How does Antimullerian Hormone Explain the impairment of folliculogenesis in PCOS, its effects on the dysfunctional gonadotropin control, besides its implication in transgenerational transfer of PCOS-A

Earlier we had reviewed on the different classification methods of Polycystic ovary syndrome (PCOS) ,the work of Sir –Petermann and Ibanez group in prepubarchal girls in PCOS and correlation with antimullerian hormone (AMH) amounts and different forms of therapy in PCOS].Here we tried to review the newer aspects of AMH association with PCOS pathophysiology ,its role and interaction with androgens,FSH,LH,their receptors besides influence of invention of AMH receptor2 (AMHR 2) ,the influence of AMH on hypothalamic-pituitary-gonadal(H P-G) axis influencing Gonadotropin releasing hormone(GnRH) physiology ,gonadotrope function as well as its role in transgenerational transmission of PCOS. Thus here we conducted a systematic review with regards to role of AMH in replacing the USG in PCOS and its pathophysiology in contributing to PCOS. We utilized search engine pubmed,google scholar ;web of science ;embase; Cochrane review library utilizing the MeSH terms like PCOS;AMH; Rotterdam criteria; Insulin resistance ; hypothalamic-pituitary -gonadal(H-P-G) axis influence ;animal studies ;human studies; transgenerational transfer of PCOS ;effects of exaggerated prenatal androgens on offspring; Role of Vitamin D from 1990’s to 2021 till date. We found a total of 600 articles out of which we selected 71 articles for this review. No meta-analysis was done. Here we discuss the various points in detail utilizing clinical experiments along with animal studies to validate the posits .Besides the lot of research avenues opened up a lot of exciting development might be in the pipeline, i.e. the generation of AMRH2 antagonists which might aid in the selection of a dominant follicle (DF) without the need for ovarian stimulation and hence financial burden along with risk of ovarian hyper stimulation syndrome (OHSS) gets circumvented.