Elevated Anti-M\xfcllerian Hormone Levels in Newborns of Women with Polycystic Ovary Syndrome: a Systematic Review and Meta-analysis Based on Observational Studies

Siyu Zhou,Yongcheng Sheng,Shu Wen,Liangzhi Xu,Deying Kang,Danhua Lu

doi:10.1007/s43032-021-00652-w

Abstract

We performed this updated systematic review and meta-analysis to evaluate anti-Müllerian hormone levels (AMH) in newborns of mothers with polycystic ovary syndrome (PCOS) compared with healthy controls. A search of the literature was conducted in the PubMed, MEDLINE, EMBASE, Cochrane Library, CBM, CNKI, WANFANG, and VIP for articles to assess AMH levels in offspring of PCOS and non-PCOS mothers irrespective of language. These databases were searched from their inception to December 7, 2020. The quality of studies was assessed using the Newcastle-Ottawa Scale (NOS) scoring system. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were adopted to calculate the overall estimates with random-effects models. A total of 6 studies with 846 participants were included. The pooled analysis found an increased AMH level in the umbilical cord blood in newborns of PCOS mothers (SMD =0.62, 95% CI [0.28, 0.95]). Subgroup analyses revealed an elevation of AMH concentrations in female neonates, neonates born to American and Asian PCOS mothers. In addition, higher AMH levels were also found in studies diagnosed by the National Institute of Health (NIH) criteria, maternal clinical/biochemical hyperandrogenism, or maternal body mass index (BMI) >30 kg/m2. Meta-regression analysis suggested that diagnostic criterion contributed mostly to the high heterogeneity. We demonstrated that AMH levels in neonates born to PCOS mothers were essentially higher, which indicates that AMH may act as an enigmatic role in the pathogenesis of PCOS which inhibits folliculogenesis in the fetal stage.

Highlights

We performed this updated systematic review and meta-analysis to evaluate anti-Müllerian hormone levels (AMH) in newborns of mothers with polycystic ovary syndrome (PCOS) compared with healthy controls
As a reflection of the increased stock of the preantral and small antral follicles, serum AMH levels were found significantly 2–4 folds ascended in PCOS individuals and were positively associated with total testosterone levels and free androgen index levels [8, 9]
Numerous animal studies laid the foundations of this developmental hypothesis for PCOS etiology [18, 19], this theory was doubted in human for many years, and insufficient observational human studies were conducted with controversial results

Summary

Introduction

We performed this updated systematic review and meta-analysis to evaluate anti-Müllerian hormone levels (AMH) in newborns of mothers with polycystic ovary syndrome (PCOS) compared with healthy controls. Polycystic ovary syndrome (PCOS) is a common metabolic and endocrine disorder that affects about 8 to 13% females in their reproductive lifespan according to criteria used [1] It is characterized by ovulatory dysfunction, androgen excess (primarily ovarian and adrenal in origin), and the appearance. It could be explained that maternal testosterone might be bound by sex hormone-binding globulin (SHBG) and quickly degraded and converted by the placenta’s high levels of aromatase into estradiol This mechanism has greatly contributed to protecting the fetus from a hyperandrogenic state [21]

Methods

Results

Conclusion