Association between High AMH Levels in PCOS Patients and IVF/ICSI Outcomes: a systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational studies
PubMed 42500182 · doi:10.61622/rbgo/2026rbgo25
What was done
A systematic review and meta-analysis searched MEDLINE, Web of Science, and Scopus through September 17, 2024. The authors included observational studies of PCOS patients stratified by Anti-Müllerian Hormone (AMH) levels reporting IVF/ICSI outcomes (live birth rate, clinical pregnancy rate, miscarriage rate, oocytes retrieved, MII oocytes, and fertilization rate). Risk of bias was evaluated using the NHLBI Study Quality Assessment Tool, and sensitivity analyses were performed using a leave-one-out approach.
What was found
Across 13 included studies (10 low risk of bias, 2 unclear, 1 high risk): - Live birth rate was lower in women with high AMH levels (OR: 0.85; 95% CI: 0.71–1.02), which reached statistical significance in a leave-one-out sensitivity analysis (OR: 0.80; 95% CI: 0.64–0.99). - Oocytes retrieved were higher in the high AMH group (mean difference: 3.52; 95% CI: 1.70–5.33). - Clinical pregnancy rate showed no significant difference (OR: 0.98; 95% CI: 0.82–1.17). - Miscarriage rate showed a non-significant elevation (OR: 1.25; 95% CI: 0.88–1.76). - Fertilization rate showed no significant difference.
Why it matters
Although higher AMH indicates greater ovarian reserve and yields more retrieved oocytes, elevated AMH in PCOS patients may paradoxically compromise live birth success during IVF/ICSI.
Limits
The synthesis is restricted to observational studies subject to potential residual confounding. The abstract does not report the total participant count or the threshold values used to define high AMH across included studies. Differences in clinical protocols (stimulation type, fresh vs. frozen embryo transfer) across included studies were not described in the abstract.
Cited by
- supports Women with PCOS typically exhibit a high ovarian reserve (follicle count) but have reduced oocyte quality.
- context PCOS and endometriosis diminish both ovarian egg count and egg quality.