Anti-Mullerian Hormone levels after metformin treatment in polycystic ovary syndrome: A systematic review and meta-analysis

This systematic review and meta-analysis aim to evaluate whether treatment with metformin would reduce Anti-Mullerian Hormone levels in patients with polycystic ovary syndrome. A search was performed in Medline, Embase, Web of Science, and Cochrane Library databases and grey literature (Google Scholar). The following keywords were used in the search strategy: "Polycystic Ovary Syndrome", "Anti-Mullerian Hormone", "Metformin". The search was limited to human studies, with no language restriction. 328 studies were found, 45 studies were selected for full-text reading and 16 of those studies, six randomized controlled trial and 10 non-randomized studies were included. The synthesis of randomized controlled trials, metformin showed a reduction in serum levels of Anti-Mullerian Hormone compared to control groups (SMD - 0.53, 95 %CI -0.84 to -0.22, p < 0.001, I-2 = 0 %, four studies, 171 participants, high quality of evidence). Six non-randomized studies evaluated data before and after the metformin intervention. The synthesis showed that using metformin reduced serum Anti-Mullerian Hormone values (SMD - 0.79, 95 %CI -1.03 to -0.56, p < 0.001, I-2 = 0 %, six studies, 299 participants, low quality of evidence). Metformin administration in women with polycystic ovary syndrome is associated significantly with reduced Anti-Mullerian Hormone serum levels.