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Abstract
Objective
This study aims to examine the short-term effects of oral metformin (MET) on serum anti-müllerian hormone (AMH) levels and to verify its impact on AMH concentrations in women with polycystic ovary syndrome (PCOS).
Methods
The literature search, extending from January 2000 to April 2023, was conducted using databases such as PubMed, Embase, and the Cochrane Central, resulting in the inclusion of 20 studies. These selected studies, evaluated for quality using the Newcastle–Ottawa Scale, investigated changes in AMH levels before and after treatment, with durations ranging from less than three months to over six months. The reported outcomes were quantified as standardized mean differences (SMD) with 95% confidence intervals (CI). This comprehensive systematic review and meta-analysis was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42023420705. The statistical analyses were performed using Review Manager 5.4.1.
Results
① The study incorporated 20 articles, consisting of 12 prospective studies, 7 randomized controlled trials (RCT), and 1 cross-sectional study. ② Serum AMH levels in patients with PCOS diminish subsequent to the oral administration of MET. ③ Across the spectrum of studies analyzed, a pronounced degree of heterogeneity is evident, potentially ascribed to differential parameters including body mass index (BMI), daily pharmacological dosages, the temporal extent of treatment regimens, criteria of PCOS, and detection Methods. ④ The impact of MET on AMH levels exhibits a dose-responsive trend, with escalating doses of MET being associated with progressively greater declines in AMH concentrations in the patient population. ⑤ For women with PCOS receiving MET therapy, a minimum treatment duration of three months may be necessary to observe a reduction in serum AMH levels.
Conclusions
The results of this meta-analysis indicate that MET treatment exerts a suppressive effect on serum AMH levels in women with PCOS. It appears that a treatment duration of at least three months is required to achieve a significant decrease in AMH concentrations. Furthermore, the influence of MET on AMH is dose-dependent, with higher doses correlating with more pronounced reductions in AMH levels among the patients studied.
Acknowledgements
We would like to express our gratitude for the valuable discussion with Shijun Xia, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, in how to approach system analysis and use Review Manager.
Disclosure statement
The authors declare no competing interests.
Consent for publication
The author assures that the described work has not been published before, and is not under consideration for publication elsewhere. The publication has received explicit or implicit approval from all coauthors, if applicable, and from the appropriate authorities at the research institution.
Availability of data and materials
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Authors’ contributions
Hongcen Liu: Conceptualization, Methodology, Software, Investigation, Formal Analysis, Writing - Original Draft, Data Curation.
Li Mo: Conceptualization, Methodology, Software, Investigation, Formal Analysis, Writing - Original Draft.
Xiaofang Tian: Conceptualization, Software, Formal Analysis, Writing - Original Draft, Data Curation, Visualization.
Shizhen Fan: Conceptualization, Methodology, Software, Investigation, Formal Analysis, Writing - Original Draft.
Jiayi Hu: Methodology, Software, Investigation, Formal Analysis.
Lin Zhang: Validation, Writing - Review & Editing.
Bohai Yu Conceptualization, Funding Acquisition, Resources, Supervision, Writing - Review & Editing.