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Association between High AMH Levels in PCOS Patients and IVF/ICSI Outcomes: a systematic review and meta-analysis
Angélica Martins1, Renato Ferreira-da-Silva1,2,3, Ana Margarida Póvoa1,4,5
1University of Porto Faculty of Medicine Porto Portugal Faculty of Medicine of the University of Porto, Porto, Portugal.
Summary
High Anti-Müllerian Hormone (AMH) levels in women with Polycystic Ovary Syndrome (PCOS) are linked to fewer live births and more retrieved oocytes during In Vitro Fertilization (IVF)/Intracytoplasmic Sperm Injection (ICSI). Further research is needed to understand these outcomes.
Area of Science:
- Reproductive Endocrinology
- Infertility Research
- Gynecology
Background:
- Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting reproductive-aged women.
- Anti-Müllerian Hormone (AMH) is a marker of ovarian reserve, often elevated in women with PCOS.
- In Vitro Fertilization (IVF)/Intracytoplasmic Sperm Injection (ICSI) is a common treatment for infertility in PCOS patients.
Purpose of the Study:
- To evaluate the association between high Anti-Müllerian Hormone (AMH) levels and key outcomes of In Vitro Fertilization (IVF)/Intracytoplasmic Sperm Injection (ICSI) in women with Polycystic Ovary Syndrome (PCOS).
Main Methods:
- A systematic search of MEDLINE, Web of Science, and Scopus was conducted.
- Observational studies in PCOS patients stratified by AMH levels were included.
- Data were extracted and risk of bias was assessed; meta-analysis was performed where appropriate.
Main Results:
- High AMH levels were associated with a lower live birth rate (OR: 0.80; 95%CI: 0.64-0.99) after sensitivity analysis.
- More oocytes were retrieved in women with high AMH levels (MD: 3.52; 95%CI: 1.70-5.33).
- No significant differences were found in clinical pregnancy or fertilization rates; miscarriage rates showed a non-significant increase.
Conclusions:
- Elevated AMH levels in PCOS patients, while indicating greater ovarian reserve, negatively influence IVF/ICSI outcomes.
- Individualized assisted reproductive technology (ART) strategies are suggested for PCOS patients with high AMH.
- Further research is needed to elucidate the mechanisms underlying these associations.
