Objective: To study the association between antimüllerian hormone (AMH) and antral follicle count (AFC) with embryo euploidy rates in patients undergoing in vitro fertilization (IVF) with preimplantation genetic testing for aneuploidy (PGT-A), independent of maternal age and other confounding factors.

Design: Retrospective cohort study.

Subjects: A total of 11,473 women who underwent 13,451 IVF cycles with PGT-A between October 2016 and August 2024 across a large national network of infertility clinics in the United States.

Exposure: Values of AMH and AFC recorded within 6 months of oocyte retrieval. Both AMH and AFC were categorized on the basis of Bologna criteria for diminished ovarian reserve: AMH <1.1, 1.1-4.0, and >4.0 ng/mL; AFC <7, 7-16, and >16.

Main outcome measures: Adjusted relative risk (RR) of embryo euploidy on the basis of AMH and AFC levels, with secondary outcomes including live birth, clinical pregnancy, and implantation rates.

Results: Euploidy rates were comparable across AMH categories (56.9%, 54.0%, and 55.8% for AMH <1.1, 1.1-4.0, and >4.0 ng/mL, respectively) and AFC categories (56.3%, 54.8%, and 54.9% for AFC <7, 7-16, and >16, respectively). After adjustment, euploidy was modestly higher in the lowest AMH category (RR: 1.08; 95% confidence interval [CI]: 1.05, 1.11) but similar in the highest AMH category (RR: 1.00; 95% CI: 0.98, 1.02). Euploidy rates were comparable among AFC <7 and 7-16 (RR: 1.00; 95% CI: 0.98, 1.03) but slightly lower in AFC >16 (RR: 0.96; 95% CI: 0.95, 0.98). Both AMH and AFC levels were not significantly associated with live birth, clinical pregnancy, or implantation rates.

Conclusion: Contrary to recent studies, lower AMH and AFC levels were not associated with a clinically significant decrease in embryo euploidy or live birth outcomes. These findings suggest that although AMH and AFC are useful for assessing ovarian reserve, they may have limited value in predicting embryo euploidy when considered independently of other factors, such as maternal age.