, 82 patients were categorised based on the AMH concentration in the peripheral blood into the DOR, good ovarian reserve, and PCOS tendency groups. Only 15.85% of women with aneuploid pregnancy history demonstrated DOR, whereas 9.76% showed a PCOS tendency. More than half the patients (74.39%) showed good ovarian reserve. The distribution of AMH concentrations between the case and control groups significantly differed. This result suggests that women with aneuploid pregnancy history exhibit differences in ovarian reserve compared to the control group, and such alterations in ovarian reserve may contribute to the occurrence of aneuploid pregnancies. Warburton [30] examined the relationship between biological age and aneuploidy in women and demonstrated that smoking can result in a DOR; however, no evidence suggests that smoking increases the incidence of aneuploid pregnancies. Specifically, the study proposed that meiotic errors in oocytes may be linked to alterations in key proteins involved in meiotic regulation, cellular metabolic factors, and mitochondrial function. The abovementioned study results differ from those of previous reports, which considered DOR as the main risk factor for aneuploidy [31,32,33]. However, the results revealed that 74.39% of patients evaluated for ovarian reserve using AMH did not show DOR. The disparity between the current and previous results may be due to the following reasons. First, approximately 1–5% of all aneuploidies are caused by chromosomal abnormalities in sperm [34,35]. In this study, the source of chromosomal additions or deletions in the foetus or foetal aneuploidy was not examined. The ovarian function in women may be normal if aneuploidy is caused by male factors. Second, chromosomal abnormalities in aborted embryos were mainly determined by copy number variation sequencing or chromosomal microarray analysis and karyotype analysis was not reported in this study. Therefore, these aneuploid cases cannot be distinguished from translocation or standard trisomy. An embryo is not associated with DOR if it undergoes translocation trisomy. Third, serum AMH concentration mainly reflects the follicle count and the quality of follicles has not been evaluated [36]. Binary logistic and ROC curve analyses were conducted in the cohort without PCOS and showed that a decline in serum AMH concentrations was a risk factor for aneuploid pregnancy. The ROC curve analysis revealed that the serum AMH concentration of women, when used as an indicator to predict the risk of aneuploidy, did not show significant eugenics. However, relevant data could not be obtained on factors that could influence AMH concentrations in women's blood, such as ethnicity and body mass index. Therefore, the generalisability of these findings is limited. Conclusion This study indicates that low AMH concentration may be a high-risk factor for aneuploidy. However, most women with a history of aneuploid pregnancy may exhibit ovarian reserve within the normal range. Collectively, the findings of this study provide a new perspective for the understanding of aneuploidy in women. Abbreviations Anti-Müllerian hormone AMH Diminished ovarian reserve DOR Polycystic ovary syndrome PCOS Follicle-stimulating hormone FSH Receiver operating characteristic ROC Confidence interval CI Declarations Ethics approval and consent to participate This study was conducted in accordance with the Declaration of Helsinki (2000) of the World Medical Association. The Ethics Committee of Inner Mongolia Medical University, China, approved the study protocol (approval number: YKD2016108). Informed consent was not necessary because the data were deidentified. Consent for publication Not applicable. Availability of data and materials The datasets generated and/or analysed during the current study are not publicly available due to information privacy but are available from the corresponding author upon reasonable request. Competing interests The author declares no competing interests. Funding This work was supported by grants from the Natural Science Foundation of China (81660542) and the Inner Mongolia Natural Science Fund (2018MS08091). Authors' contributions Xiao Xi Zhao conceived and designed the study, wrote the manuscript, and acquired funding. Acknowledgments I thank Dr Barbara Burmen for critically reading the manuscript and providing editorial help and suggestions. References Elmerdahl Frederiksen L, Ølgaard SM, Roos L, Petersen OB, Rode L, Hartwig T, et al. Maternal age and the risk of fetal aneuploidy: a nationwide cohort study of more than 500 000 singleton pregnancies in Denmark from 2008 to 2017. Acta Obstet Gynecol Scand. 2024;103:351-9. Wasielak-Politowska M, Kordowitzki P. Chromosome segregation in the oocyte: what goes wrong during aging. Int J Mol Sci. 2022;23:2880. Sánchez-Pavón E, Mendoza H, García-Ferreyra J. Trisomy 21 and assisted reproductive technologies: a review. 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Jiang X, Yan J, Sheng Y, Sun M, Cui L, Chen ZJ. Low anti-Müllerian hormone concentration is associated with increased risk of embryonic aneuploidy in women of advanced age. Reprod Biomed Online. 2018;37:178-83. Piltonen TT, Viita-Aho J, Saarela U, Melin J, Forslund M. Utility of serum anti-Müllerian hormone measurement as part of polycystic ovary syndrome diagnosis. Semin Reprod Med. 2024;42:49-59. Cohen J, Chabbert-Buffet N, Darai E. Diminished ovarian reserve, premature ovarian failure, poor ovarian responder--a plea for universal definitions. J Assist Reprod Genet. 2015;32(12):1709-1712. Vale-Fernandes E, Barreiro M, Monteiro MP. Candidates selection for oocyte donation in a public gamete bank-Predictive value of the anti-Müllerian hormone. Porto Biomed J. 2023;8(1):e199. Oliveira TFS, Barreiro M, Tomé A, Vale-Fernandes E. Female Reproductive Health - study of an egg donor population. JBRA Assist Reprod. 