Can polymorphisms of AMH/AMHR2 affect ovarian stimulation outcomes? A systematic review and meta-analysis

BACKGROUND: Previous studies have investigated the effects of anti-Müllerian hormone (AMH) and AMH type II receptor (AMHR2) polymorphisms on ovarian stimulation outcomes, but the results were inconsistent. METHODS: We searched PubMed, Web of Science, Embase, and Cochrane Central Register of Controlled Trials databases for the literature used in this meta-analysis. The meta-analysis was performed with a random effects model with RevMan 5.3.5. Results were expressed as the relative risk (RR) for discrete data and the mean difference (MD) for continuous outcomes with a 95% confidence interval (CI). RESULTS: Seven studies with 2078 participants were included. More metaphase II (MII) oocytes were retrieved in the T allele carrier of AMH (rs10407022) in the dominant model (MD: 1.20, 95% CI: 0.76 to 1.65, I(2) = 0%, P < 0.00001), homozygote model (MD: 1.68, 95% CI: 0.35 to 3.01, I(2) = 70%, P = 0.01) and heterogeneity model (MD: 1.20, 95% CI: 0.74 to 1.66, I(2) = 0%, P < 0.00001). Oocytes retrieved from the Asian region in the TT carrier were significantly lesser than those in the GG/GT carrier in AMH (rs10407022) (MD: -1.41, 95% CI: − 1.75 to − 1.07, I(2) = 0%). Differences in the stimulation duration, gonadotropin (Gn) dosage, and pregnancy rate were insignificant. CONCLUSIONS: Our analysis indicated that the polymorphisms of AMH/AMHR2 could influence the ovarian stimulation outcomes. Prospective studies with a larger sample size and more rigorous design are needed in the future to further confirm these findings.