The First Clinical College of Chongqing Medical University, Chongqing, 401331, China.
Center for Reproductive Medicine, Shandong University, Jinan, 250012, Shandong Province, China.
Reprod Biol Endocrinol. 2023 Oct 23;21(1):95. doi: 10.1186/s12958-023-01153-y.
Anti-Müllerian hormone (AMH) levels are increased in polycystic ovary syndrome (PCOS) patients and are associated with PCOS severity.
To evaluate the associations between serum AMH levels and in vitro fertilization (IVF)/ intracytoplasmic sperm injection (ICSI) outcomes in patients with PCOS.
PubMed, Embase, and the Cochrane Library were searched on 11 July 2022.
Studies reporting the association between serum AMH levels and IVF/ICSI outcomes in PCOS patients were considered for inclusion. The primary outcomes were clinical pregnancy, live birth, and ovarian hyperstimulation syndrome.
Data were extracted using a standardized data extraction form. Study quality was assessed independently by two groups of researchers.
Nineteen studies were included in this review. Meta-analyses demonstrated that PCOS patients with a serum AMH level within the 75-100 percentile had a decreased odds of clinical pregnancy (OR: 0.77, 95% CI: 0.63-0.93) and livebirth (OR: 0.71; 95% CI: 0.58-0.87) compared to those within the 0-25 percentile. An increased AMH level was also correlated with an increased number of oocytes retrieved (SMD: 0.90, 95% CI: 0.30-1.51) and a lower odds of fertilization (OR: 0.92, 95% CI: 0.87-0.98). There was no significant difference in the number of MII oocytes (SMD: 1.85, 95% CI: -1.07-4.78), E on the day of hCG (SMD: 0.12; 95% CI: -0.98-1.23), or implantation (OR: 0.82, 95% CI: 0.28-2.39) between the two groups. In addition, we found significant dose-response associations between serum AMH level and clinical pregnancy, live birth, number of oocytes retrieved, and fertilization in PCOS patients.
AMH may have clinical utility in counseling regarding IVF/ICSI outcomes among women with PCOS who wish to undergo fertility treatment. More large-scale, high-quality cohort studies are needed to confirm these findings.
抗苗勒氏管激素（AMH）水平在多囊卵巢综合征（PCOS）患者中升高，并与 PCOS 的严重程度相关。
评估多囊卵巢综合征患者血清 AMH 水平与体外受精（IVF）/卵胞浆内单精子注射（ICSI）结局之间的相关性。
于 2022 年 7 月 11 日检索了 PubMed、Embase 和 Cochrane 图书馆。
纳入了报告多囊卵巢综合征患者血清 AMH 水平与 IVF/ICSI 结局之间相关性的研究。主要结局是临床妊娠、活产和卵巢过度刺激综合征。
使用标准化数据提取表提取数据。两组研究人员独立评估研究质量。
本综述纳入了 19 项研究。荟萃分析表明，血清 AMH 水平在 75-100 百分位的多囊卵巢综合征患者，与血清 AMH 水平在 0-25 百分位的患者相比，临床妊娠（OR：0.77，95%CI：0.63-0.93）和活产（OR：0.71，95%CI：0.58-0.87）的几率降低。较高的 AMH 水平还与获得的卵母细胞数量增加（SMD：0.90，95%CI：0.30-1.51）和受精几率降低相关（OR：0.92，95%CI：0.87-0.98）。两组之间，MII 卵母细胞数量（SMD：1.85，95%CI：-1.07-4.78）、HCG 日的 E（SMD：0.12，95%CI：-0.98-1.23）或着床（OR：0.82，95%CI：0.28-2.39）无显著差异。此外，我们发现多囊卵巢综合征患者血清 AMH 水平与临床妊娠、活产、获卵数和受精之间存在显著的剂量反应关系。
在希望接受生育治疗的多囊卵巢综合征女性中，AMH 可能在 IVF/ICSI 结局咨询方面具有临床应用价值。需要更多的大规模、高质量队列研究来证实这些发现。
