Daughters of PCOS mothers and AMH plasma concentrations in pre-puberty and puberty: A meta-analysis.

Purpose: to compare the Anti-Müllerian hormone (AMH) plasma concentrations of pre-pubertal and pubertal daughters born to polycystic ovary syndrome (PCOS) mothers to daughters born to control mothers and to investigate their alterations during pre-puberty and all stages of puberty.

Methods: We critically investigated and meta-analyzed observational studies, which compared the plasma concentrations of AMH in pre-pubertal and pubertal daughters of PCOS pregnancies. A search of the literature was completed till the end of June of 2024 in the PubMed, Scopus, and Medline for the eligible studies. The meta-analysis followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). The primary outcome included AMH plasma concentrations.

Results: Our search yielded 961 potentially eligible studies, 5 of which were finally studied. Pre-pubertal female offsprings of PCOS mothers present higher plasma concentrations of AMH, with the pooled mean difference 10.08, while also pubertal daughters of PCOS mothers present higher plasma concentrations of AMH, with the pooled mean difference 15.79.

Conclusion: Pre-pubertal and pubertal female offsprings of PCOS mothers show higher AMH plasma concentrations, when compared to daughters of healthy mothers without PCOS. The main pathophysiological pathways of these findings seem to be hyperandrogenism, hyperinsulinemia, and also genetic, epigenetic and intrauterine factors.