2023 ;27(4):638-643. Warburton D. 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Assessment of sperm chromosomal abnormalities using fluorescence in situ hybridisation (FISH): implications for reproductive potential. J Assist Reprod Genet. 2024;41:2787-93. Borges E, Braga DPAF, Setti A, Figueira RC, Iaconelli A Jr. The predictive value of serum concentrations of anti-Müllerian hormone for oocyte quality, fertilization, and implantation. JBRA Assist Reprod. 2017;21:176-82. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 10 May, 2026 Reviewers agreed at journal 10 May, 2026 Reviewers invited by journal 08 May, 2026 Submission checks completed at journal 05 Apr, 2026 First submitted to journal 18 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5905206","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":617927571,"identity":"eefdbf21-9cda-413a-bbd8-35844a0e6f73","order_by":0,"name":"Xiao Xi Zhao","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA20lEQVRIiWNgGAWjYDACCQhlxy///uGDhIoa4rUkSzbkMBs8OHOMeC2MGxpy2CQftjAT1iE/u/nhY942BmYDhrPHKhIb2Bj427sT8GphnHPM2HDGGQY+c8a+tBuJO2QYJM6c3YBXC7NEgpnEhwoGZstmBrMbiWfYGAwkcvFrYZNI/yaRYAD0yzEGs4LENmbCWngkcsC2MG44w2PGQJQWCYmcYqBfJJIlZ7AlSyScOcZD0C/yM9I3AkPMxo5fgvngxx8VNXL87b34tcAsQ7iUGOWjYBSMglEwCggAACkeQrw9ZkKZAAAAAElFTkSuQmCC","orcid":"","institution":"Affiliated Hospital of Inner Mongolia Medical University","correspondingAuthor":true,"prefix":"","firstName":"Xiao","middleName":"Xi","lastName":"Zhao","suffix":""}],"badges":[],"createdAt":"2025-01-26 08:08:17","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5905206/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5905206/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":108411085,"identity":"2e9ba5c5-0da3-4b21-ba9f-6d32cdee250e","added_by":"auto","created_at":"2026-05-04 10:20:05","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":40580,"visible":true,"origin":"","legend":"\u003cp\u003eOvarian reserve among 82women with aneuploid pregnancy history\u003c/p\u003e","description":"","filename":"drawingimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-5905206/v1/92aad4da27b2cf53622cd82e.png"},{"id":108493477,"identity":"278e4542-beb0-44b8-8433-35e3ecc76d75","added_by":"auto","created_at":"2026-05-05 10:00:39","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":102427,"visible":true,"origin":"","legend":"\u003cp\u003eDistribution of aneuploidy in 82 foetuses\u003c/p\u003e","description":"","filename":"drawingimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-5905206/v1/ad3f6242f2a8c0a14eebbad5.png"},{"id":108494734,"identity":"e163431c-af47-4bce-8988-a25f09e6797b","added_by":"auto","created_at":"2026-05-05 10:07:01","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":369082,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5905206/v1/7170913f-8e76-4268-9240-defbd62385f9.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Relationship between anti-Müllerian hormone concentration in the peripheral blood of women and aneuploid pregnancy","fulltext":[{"header":"Background","content":"\u003cp\u003eThe mechanisms that trigger chromosomal nondisjunction remain unclear, and effective preventive and control measures against aneuploid pregnancies are currently lacking. Many studies have demonstrated that women of advanced age are more prone to aneuploid pregnancies [1,2]. Investigations on the origin of an additional chromosome in the karyotype of children with trisomy 21 revealed that over 95% of the extra chromosomes originate from the mother [3,4]. Therefore, aneuploidy may be induced by the non-separation of chromosomes in oocytes during meiosis, which is the egg formation process. The ovaries exhibit alterations in the number of follicles and egg quality in women of advanced age.\u003c/p\u003e \u003cp\u003eBrook et al. [5] conducted animal experiments in 1984 to verify the association between a reduced follicle number and the occurrence of aneuploid pregnancies. They revealed that when one ovary was removed from the mice, the frequency of aneuploid offspring in ovariectomised mice was elevated compared with that in mice without ovariectomy. Based on this experiment, the occurrence of aneuploid pregnancies was hypothesised to be associated with follicular pool shrinkage. This hypothesis has been supported by some scholars from the following two perspectives. First, menopausal age and ovarian resection history in women with a history of aneuploid pregnancy were investigated, and the results indicated that their menopausal age was 1 year earlier than that of those with normal chromosomal pregnancies [6]. Additionally, the proportion of women with a history of ovarian surgery was substantially higher among women with aneuploid pregnancies than among those without [7]. Other studies have shown that the basal follicle-stimulating hormone (FSH) level (\u0026gt;\u0026thinsp;10 mIU/mL) increases in women with aneuploidy [8]. This evidence supports the relationship between aneuploid pregnancies and follicular pool shrinkage.\u003c/p\u003e \u003cp\u003eRecently, two studies have investigated the association between diminished ovarian reserve (DOR) and embryonic aneuploidy incidence. Jaswa et al. [9] documented a significant reduction in the number of diploid blastocysts among patients with DOR, even after controlling for age-related factors. Fouks et al. [10] found that the rate of aneuploid embryo formation in women with DOR or poor ovarian response was similar to that observed in the general population after controlling for other confounding factors.