{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T06:00:23Z","timestamp":1785218423994,"version":"3.55.0"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"\n Background<\/jats:title>\n Anti-M\u00fcllerian hormone (AMH) is typically elevated in women with polycystic ovary syndrome (PCOS), but its relationship with assisted reproductive technology (ART) outcomes remains unclear.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n This systematic review and meta-analysis aimed to evaluate the association between AMH levels and pregnancy outcomes in women with PCOS undergoing ART.<\/jats:p>\n <\/jats:sec>\n \n Search methods<\/jats:title>\n Observational studies published between January 2020 and May 2025 were identified from major databases. The search strategy incorporated controlled vocabulary and keywords related to \u201cPolycystic Ovary Syndrome,\u201d \u201canti-M\u00fcllerian hormone,\u201d and ART outcomes. Eight studies were included.<\/jats:p>\n <\/jats:sec>\n \n Main outcomes<\/jats:title>\n \n Higher oocyte yields were observed across ascending AMH subgroups, with significant differences detected in all pairwise comparisons (low vs. high: MD = \u22123.91, 95% CI: \u22125.60 to \u22122.23; Z = 4.55,\n P<\/jats:italic>\n &lt; 0.001, I\n 2<\/jats:sup>\n = 86%; low vs. medium: MD = \u22122.33, 95% CI: \u22122.79 to \u22121.86; Z = 9.77,\n P<\/jats:italic>\n &lt; 0.001, I\n 2<\/jats:sup>\n = 50%; medium vs. high: MD = \u22121.70, 95% CI: \u22123.31 to \u22120.09; Z = 2.07,\n P<\/jats:italic>\n = 0.04, I\n 2<\/jats:sup>\n = 0%). Higher AMH levels were significantly associated with increased risk of ovarian hyperstimulation syndrome (OHSS). Compared with the low AMH group, the high AMH group had a higher OHSS risk (OR = 0.64, 95% CI: 0.47\u20130.88, Z = 2.77,\n P<\/jats:italic>\n = 0.006, I\n 2<\/jats:sup>\n = 0%). Similarly, the high AMH group also presented a significantly elevated OHSS risk relative to the medium AMH group (OR = 0.40, 95% CI: 0.23\u20130.70, Z = 3.19,\n P<\/jats:italic>\n = 0.006, I\n 2<\/jats:sup>\n = 0%). Paradoxically, reproductive outcomes appear more favorable in participants with lower AMH levels: low AMH was associated with higher live birth rates versus both medium (RR = 1.15, 95% CI: 1.07\u20131.24; Z = 3.71, &lt; 0.001, I\n 2<\/jats:sup>\n = 39%) and high AMH (RR = 1.19, 95% CI: 1.10\u20131.28; Z = 4.53,\n P<\/jats:italic>\n &lt; 0.001, I\n 2<\/jats:sup>\n = 27%), as well as a lower miscarriage risk (low vs. medium: RR = 0.60, 95% CI: 0.42\u20130.86; Z = 2.80,\n P<\/jats:italic>\n = 0.005, I\n 2<\/jats:sup>\n = 0%; low vs. high: RR = 0.72, 95% CI: 0.53\u20130.98; Z = 2.10,\n P<\/jats:italic>\n = 0.04, I\n 2<\/jats:sup>\n = 49%). No significant associations were found between AMH levels and cumulative live birth rates, clinical pregnancy rates, or number of good-quality embryos.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The distinct intermediate phenotype of the medium AMH group, exhibiting superior live birth outcomes compared to high AMH, yet inferior to low AMH, underscores the value of finer stratification beyond a simple binary classification.<\/jats:p>\n <\/jats:sec>\n \n Systematic review registration<\/jats:title>\n \n https:\/\/www.crd.york.ac.uk\/prospero\/<\/jats:ext-link>\n , identifier [CRD420251089070].\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fmed.2026.1859573","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T05:37:45Z","timestamp":1785217065000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Anti-M\u00fcllerian hormone levels and live birth rate in polycystic ovary syndrome patients undergoing assisted reproductive technology: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Xiangui","family":"Wei","sequence":"first","affiliation":[{"name":"Integrated Traditional Chinese and Western Medicine Reproductive Center, Hohhot First Hospital","place":["Hohhot, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Chifeng Municipal Hospital, Chifeng","place":["Inner Mongolia Autonomous Region, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Hu","sequence":"additional","affiliation":[{"name":"Integrated Traditional Chinese and Western Medicine Reproductive Center, Hohhot First Hospital","place":["Hohhot, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Li","sequence":"additional","affiliation":[{"name":"Integrated Traditional Chinese and Western Medicine Reproductive Center, Hohhot First Hospital","place":["Hohhot, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Liu","sequence":"additional","affiliation":[{"name":"Integrated Traditional Chinese and Western Medicine Reproductive Center, Hohhot First Hospital","place":["Hohhot, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaohui","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoli","family":"Zhao","sequence":"additional","affiliation":[{"name":"Reproductive Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine","place":["Tianjin, 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