The Impact of Metformin Treatment on Serum Level of AMH and on Ovulation and Pregnancy Outcome in Women With PCOS

Anti-Müllerian Hormone (AMH) AMH inhibits follicle recruitment and may reduce FSH action, contributing to ovulatory issues in females. PCOS patients often receive metformin treatment. This study aimed to investigate metformin's effect on serum AMH levels in PCOS women and its impact on ovulation and pregnancy rates. This interventional study was performed between June 2023 and June 2024. 100 PCOS women attending the infertility departments of Maternity Teaching Hospital in Adiwniyah province, Iraq, were invited to participate in the study. PCOS was diagnosed based on the Rotterdam consensus statements criteria. Metformin was given to 50 women (study group) and 50 women received placebo o serve as a control group. After 3 months, comparison of mean serum AMH between study groups revealed significant variation (P=0.020) and this significant variation became more pronounced 6 months later (P<0.001). In case of placebo group, comparison of baseline mean serum AMH to those after 3 months and after 6 months revealed minimal no significant changes (P>0.05); whereas the use of metformin resulted in significant reduction of mean serum AMH 3 months later (P=0.006) and the reduction was more significant 6 months later (P<0.001). The rate of ovulation and the rate of positive pregnancy test were reported to be higher significantly in metformin group in contrast to placebo group (P=0.001 and 0.016, respectively). Metformin treatment is efficient and safe in reducing serum AMH in women with PCOS, thus indicating reduction in antral follicle count and changes in overall hormonal status that can improve ovulation and pregnancy in those women.