\u003c/p\u003e \u003cp\u003ePatients with polycystic ovary syndrome (PCOS) exhibit a higher number of follicles in their ovaries than do those with DOR. However, these follicles tend to be of inferior quality, leading to an increased incidence of chimeric aneuploid embryos in these patients [11,12]. Serum anti-M\u0026uuml;llerian hormone (AMH) concentrations are significantly higher in this patient cohort than in the general population [13]. In the case group of this study, 12 patients were diagnosed with PCOS before pregnancy, accounting for 14.63% of all cases, a rate significantly higher than that observed in the general population (5\u0026ndash;8%) [14,15]. Therefore, categorising this group distinctly is imperative. Currently, whether women with PCOS are more likely to have aneuploid foetuses has not been reported. Since only 12 patients with PCOS were included in this study and the sample size was insufficient for statistical analysis, the relationship between serum AMH concentration and aneuploidy in the PCOS group was not further investigated. Therefore, exploring the relationship between ovarian reserve and chromosome aneuploid pregnancies is essential for understanding the related factors leading to aneuploid pregnancies and preventing them.\u003c/p\u003e \u003cp\u003eCurrently, clinical approaches for evaluating ovarian reserve include detecting AMH, FSH, basal oestrogen, and statin B levels in the peripheral blood of women and measuring follicle counts in the central ovarian sinus via ultrasound. Among these strategies, detecting AMH levels in the peripheral blood of women is considered an ideal indicator of ovarian reserve [16,17,18]. AMH, a member of the transforming growth factor β superfamily, is a glycoprotein secreted by the granulosa cells of the preantral and antral follicles in the ovary. Serum AMH in females is closely linked to follicular development, with its secretion peaking during adolescence and reproductive age, followed by a gradual decline in its concentration with advancing age [19]. AMH is not influenced by the endocrine regulation of the hypothalamic\u0026ndash;pituitary\u0026ndash;gonadal axis, is minimally affected by the menstrual cycle, and can be measured at any time during the cycle [20]. Therefore, it is extensively used to assess ovarian reserve [21] and predict menopause time [22] and can serve as a marker of ovarian biological age [23].\u003c/p\u003e \u003cp\u003eRecently, researchers have investigated the association between serum AMH concentrations and embryonic aneuploidy. A retrospective study by Shim et al. [24] revealed that low AMH concentration in the peripheral blood of women could serve as a marker for predicting foetal aneuploidy. Jiang et al. [25] studied 394 patients with unexplained recurrent spontaneous abortion and revealed that low serum AMH concentrations are associated with an elevated risk of foetal aneuploidy only in women of advanced age (age\u0026thinsp;\u0026ge;\u0026thinsp;35 years). However, the proportion of women with aneuploid pregnancies who have DOR remains unknown. The extent of ovarian reserve declines may influence the likelihood of aneuploid pregnancies, raising the question of whether AMH can serve as a predictive marker for this risk. Studies on these issues are important for developing strategies to prevent aneuploidy.\u003c/p\u003e \u003cp\u003eVarious factors, including age, body mass index, and ethnicity, affect serum AMH concentration in women. No universally accepted cut-off value exists for assessing ovarian reserve based on AMH levels [26]. Therefore, this study aimed to evaluate the ovarian reserve of women with aneuploid pregnancy history using commonly accepted clinical criteria and changes in serum AMH concentrations observed in healthy women [27,28,29]. AMH concentrations of \u0026lt;\u0026thinsp;1.2, 1.2\u0026ndash;7, and \u0026gt;\u0026thinsp;7 ng/mL indicate DOR, good ovarian function, and PCOS tendency, respectively.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and participants\u003c/h2\u003e \u003cp\u003eThis retrospective case\u0026ndash;control study included 82 women with a history of aneuploid pregnancy undergoing genetic counselling and 35 with healthy pregnancies at the Obstetrics and Gynaecology Department of the Affiliated Hospital of Inner Mongolia Medical University, China, between January 2018 and November 2024. The Institutional Review Board of the Inner Mongolia Medical University, China, approved the study protocol (approval number: YKD2016108).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eInclusion and exclusion criteria\u003c/h3\u003e\n\u003cp\u003eThe age range for the case and control groups was 20\u0026ndash;45 years. Participants in the case group were categorised into case groups 1 (women without PCOS, n\u0026thinsp;=\u0026thinsp;70) and 2 (those with PCOS, n\u0026thinsp;=\u0026thinsp;12). The control group (n\u0026thinsp;=\u0026thinsp;35) consisted of women who concurrently underwent pre-pregnancy physical examinations; had given birth to healthy children; experienced regular menstrual cycles; and had no history of adverse fertility outcomes, endocrine disorders, or ovarian surgeries. The inclusion criterion for the case group was women with aneuploid pregnancy history but without chromosomal abnormalities in them or their partner, whereas the exclusion criteria were women with foetal chromosomes with chimeric trisomy, partial deletion or duplication, or chromosomal translocation or inversion. Clinical data, which include age, menstrual history, fertility history, medical history, embryo or foetal chromosome examination results, and AMH examination results (AMH test results detected within 1 year after the embryo is diagnosed as aneuploid), were systematically obtained from the hospital's case management system at the time of each patient visit.