Effect of Metformin on Anti-Mullerian Hormone Level in Infertile Women with Polycystic Ovary Syndrome

Open Access

Abstract

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder and major cause of anovulatory infertility, often associated with metabolic dysfunction. Anti-Mullerian hormone (AMH), typically elevated in PCOS, may be modulated by metformin therapy, though existing evidence remains inconsistent. Objective: The aim of the study was to evaluate the effect of metformin on serum Anti-Mullerian Hormone levels in infertile women with Polycystic Ovary Syndrome. Methods & Materials: This prospective interventional study at the Department of Obstetrics and Gynaecology, Bangladesh Medical University (BMU), Dhaka, Bangladesh, from January to December 2025, included 80 infertile women with PCOS. Participants received three months of oral metformin, and serum AMH was measured pre- and post-treatment. Demographic and clinical data were collected, and AMH changes, BMI-stratified effects, and correlations with baseline AMH were analyzed using SPSS 25.0 (p < 0.05). Results: Among 80 infertile women with PCOS (mean age 29.1 ± 4.5 years), most were overweight or obese (65.0%), with menstrual irregularity in 72.5% and hyperandrogenism in 65%. Baseline AMH was 8.4 ± 2.1 ng/mL and decreased to 6.1 ± 1.8 ng/mL after 3 months of metformin (mean reduction 2.3 ± 1.2, p < 0.001), with 77.5% showing a decrease. AMH reduction was greatest in obese participants, and baseline AMH positively correlated with BMI (r = 0.41) and AMH reduction (r = 0.52), all p < 0.001. Conclusion: Metformin effectively reduces elevated serum AMH levels in infertile women with PCOS, with greater reductions observed in those with higher BMI.