Conclusion:
We found that the frequency of uterine abnormality is more common in
PCOS patients than the normal population and this is not correlated with
maternal serum AMH levels.
Considering that PCOS is a transgenerational and transmissible disease,
high frequency of uterine cavity abnormalities in PCOS patients can be
attributed to increased, either direct effect of cord blood AMH levels
to uterine development via WNT genes or indirect effect of AMH via
increasing intrauterine GnRh Pulsatility - LH levels or reducing
placental aromatase enzyme which is blocking maternal androgens,
intrauterine androgens and downregulation of HOXA genes. (Figure 4)
Longitudinal studies are needed to investigate the relationship between
umbilical cord AMH, androgens and other sex steroids levels, shape of
uterine cavity and pregnancy complications.