\u003c/p\u003e\n\u003ch3\u003eStatistical analyses\u003c/h3\u003e\n\u003cp\u003eAll statistical analyses were performed using SPSS Statistics for Windows, version 19.0 (SPSS Inc., Chicago, Ill, USA). Pearson chi-square test was used to compare the number of pregnancies and deliveries, as well as AMH concentration distribution, between the two groups. Age and AMH concentrations in the case and control groups were not normally distributed according to the Shapiro\u0026ndash;Wilk test; therefore, between-group differences were assessed using the Mann\u0026ndash;Whitney U test. Binary logistic regression analysis was conducted to evaluate whether serum AMH concentration in women was a significant risk factor for aneuploidy. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of serum AMH levels for aneuploidy in women. Statistical significance was set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e \u003cb\u003eComparative analysis of general information between the case and control groups and evaluation of ovarian reserve function in women with aneuploid pregnancy history\u003c/b\u003e \u003c/p\u003e \u003cp\u003eSignificant differences were observed in the number of pregnancies and births between the case (n\u0026thinsp;=\u0026thinsp;82) and control (n\u0026thinsp;=\u0026thinsp;35) groups but not in age and AMH concentrations (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The diagnostic criteria for ovarian reserve based on AMH concentrations were applied. Both groups were subdivided into three categories for comparative analysis, revealing significant differences among these subgroups. In the case group, 12 women had been diagnosed with PCOS before pregnancy. Three patients had undergone pelvic surgery: two for removal of endometriomas and one for salpingectomy. Additionally, three other patients had histories of endocrine disorders, including hypothyroidism, diabetes, and pituitary microadenoma. Seventeen women reported irregular menstrual cycles in the case group.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparative analysis of general information between the case and control groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eParticipants, n\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eχ\u003csup\u003e2\u003c/sup\u003e/z\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep\u003cem\u003e-\u003c/em\u003evalue\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e82\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge, median (range) (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e32.60 (26\u0026ndash;45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.97 (26\u0026ndash;40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-1.008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.314\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIrregular menstruation, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17 (20.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSerum AMH, mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD (ng/mL)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.47\u0026thinsp;\u0026plusmn;\u0026thinsp;3.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.22\u0026thinsp;\u0026plusmn;\u0026thinsp;1.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.616\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.538\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;1.2\u0026thinsp;ng/mL, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13 (15.85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (20.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIrregular menstruation, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 (23.08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;1.2, \u0026lt;\u0026thinsp;7.0\u0026thinsp;ng/mL, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e61 (74.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28 (80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIrregular menstruation, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7 (11.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;7.0\u0026thinsp;ng/mL, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8 (9.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIrregular menstruation, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7 (87.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of pregnancies\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.90 (1\u0026ndash;6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.34 (1\u0026ndash;3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e88.966\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of births\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.17 (0\u0026ndash;2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.03 (1\u0026ndash;2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePolycystic ovary syndrome\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12 (14.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHistory of ovarian surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 (3.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther endocrine history\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 (3.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eAMH, anti-M\u0026uuml;llerian hormone; SD, standard deviation\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eOvarian reserve assessment in 82 cases based on serum AMH concentrations is shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Specifically, 15.85% exhibited an AMH concentration of \u0026lt;\u0026thinsp;1.2 ng/mL and 9.76% demonstrated a concentration of \u0026gt;\u0026thinsp;7 ng/mL, indicative of DOR function and PCOS tendency, respectively. The remaining 74.39% had AMH levels within the normal range, reflecting normal ovarian reserve function.