The effect of metabolic bariatric surgery on Anti-Müllerian hormone levels: a systematic review and meta-regression analysis

The possible anti-Mullerian hormone (AMH)-reduction impact of metabolic bariatric surgery has been assessed in a number of interventional investigations. The outcomes are still incongruous, however. This research sought to thoroughly examine the effects of metabolic bariatric surgery on AMH in order to have a better understanding of them. Using standard keywords, the Scopus, PubMed/Medline, Web of Science, Cochrane, and Embase databases were searched to find all eligible human studies, including observational cohorts and single-arm pre–post studies, examining the levels of AMH after metabolic bariatric surgery treatment. For the best result estimate, random-effects model analysis produced 95% confidence intervals and a pooled weighted mean difference. This article includes 15 treatment arms with a total of 459 participants. The results from the random-effects meta-analysis showed a significant reduction in AMH levels in the included observational and pre–post studies, with a pooled weighted mean difference (WMD) of −0.58 ng/ml [95% confidence interval (CI): −1.10 to −0.06; p = 0.028]. Subgroup analysis indicated that metabolic bariatric surgery had a greater effect on AMH reduction in the population with PCOS, with a time after the intervention of 48 weeks or longer, and in participants aged 30 years or younger compared to other groups. This meta-analysis suggests that metabolic bariatric surgery is associated with reductions in AMH, particularly in women with PCOS. However, due to high heterogeneity, low-quality evidence, and lack of fertility outcomes, these results should be interpreted with caution. The implications for fertility remain uncertain.