Anti-Mullerian hormone and associated pregnancy outcomes in females with polycystic ovary syndrome undergoing In vitro fertilization-embryo transfer

Abstract

<p><strong>Background and Objective</strong><strong>: </strong>Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among reproductive-aged women worldwide. Pregnancy in these women is highly affected by serum levels of Anti-Mullerian hormone (AMH). This study aimed to determine the association of serum AMH levels with pregnancy outcomes in females with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization-embryo transfer (IVF-ET)</p>
 <p><strong>Methods: </strong>A total of 200 PCOS patients<strong> </strong>undergoing IVF-ET in the Reproductive Medicine Center, Second People's Hospital of Jingmen, China were included. The patients were divided into two groups, A and B, based on their AMH levels. Serum sex hormones levels and pregnancy outcomes in terms of fertilization, cleavage, implantation, high quality embryo and biochemical  and clinical pregnancy rates were compared.</p>
 <p><strong>Results: </strong>Mean age of the patients was<strong> </strong>28.74±2.07 years in group A and 29.74±2.23<sup> </sup>years in group B. Participants in group A had lower serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), and testosterone (T) compared to group B. Also, better pregnancy outcomes and lower frequency of pregnancy complications were seen in the participants of group A (P<0.05). AMH serum levels showed high specificity and sensitivity in predicting IVF-ET clinical pregnancy in PCOS patients.</p>
 <p><strong>Conclusion: </strong>Serum AMH levels in females with PCOS  predict  improved sex hormone profile and clinical pregnancy outcomes after IVF-ET</p>

Association between serum AMH levels and IVF/ICSI outcomes in patients with polycystic ovary syndrome: a systematic review and meta-analysis

“…Although there were more high-quality embryos transferred in the average-AMH group than in the low-AMH group, the difference in miscarriage rate was not significant among these three groups, indicating that AMH was not associated with miscarriage rate among PCOS patients. Du et al [ 25 ] also reported the early miscarriage rate in their two subgroups. The findings suggested that the rate of early miscarriage was significantly lower among the participants in the low-AMH group, with an incidence of early miscarriage of 6.67% (6/90) in the low-AMH group and 19.09% (21/110) in the high-AMH group ( p < 0.001).…”

“…Seven studies classified participants into the low-AMH group (the 0-25 th percentile), average-AMH group (the 25-75 th percentile), and high-AMH group (the 75-100 th percentile) [ 13 , 15 , 16 , 19 – 22 ]; three studies classified participants into the 75–90 th percentile group and 90-100 th percentile group [ 14 , 23 , 24 ]. The remaining studies did not classify participants into different groups based on AMH levels but analyzed AMH levels as a continuous variable [ 22 , 25 – 33 ] and thus were not included in the quantitative analysis (meta-analysis). All 19 studies used the Rotterdam criteria for the diagnosis of PCOS.…”

“…There was a moderate degree of heterogeneity ( I 2 = 46%). In addition, Du et al [ 25 ] examined clinical pregnancy rate in a cohort of 200 PCOS patients aged 25 to 36 years undergoing IVF-ET. Patients were divided into two different groups based on a cutoff AMH level of 6.99 ng/L.…”

“…There was a moderate degree of heterogeneity ( I 2 = 36.1%). In addition, Du et al [ 25 ] and Arabzadeh et al [ 31 ] reported a null association between AMH and the fertilization rate ( p > 0.05). The result of the dose–response meta-analysis is shown in Fig.…”

“…There was a high degree of heterogeneity ( I 2 = 79%). Du et al [ 25 ] reported that the incidence of implantation was 41.1% (37/90) in the low-AMH group (< 6.99 ng/L) and 20.91% (23/110) in the high-AMH group (> 6.99 ng/L). Additionally, Arabzadeh et al [ 31 ] reported that AMH was not associated with implantation rate in women with PCOS (r = -0.299, p = 0.138) but was positively associated with implantation rate in the non-PCOS control group (r = 0.305, p = 0.05).…”