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e\n\u003ch3\u003eDistribution of chromosomal abnormalities in 82 foetuses in the case group\u003c/h3\u003e\n\u003cp\u003eThe results of chromosomal abnormalities in 82 foetuses are shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e., among which trisomy 21 accounted for 26.83%, followed by trisomy 16 at 14.63%.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eComparison of AMH concentrations between 70 women with aneuploidy history without PCOS and a control group and evaluation of AMH as a predictor of aneuploidy risk\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe patients were categorised into case groups 1 (without a history of PCOS) and 2 (with a history of PCOS). These groups were compared against the control group. No statistically significant difference was found in age across the three groups. However, significant differences were observed in AMH concentrations between both case groups and the control group (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of age and serum AMH levels between the two case groups and the control group\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase group 1 (n\u0026thinsp;=\u0026thinsp;70)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl group (n\u0026thinsp;=\u0026thinsp;35)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ez\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32.90\u0026thinsp;\u0026plusmn;\u0026thinsp;4.23\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.97\u0026thinsp;\u0026plusmn;\u0026thinsp;4.31\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-1.283\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.199\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAMH (ng/mL)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.58\u0026thinsp;\u0026plusmn;\u0026thinsp;1.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.22\u0026thinsp;\u0026plusmn;\u0026thinsp;1.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-2.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.045\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCase group 2 (n\u0026thinsp;=\u0026thinsp;12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl group (n\u0026thinsp;=\u0026thinsp;35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30.83\u0026thinsp;\u0026plusmn;\u0026thinsp;3.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.97\u0026thinsp;\u0026plusmn;\u0026thinsp;4.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-0.480\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.631\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAMH (ng/mL)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.66\u0026thinsp;\u0026plusmn;\u0026thinsp;4.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.22\u0026thinsp;\u0026plusmn;\u0026thinsp;1.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-4.660\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eAMH, anti-M\u0026uuml;llerian hormone\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eLogistic regression analysis revealed that a lower AMH concentration is a significant risk factor for aneuploidy. Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e presents the results of the ROC curve analysis. The AMH concentration demonstrated a predictive accuracy of 62% for aneuploidy risk, which is marginally superior to the predictive accuracy based on age alone.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eROC curves for women's age and serum AMH concentration in assessing aneuploidy risk\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAUC\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eS.T.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLower\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eUpper\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.577\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.062\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.201\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.455\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.699\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAMH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.057\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.045\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.509\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.731\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAMH, anti-M\u0026uuml;llerian hormone; CI, confidence interval; AUC, area under the predicted risk curve; ROC, receiver operating characteristic; S.T., Standard error\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eA lower serum AMH concentration in women with aneuploidy without a history of PCOS is a risk factor for aneuploidy. Based on ovarian reserve assessment using AMH, approximately 15% of women with aneuploid pregnancy history exhibited DOR. To further explore the ovarian reserve of women with aneuploid pregnancy history, 82 patients were categorised based on the AMH concentration in the peripheral blood into the DOR, good ovarian reserve, and PCOS tendency groups. Only 15.85% of women with aneuploid pregnancy history demonstrated DOR, whereas 9.76% showed a PCOS tendency. More than half the patients (74.39%) showed good ovarian reserve. The distribution of AMH concentrations between the case and control groups significantly differed. This result suggests that women with aneuploid pregnancy history exhibit differences in ovarian reserve compared to the control group, and such alterations in ovarian reserve may contribute to the occurrence of aneuploid pregnancies.\u003c/p\u003e \u003cp\u003eWarburton [30] examined the relationship between biological age and aneuploidy in women and demonstrated that smoking can result in a DOR; however, no evidence suggests that smoking increases the incidence of aneuploid pregnancies. Specifically, the study proposed that meiotic errors in oocytes may be linked to alterations in key proteins involved in meiotic regulation, cellular metabolic factors, and mitochondrial function. The abovementioned study results differ from those of previous reports, which considered DOR as the main risk factor for aneuploidy [31,32,33].