Thyroid function tests and serum anti-Müllerian hormone in various populations, is there any association? A systematic review and meta-analysis.

PURPOSE: This systematic review and meta-analysis aimed to evaluate the association between anti-Müllerian hormone (AMH) as a biomarker of ovarian reserve and various thyroid function tests, including thyroid-stimulating hormone (TSH), free T3 (FT3), free T4 (FT4), T3, T4, and thyroid autoantibodies, such as thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb), in various female populations.

METHODS

A comprehensive literature search was conducted across six electronic databases and original observational studies examining the correlation between AMH levels and at least one TFT, TPOAb, or TgAb.

RESULTS

Forty studies with 14,009 participants were included in the quantitative synthesis. The pooled results showed that AMH levels were not significantly correlated with TSH levels in the overall population or diverse subgroups. However, after adjusting for publication bias, a small, but significant, positive correlation was observed. Meta-regression analyses identified estradiol, FT3, and follicle-stimulating hormone (FSH) as significant moderators of AMH-TSH association in various populations. AMH was significantly positively correlated with FT3 (r = 0.177) and FT4 (r = 058), negatively correlated with T3 (r = - 0.202) and T4 (r = - 0.216) in the overall population, and significantly positively correlated with TPOAb in the normal population (r = 0.348). AMH levels were not significantly correlated with TgAb levels. Meta-regression revealed body mass index and FT4 as moderators in AMH-FT4 and AMH-TPOAb correlations.

CONCLUSION

These findings highlight the complex relationship between AMH and thyroid function markers with potential moderators influencing these associations. Further well-controlled longitudinal studies are required to clarify the underlying mechanisms and clinical implications of these associations across reproductive stages and metabolic profiles.