Background: Anti-Müllerian hormone (AMH) reflects ovarian reserve and predicts
ovulation induction outcomes. This study evaluates the impact of serum AMH on ovulation
induction using conventional and extended letrozole regimens in women with PCOS.
Methods: A prospective randomized study was conducted on 148 infertile PCOS women
unresponsive to 2.5 mg letrozole. Group A (conventional) received 5 mg/day from cycle day
2–6, while Group B (extended) received 5 mg/day from day 2–11. Serum AMH levels were
compared between ovulatory and non-ovulatory participants.
Results: Mean AMH levels were higher in non-ovulatory women than ovulatory ones. In the
conventional group, AMH was 4.00 ± 2.88 ng/mL in non-ovulatory vs2.41 ± 1.48 ng/mL in
ovulatory (P = 0.001). In the extended group, AMH was5.59 ± 2.31 ng/mL vs 2.29 ± 1.01
ng/mL respectively (P = 0.001). Overall, elevated AMH correlated significantly with
reduced ovulation rates (P < 0.001).
Conclusion: High AMH levels are inversely associated with ovulatory response in both
protocols. AMH can guide individualized stimulation strategies for better fertility outcomes
in PCOS.