\u003c/p\u003e \u003cp\u003eHowever, the results revealed that 74.39% of patients evaluated for ovarian reserve using AMH did not show DOR. The disparity between the current and previous results may be due to the following reasons. First, approximately 1\u0026ndash;5% of all aneuploidies are caused by chromosomal abnormalities in sperm [34,35]. In this study, the source of chromosomal additions or deletions in the foetus or foetal aneuploidy was not examined. The ovarian function in women may be normal if aneuploidy is caused by male factors. Second, chromosomal abnormalities in aborted embryos were mainly determined by copy number variation sequencing or chromosomal microarray analysis and karyotype analysis was not reported in this study. Therefore, these aneuploid cases cannot be distinguished from translocation or standard trisomy. An embryo is not associated with DOR if it undergoes translocation trisomy. Third, serum AMH concentration mainly reflects the follicle count and the quality of follicles has not been evaluated [36].\u003c/p\u003e \u003cp\u003eBinary logistic and ROC curve analyses were conducted in the cohort without PCOS and showed that a decline in serum AMH concentrations was a risk factor for aneuploid pregnancy. The ROC curve analysis revealed that the serum AMH concentration of women, when used as an indicator to predict the risk of aneuploidy, did not show significant eugenics. However, relevant data could not be obtained on factors that could influence AMH concentrations in women's blood, such as ethnicity and body mass index. Therefore, the generalisability of these findings is limited.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study indicates that low AMH concentration may be a high-risk factor for aneuploidy. However, most women with a history of aneuploid pregnancy may exhibit ovarian reserve within the normal range. Collectively, the findings of this study provide a new perspective for the understanding of aneuploidy in women.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAnti-M\u0026uuml;llerian hormone\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAMH\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDiminished ovarian reserve\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDOR\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePolycystic ovary syndrome\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePCOS\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eFollicle-stimulating hormone\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eFSH\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eReceiver operating characteristic\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eROC\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eConfidence interval\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCI\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eEthics approval and consent to participate\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in accordance with the Declaration of Helsinki (2000) of the World Medical Association. The Ethics Committee of Inner Mongolia Medical University, China, approved the study protocol (approval number: YKD2016108). Informed consent was not necessary because the data were deidentified.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e \u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eConsent for publication\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAvailability of data and materials\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analysed during the current study are not publicly available due to information privacy but are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e \u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCompeting interests\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe author declares no competing interests.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eFunding\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by grants from the Natural Science Foundation of China (81660542) and the Inner Mongolia Natural Science Fund (2018MS08091).\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAuthors\u0026apos; contributions\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eXiao Xi Zhao conceived and designed the study, wrote the manuscript, and acquired funding.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAcknowledgments\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eI thank Dr Barbara Burmen for critically reading the manuscript and providing editorial help and suggestions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cbr clear=\"all\"\u003e \u003c/strong\u003e\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eElmerdahl Frederiksen L, \u0026Oslash;lgaard SM, Roos L, Petersen OB, Rode L, Hartwig T, et al. Maternal age and the risk of fetal aneuploidy: a nationwide cohort study of more than 500\u0026thinsp;000 singleton pregnancies in Denmark from 2008 to 2017. Acta Obstet Gynecol Scand. 2024;103:351-9.\u003c/li\u003e\n\u003cli\u003eWasielak-Politowska M, Kordowitzki P. Chromosome segregation in the oocyte: what goes wrong during aging. Int J Mol Sci. 2022;23:2880.\u003c/li\u003e\n\u003cli\u003eS\u0026aacute;nchez-Pav\u0026oacute;n E, Mendoza H, Garc\u0026iacute;a-Ferreyra J. Trisomy 21 and assisted reproductive technologies: a review. JBRA Assist Reprod. 2022;26:129-41. \u003c/li\u003e\n\u003cli\u003eSperling K, Scherb H, Neitzel H. Population monitoring of trisomy 21: problems and approaches. Mol Cytogenet. 