The Association Between Body Mass Index and Anti-Müllerian Hormone Value in Women with or Without Polycystic Ovary Syndrome

Abstract

Background: Anti-Müllerian hormone (AMH) is widely used as a predictor of ovarian reserve. Although increased body weight is associated with reduced fertility, the relationship between Body Mass index (BMI) and AMH remains inconclusive, limiting its accurate interpretation. Objectives: This study aims to investigate the association between serum AMH levels and BMI among individuals with and without polycystic ovarian syndrome (PCOS). Methods: This cross-sectional, single-center study analyzed 522 patients who attended an Obstetrics and Gynecology clinic in Al-Diwaniyah, Iraq, from January 2022 to October 2024. Patients were categorized based on BMI into two groups: Those with a BMI ≥ 30 kg/m2 and those with a BMI < 30 kg/m2. The PCOS diagnosis was based on the International Classification of Diseases, 10th Revision (ICD-10) code and the Rotterdam Criteria. Inclusion criteria required female participants to be at least 19 years old with documented BMI and AMH test results within the study period. Exclusion criteria included diabetes, systemic diseases, galactorrhea, endocrine disorders, metformin intake, and contraceptive use within the past four weeks. Statistical Analysis: The chi-square test, receiver operating characteristic (ROC) curve, one-way analysis of variance (ANOVA), independent samples t-test, and Pearson correlation test were used for data analysis. A P-value of ≤ 0.05 was considered statistically significant. Results: The mean BMI of the PCOS group was significantly higher than that of the non-PCOS group (31.16 ± 5.55 kg/m2 vs. 28.69 ± 5.04 kg/m2, P < 0.001). The AMH levels were significantly higher in the PCOS group compared to the non-PCOS group (4.70 ± 3.23 ng/mL vs. 1.59 ± 1.57 ng/mL, P < 0.001). However, the correlation between BMI and serum AMH levels was not statistically significant in either the PCOS group (P = 0.318) or the non-PCOS group (P = 0.417). Conclusions: There is no significant correlation between AMH levels and BMI across the study population, regardless of PCOS status. Additionally, no significant differences in serum AMH levels were observed between patients with BMIs ≥ 30 kg/m2 and those with BMIs < 30 kg/m2. A key limitation of this study is that it was conducted in a single clinic. Therefore, further studies involving a broader population are recommended.