The Impact of High Circulating Anti-Müllerian Hormone on Endometrial Thickness and Outcome of Assisted Reproductive Technology in Women with Polycystic Ovarian Syndrome: A Cohort Study.

Background: Elevated circulating anti-Müllerian hormone (AMH) in women with the polycystic ovarian syndrome (PCOS) has been found to have a detrimental effect on endometrial function. This may adversely affect the outcome of fertilisation (IVF) in PCOS women.

Aims: To investigate the impact of high serum AMH concentrations on endometrial thickness (ET) and the outcome of IVF in women with PCOS.

Settings And Design: This retrospective cohort study included all PCOS women who underwent fresh IVF\intracytoplasmic sperm injection cycles between January 2016 and December 2021 in one major IVF centre.

Materials And Methods: PCOS diagnosis was based on Rotterdam criteria, and participants were identified from centre database. All women received antagonist protocol. Primary outcomes were trigger-day ET and live birth rate (LBR). Circulating AMH was correlated with ET and ovarian response.

Statistical Analysis Used: AMH levels were compared between women with and without live birth. ET and LBRs were compared between women with AMH <7.0 ng/ml versus those with AMH ≥7.0 ng/ml.

Results: The study included 102 PCOS women, of which six were excluded due to poor response ( = 4), hyperresponse ( = 1) or fertilisation failure ( = 1). Of the remaining 96 women, 42 (43.8%) achieved a live birth. There was no statistically significant ( > 0.05) correlation between AMH and ET. Mean ± standard deviation AMH concentration was not significantly ( > 0.05) different between women with live birth (6.5 ± 3.4 ng/ml) and those without (6.5 ± 2.4 ng/ml). High AMH positively correlated with the number of oocytes retrieved, metaphase II oocytes and embryos ( = 0.003, 0.006 and 0.006, respectively). There was no statistically significant ( > 0.05) difference in ET or LBR between women with AMH <7.0 ng/ml ( = 72; ET, 10.7 ± 1.8 mm; LBR, 45.8% [33/72] versus those with AMH ≥7.0 ng/ml ( = 24; ET, 10.8 ± 1.7 mm; LBR, 37.5% [9/24]).

Conclusions: High circulating AMH in PCOS women does not seem to negatively affect ET or LBRs during assisted reproductive technology.