2023,16:6. \u003c/li\u003e\n\u003cli\u003eBrook JD, Gosden RG, Chandley AC. Maternal ageing and aneuploid embryos--evidence from the mouse that biological and not chronological age is the important influence. Hum Genet. 1984;66:41-5. \u003c/li\u003e\n\u003cli\u003eKline J, Kinney A, Levin B, Warburton D. Trisomic pregnancy and earlier age at menopause. Am J Hum Genet. 2000;67:395-404.\u003c/li\u003e\n\u003cli\u003eHaadsma ML, Mooij TM, Groen H, Burger CW, Lambalk CB, Broekmans FJ, et al. A reduced size of the ovarian follicle pool is associated with an increased risk of a trisomic pregnancy in IVF-treated women. Hum Reprod. 2010;25:552-8. \u003c/li\u003e\n\u003cli\u003eKline JK, Kinney AM, Levin B, Kelly AC, Ferin M, Warburton D. Trisomic pregnancy and elevated FSH: implications for the oocyte pool hypothesis. Hum Reprod. 2011;26:1537-50. \u003c/li\u003e\n\u003cli\u003eJaswa EG, McCulloch CE, Simbulan R, Cedars MI, Rosen MP. Diminished ovarian reserve is associated with reduced euploid rates via preimplantation genetic testing for aneuploidy independently from age: evidence for concomitant reduction in oocyte quality with quantity. Fertil Steril. 2021;115:966-73. \u003c/li\u003e\n\u003cli\u003eFouks Y, Penzias A, Neuhausser W, Vaughan D, Sakkas D. A diagnosis of diminished ovarian reserve does not impact embryo aneuploidy or live birth rates compared to patients with normal ovarian reserve. Fertil Steril. 2022;118:504-12. \u003c/li\u003e\n\u003cli\u003eLuo L, Wang W, Xu Y, Yang Y, Zhang L, Gao J, et al. Differences in preimplantation blastocyst chromosomal aberrations between polycystic ovary syndrome women and controls: a multi-center retrospective cohort study. J Assist Reprod Genet. 2024;41:3051-9.\u003c/li\u003e\n\u003cli\u003eMoreira T, Leal C, Barreiro M, Tom\u0026eacute; A, Vale-Fernandes E. Predictors of Pregnancy after Artificial Insemination in Women with Polycystic Ovary Syndrome. JBRA Assist Reprod. 2025;29(2):201-210.\u003c/li\u003e\n\u003cli\u003eMiyake N, Osuka S, Ohsawa I, Tonoike T, Uno T, Tsuzuki K, et al. Association between anti-M\u0026uuml;llerian hormone levels and polycystic ovary syndrome in a general cohort of young women in Japan. Reprod Med Biol. 2024;23:e12615.\u003c/li\u003e\n\u003cli\u003eBozdag G, Mumusoglu S, Zengin D, Karabulut E, Yildiz BO. The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod. 2016;31:2841-55.\u003c/li\u003e\n\u003cli\u003eLauritsen MP, Bentzen JG, Pinborg A, Loft A, Forman JL, Thuesen LL, et al. The prevalence of polycystic ovary syndrome in a normal population according to the Rotterdam criteria versus revised criteria including anti-Mullerian hormone. Hum Reprod. 2014;29:791-801.\u003c/li\u003e\n\u003cli\u003eCedars MI. Evaluation of female fertility-AMH and ovarian reserve testing. J Clin Endocrinol Metab. 2022;107:1510-9. \u003c/li\u003e\n\u003cli\u003edi Clemente N, Racine C, Pierre A, Taieb J. Anti-M\u0026uuml;llerian hormone in female reproduction. Endocr Rev. 2021;42:753-82.\u003c/li\u003e\n\u003cli\u003eReis AB, Leal C, Barreiro M, Tom\u0026eacute; A, Vale-Fernandes E. Anti-M\u0026uuml;llerian hormone as a predictor of the number of oocytes obtained during in vitro fertilization treatments. JBRA Assist Reprod. 2024;28(4):597-603.\u003c/li\u003e\n\u003cli\u003eMoolhuijsen LME, Visser JA. Anti-M\u0026uuml;llerian hormone and ovarian reserve: update on assessing ovarian function. J Clin Endocrinol Metab. 2020;105:3361-73.\u003c/li\u003e\n\u003cli\u003eRussell N, Gilmore A, Roudebush WE. Clinical utilities of anti-M\u0026uuml;llerian hormone. J Clin Med. 2022;11:7209.\u003c/li\u003e\n\u003cli\u003eHarris BS, Steiner AZ, Jukic AM. Ovarian reserve biomarkers and menstrual cycle length in a prospective cohort study. J Clin Endocrinol Metab. 2021;106:e3748-59. \u003c/li\u003e\n\u003cli\u003ede Kat AC, Broekmans FJM, Lambalk CB. Role of AMH in prediction of menopause. Front Endocrinol (Lausanne). 2021;12:733731.\u003c/li\u003e\n\u003cli\u003eDewailly D, Laven J. AMH as the primary marker for fertility. Eur J Endocrinol. 2019;181:D45-51. \u003c/li\u003e\n\u003cli\u003eShim SH, Ha HI, Jung YW, Shim SS, Cho YK, Kim JY, et al. Maternal antimullerian hormone as a predictor of fetal aneuploidy occurring in an early pregnancy loss. Obstet Gynecol Sci. 2015;58:494-500.\u003c/li\u003e\n\u003cli\u003eJiang X, Yan J, Sheng Y, Sun M, Cui L, Chen ZJ. Low anti-M\u0026uuml;llerian hormone concentration is associated with increased risk of embryonic aneuploidy in women of advanced age. Reprod Biomed Online. 2018;37:178-83.\u003c/li\u003e\n\u003cli\u003ePiltonen TT, Viita-Aho J, Saarela U, Melin J, Forslund M. Utility of serum anti-M\u0026uuml;llerian hormone measurement as part of polycystic ovary syndrome diagnosis. Semin Reprod Med. 2024;42:49-59.\u003c/li\u003e\n\u003cli\u003eCohen J, Chabbert-Buffet N, Darai E. Diminished ovarian reserve, premature ovarian failure, poor ovarian responder--a plea for universal definitions. J Assist Reprod Genet. 2015;32(12):1709-1712.\u003c/li\u003e\n\u003cli\u003eVale-Fernandes E, Barreiro M, Monteiro MP. Candidates selection for oocyte donation in a public gamete bank-Predictive value of the anti-M\u0026uuml;llerian hormone. Porto Biomed J. 2023;8(1):e199. \u003c/li\u003e\n\u003cli\u003eOliveira TFS, Barreiro M, Tom\u0026eacute; A, Vale-Fernandes E. Female Reproductive Health - study of an egg donor population. JBRA Assist Reprod. 2023 ;27(4):638-643.\u003c/li\u003e\n\u003cli\u003eWarburton D. Biological aging and the etiology of aneuploidy. Cytogenet Genome Res. 2005;111:266-72. \u003c/li\u003e\n\u003cli\u003eKline J, Kinney A, Reuss ML, Kelly A, Levin B, Ferin M, et al. Trisomic pregnancy and the oocyte pool. Hum Reprod. 2004;19:1633-43. \u003c/li\u003e\n\u003cli\u003eJacobs CK, Nicolielo M, Alegretti JR, Canto MD, Renzini MM, De Ponti E, et al. Basal FSH values are positively associated with aneuploidy incidence in pre-advanced maternal age (AMA) but not in AMA patients. J Assist Reprod Genet. 