Anti-Müllerian hormone as a biomarker of ovarian function and spontaneous puberty in Turner syndrome: a systematic review
Bibliographic record
Abstract
Background: Turner syndrome (TS), caused by complete or partial X chromosome monosomy, often leads to primary ovarian insufficiency (POI) and pubertal delay. Anti-Müllerian hormone (AMH) is a key biomarker of ovarian reserve, but its predictive role in spontaneous puberty and ovarian function in TS remains unclear. Methods: This systematic review followed PRISMA guidelines and included studies from PubMed, Embase, and Cochrane (2000-2025). Nine studies (865 TS patients, 976 controls) were analyzed. Outcomes included AMH levels in TS versus controls, association with spontaneous puberty, and predictive value for fertility preservation. Risk of bias was assessed using the Newcastle-Ottawa Scale. Results: TS patients had significantly lower AMH levels than controls (weighted mean differences (WMD): -3.04 ng/mL, 95% CI: -3.26 to -2.83, p < 0.001). Detectable AMH correlated with spontaneous puberty (OR=5.12, 95% CI: 2.87-9.12), particularly in mosaic karyotypes. Subgroup analyses revealed assay variability, with ELISA-based methods detecting low but clinically relevant AMH levels. Sensitivity analyses confirmed robustness, and publication bias was minimal (Egger's p = 0.283). Conclusion: AMH is a reliable biomarker for ovarian reserve and spontaneous puberty prediction in TS. Its integration into clinical practice may improve fertility counseling and hormone therapy timing. However, standardized assays and prospective studies are needed to optimize its diagnostic accuracy. Systematic review registration: https://www.crd.york.ac.uk/prospero/ PROSPERO, identifier CRD420251051633.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.036 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.010 | 0.008 |
| Bibliometrics | 0.007 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".