Insulin has profound effects on the ovarian stroma and follicle levels. The prevalence of metabolic syndrome in women with PCOS is 3.35 times higher than that in other women. The results of previous studies indicated that hyperinsulinemia and insulin resistance cause metabolic syndrome and play an important role in the development of reproductive disorders in women with PCOS. Given that insulin resistance is determinant in the manifestations of PCOS, it is considered as the primary goal for managing PCOS. Some of the risk factors, such as insulin resistance, dyslipidemia, and oxidative stress, cause early onset of type 2 diabetes and cardiovascular disease among PCOS patients, as the risk of heart attack (myocardial infarction) in women with PCOS is 7.4 times higher than that in other women. Causes of PCOS may be a range of endocrine disorder, such as hypothalamic-pituitary-adrenal (HPA) axis dysfunction, ovarian disorders, and insulin signaling. The global prevalence of PCOS has been reported between 5 and 10%, which is associated with symptoms, such as oligomenor rhea or amenorrhea and acne. Polycystic ovary syndrome (PCOS) is the most common endocrine disorder and the most important cause of anovulatory infertility in women of reproductive age. Although the results graded by very low-quality evidence, it is recommended to include exercise in the treatment programs of PCOS patients. It seems more duration of the exercise has a more potential advantage to reduce the AMH levels in women with PCOS. This systematic review and meta-analysis showed that either strength exercise or aerobic exercise decrease the AMH level in PCOS women. GRADEpro software was used to grade the level of evidence. The results of subgroup analysis demonstrated that the effect of resistance training for 16 weeks was higher on women with body mass index (BMI) (≥ 25 kg/m 2) and AMH (≥ 10 ng/mL) before the intervention. As a result of the combination of the studies, after exercise, AMH level in the intervention group significantly decreased up to 0.517 ± 0.169 more than that in the control group ( P ˂ 0.05).
Finally, 12 articles were included in the meta-analysis. All published studies, which met the inclusion criteria, were searched in SID, MagIran, Embase, PubMed, Scopus, Web of Science (WoS) databases, and Google Scholar motor engine using related MeSH/Emtree terms, which were combined with free text word. The present study was conducted according to the PRISMA guidelines from 2011 to October 2021. The present study aimed to estimate the pooled effect of exercise on anti-Mullerian hormone (AMH) levels in PCOS women using systematic review and meta-analysis.
Polycystic ovary syndrome (PCOS) is considered as the most common endocrinopathy among women of childbearing age and the most important cause of anovulatory infertility.
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