2024;41:2397-404.\u003c/li\u003e\n\u003cli\u003eKatz-Jaffe MG, Surrey ES, Minjarez DA, Gustofson RL, Stevens JM, Schoolcraft WB. Association of abnormal ovarian reserve parameters with a higher incidence of aneuploidy blastocysts. Obstet Gynecol. 2013;121:71-7.\u003c/li\u003e\n\u003cli\u003eRodrigo L, Meseguer M, Mateu E, Mercader A, Peinado V, Bori L, et al. Sperm chromosomal abnormalities and their contribution to human embryo aneuploidy. Biol Reprod. 2019;101:1091-101.\u003c/li\u003e\n\u003cli\u003eLuongo FP, Annunzi E, Girolamo F, Belmonte G, Ponchia R, Piomboni P, et al. Assessment of sperm chromosomal abnormalities using fluorescence in situ hybridisation (FISH): implications for reproductive potential. J Assist Reprod Genet. 2024;41:2787-93. \u003c/li\u003e\n\u003cli\u003eBorges E, Braga DPAF, Setti A, Figueira RC, Iaconelli A Jr. The predictive value of serum concentrations of anti-M\u0026uuml;llerian hormone for oocyte quality, fertilization, and implantation. JBRA Assist Reprod. 2017;21:176-82. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"anti-Müllerian hormone, aneuploidy, diminished ovarian reserve, polycystic ovary syndrome","lastPublishedDoi":"10.21203/rs.3.rs-5905206/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5905206/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eWhile diminished ovarian reserve (DOR) is a risk factor for aneuploid pregnancies, its role in women with a history of aneuploid pregnancy remains poorly understood. Anti-M\u0026uuml;llerian hormone (AMH) is an effective biomarker for assessing ovarian reserve. This study evaluated ovarian reserve in women with aneuploid pregnancy history and whether serum AMH concentration is a predictive indicator of aneuploidy risk.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA case\u0026ndash;control study was conducted among 82 women with aneuploid pregnancy history and 35 with healthy pregnancies at the Affiliated Hospital of Inner Mongolia Medical University between January 2018 and November 2024. Based on the history of polycystic ovary syndrome (PCOS) before pregnancy, the participants were categorised into case groups 1 (without PCOS, n\u0026thinsp;=\u0026thinsp;70) and 2 (with PCOS, n\u0026thinsp;=\u0026thinsp;12). Mann\u0026ndash;Whitney U test was used to compare age and AMH levels between the case and control groups. A logistic regression model was employed to analyse the relationship between serum AMH concentration and the occurrence of aneuploidy, whereas receiver operating characteristic curve analysis was used to evaluate the predictive value of serum AMH level for aneuploidy in women. Ovarian reserve in these cases was categorised as DOR (AMH level\u0026thinsp;\u0026lt;\u0026thinsp;1.2 ng/mL), good ovarian reserve (AMH level 1.2\u0026ndash;7 ng/mL), and PCOS tendency (AMH level\u0026thinsp;\u0026gt;\u0026thinsp;7 ng/mL).\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eNo significant differences in age and serum AMH concentration were found between the case and control groups (mean age, 32.60 and 31.97 years; mean AMH, 3.47 ng/mL and 3.22 ng/mL, respectively). Women in case group 2 (n\u0026thinsp;=\u0026thinsp;12) exhibited significantly higher serum AMH concentration (mean AMH, 8.66\u0026thinsp;\u0026plusmn;\u0026thinsp;3.09 ng/mL vs 3.22\u0026thinsp;\u0026plusmn;\u0026thinsp;1.46 ng/mL, p\u0026thinsp;=\u0026thinsp;0.001), whereas those in case group 1 demonstrated significantly lower levels than the controls (2.58\u0026thinsp;\u0026plusmn;\u0026thinsp;1.49 ng/mL vs 3.22\u0026thinsp;\u0026plusmn;\u0026thinsp;1.47 ng/mL, p\u0026thinsp;=\u0026thinsp;0.045). Low serum AMH concentrations predicted aneuploid pregnancy (odds ratio: 0.752, 95% confidence interval: 0.570\u0026ndash;0.991, p\u0026thinsp;=\u0026thinsp;0.043), and the area under the predicted risk curve was 0.62. Among the cases, 15.85% presented with DOR.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThis study indicates that low AMH concentration may be a high-risk factor for aneuploidy. However, ovarian reserve appears to remain within the normal range in most women with a history of aneuploid pregnancy. These findings provide a new perspective for understanding the occurrence of aneuploidy.\u003c/p\u003e","manuscriptTitle":"Relationship between anti-Müllerian hormone concentration in the peripheral blood of women and aneuploid pregnancy","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-04 10:20:00","doi":"10.21203/rs.3.rs-5905206/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-05-10T09:35:01+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"27015172218111845558545883972048093757","date":"2026-05-10T09:32:51+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-05-08T19:51:17+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-06T00:30:43+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pregnancy and Childbirth","date":"2026-03-18T13:11:57+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f0f995f0-a212-4fdf-979e-138826848de3","owner":[],"postedDate":"May 4th, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Accepted","date":"2026-05-12T19:47:55+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-10T09:35:01+00:00","index":73,"fulltext":""},{"type":"reviewerAgreed","content":"27015172218111845558545883972048093757","date":"2026-05-10T09:32:51+00:00","index":72,"fulltext":""},{"type":"reviewersInvited","content":"2","date":"2026-05-08T19:51:17+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-12T19:55:03+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-04 10:20:00","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5905206","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5905206","identity":"rs-5905206","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}