Relationship between anti-Mullerian hormone and ovarian response after using letrozole in subfertile polycystic ovary syndrome patients
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20253905Keywords:
Polycystic ovary syndrome, Anti-Mullerian hormone, Letrozole, FSH, SubfertilityAbstract
Background: Polycystic ovary syndrome (PCOS) is the most common cause of anovulation in reproductive-age women. Anti-Mullerian hormone (AMH) was higher in PCOS women due to increased antral follicles. This study examined the relationship between Anti-mullerian hormone and ovarian response after letrozole in sub-fertile PCOS patients.
Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, BIRDEM General Hospital, Dhaka, Bangladesh, from April 2022 to September 2023. 116 sub-fertile PCOS patients receiving Letrozole were purposively selected. Patients underwent transvaginal ultrasound (TVS) and were divided into two groups by follicle size: non-responder group (<16 mm) and responder group (≥16 mm). Data was analyzed using statistical package for the social sciences (SPSS) version 26.0.
Result: Most women were aged 21-30 years, with a mean age of group I at 30.2±3.7 and group II at 29.9±5.1. Most were primary subfertile; group I 35(65.5%) and group II 41(70.7%). Mean serum FSH was higher in group II, 9.28±5.6, than in group I, 7.19±3.64 (p<0.001). Mean AMH was higher in group II, 5.82±1.4, than in group I, 5.2±1.8 (p=0.054) but statistically non-significant. ROC curve showed AMH cut-off value of 5.12 with 62.1% sensitivity and 65.5% specificity. Patients with AMH <5.12 ng/ml had 3.1 times more chance of ovarian response versus those with AMH >5.1 ng/ml (OR=3.1; 95% CI (1.5-6.6), p=0.003).
Conclusion: Elevated serum AMH level is a risk factor for poor ovarian response in PCOS, which may require adjusting the letrozole dosage.
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References
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