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

Abstract

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, I² = 0%, P < 0.00001), homozygote model (MD: 1.68, 95% CI: 0.35 to 3.01, I² = 70%, P = 0.01) and heterogeneity model (MD: 1.20, 95% CI: 0.74 to 1.66, I² = 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, I² = 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.

Keywords: AMH; AMHR2; Meta-analysis; Polymorphism; SNP.

Fig. 1

PRISMA flow chart of literature retrieval and study selection

Fig. 2

Forest plots of differences among AMH (rs10407022) genotype carriers regarding the number of oocytes retrieved. (a) dominant model, (b) heterozygote model, (c) homozygote model, (d) recessive model

Fig. 3

Forest plots of differences among AMHR2 (rs2002555) genotype carriers regarding the number of oocytes retrieved. (a) dominant model, (b) homozygote model, (c) heterozygote model, (d) recessive model

Fig. 4

Forest plots of differences among AMH (rs10407022) genotype carriers regarding the number of MII oocytes. (a) dominant model, (b) homozygote model, (c) heterozygote mode, (d) recessive model

Fig. 5

Forest plots of subgroup analysis for the number of oocytes retrieved. (a) AMH (rs10407022), (b) AMHR2 (rs2002555)