| Table 1. Summary of the studies included. | |||||
| Study | Study type | Objective | Population | Number of individuals | Main results |
|---|---|---|---|---|---|
| Fallat et al., 1997 | To determine Mullerian inhibiting substance (MIS) levels in follicular fluid (FF) and sera of IVF patients. | Infertile patients undergoing IVF treatment with tubal factor (20), PCOS (17) and endometriosis (29) | 66 | Levels of AMH in FF and sera of PCOS patients were significantly higher than those in the other patients. Also, the percentage of immature oocytes retrieved in PCOS were significant higher and the fertilization rates were significantly lower than in the other groups. | |
| Desforges-Bullet et al., 2010 | Prospective | To confirm the increased levels of AMH in preovulatory follicles from PCOS patients and to study the role of other hormones involved in folliculogenesis in this increased secretion. | 22 PCOS patients and 20 controls undergoing IVF treatment. | 42 | AMH levels were significantly increased and FSH levels significantly decreased in FF from PCOS patients. Mean androstenedione, hCG, E2 and progesterone did not differ. |
| Mashiach et al., 2010 | Prospective | To test whether the FF concentration of AMH is associated with oocyte maturation, fertilization rate, and embryonic development in patients with PCOS undergoing IVF. | 11 PCOS patients and 12 controls. | 23 | Mean FF AMH level was smaller in PCOS patients compared with controls. In PCOS patients the mean AMH level of good quality embryos was smaller than that of poor quality embryos. No significant correlation was observed between FF AMH levels and oocyte maturation, fertilization, or cleavage rate. |
| Pabuccu et al., 2009 | Prospective | To investigate the relationship of serum and follicular-fluid AMH concentrations on the day of oocyte retrieval and reproductive outcome in PCOS patients undergoing assisted reproduction. | Infertile PCOS patients | 80 | Clinical pregnancy rates, embryo implantation rates and fertilization rates were markedly different among the low, moderate and high follicular-fluid AMH groups but not among the different serum AMH concentration groups. |
| Arabzadeh et al., 2010 | Prospective | To compare the relationship between serum or intrafollicular AMH levels and IVF outcomes in women with and without PCOS. | 26 women with PCOS and 42 normo-ovulatory controls | 68 | Median serum basal AMH and FF AMH levels were significantly higher in the PCOS group as compared to controls. In both groups, serum basal AMH levels showed a positive correlation with number of oocytes retrieved. In the control group, there was a positive relationship between serum basal AMH levels and percentage of matured oocytes and implantation rate. |
| Kaya et al., 2010 | Prospective clinical trial | To determine the possible relationship between serum AMH concentrations on day 3 and controlled ovarian stimulation and reproductive outcomes in women with PCOS. | Patients with PCOS and infertility | 60 | The CPR, IR and FR increased progressively with the increase in day-3 AMH serum concentrations. |
| Xi et al., 2012 | Prospective cohort | To investigate if day 3 serum AMH concentrations day 3 could predict controlled ovarian stimulation and reproductive outcomes in women with PCOS. |
PCOS patients undergoing their first IVF cycle | 164 | E2 levels on trigger day and oocytes retrieved significantly increased with increasing AMH levels. Implantation rate and clinical pregnancy rate were lower in the higher AMH group. FR and number of good quality embryos were comparable between groups. |
| Yilmaz et al., 2012 | Prospective sequential cross sectional study | To investigate the follicular fluid concentrations of AMH and its effect on assisted reproductive technology outcome in non-obese, non-hyperandrogenomic PCOS patients | Primary infertile patients with PCOS (16), male factor (19) and unexplained infertility (19) | 54 | FF AMH levels were higher in patients with PCOS but did not reach statistical significance. FF AMH was positively correlated with oocyte, 2PN and embryo number. FF AMH levels weren’t different between the groups who were pregnant or not. |
| Tal et al., 2014 | Retrospective cohort study | Characterize a population of women with elevated AMH (>5ng/mL). | Women with serum AMH > 5ng/mL | 134 | Greater than 97% of women with ultrahigh AMH (>10 ng/mL) had PCOS and also greater prevalence of PCOM and oligomenorrhea. Serum AMH correlated positively with LH, total testosterone, DHEAS and showed strong predictive ability for the presence of amenorrhea. Women with AMH >10 ng/mL showed higher rates of ovarian hyperstimulation syndrome and clinical pregnancy rates compared with women with AMH 5-10 ng/mL. |
| Chen et al., 2017 | Prospective study | Evaluate associations between basal serum and FF AMH levels and IVF outcomes in PCOS patients. | Infertile patients with PCOS (59), tubal and male factor (120) | 179 | Median serum and FF AMH level was higher in PCOS patients than in controls. Oocyte maturation and high-quality embryo rates were lower in PCOS patients than in controls, but both groups had similar fertilization, implantation, clinical pregnancy, and newborn rates. Peak E2 and FF AMH levels were independent predictors of oocyte number. |
| Melado Vidales et al., 2017b | Prospective observational cohort study | To assess the correlation between COH outcome parameters and AMH serum levels during IVF treatment in women with varying ovarian reserve levels. | Infertile patients undergoing IVF with low (11)/normal (16) ovarian reserve and PCOS (19). | 46 | AMH was significant correlated with AFC, number of follicles >11mm on hCG trigger day, number of oocytes retrieved and MII oocytes. AMH on hCG trigger day was correlated with top quality embryos. |