Anti-Müllerian Hormone

Anti-Müllerian Hormone (AMH) is a protein produced by granulosa cells in ovarian follicles. AMH testing, which measures the level of this hormone in the blood, provides insight into various aspects of ovarian function. Here are the primary uses of AMH testing:

  1. Ovarian Reserve Assessment: AMH levels give an indication of a woman’s ovarian reserve, meaning the number and quality of eggs left in the ovaries. Women with higher AMH levels typically have a greater number of available eggs than those with lower levels.
  2. Predicting the Onset of Menopause: While not precise, AMH levels can give a general idea about when a woman might reach menopause. Those with lower AMH levels may experience menopause earlier than those with higher levels.
  3. Fertility Treatment Predictions: In assisted reproductive technologies, such as in vitro fertilization (IVF), AMH levels can help predict how the ovaries will respond to fertility drugs. Women with high AMH levels are more likely to respond well to stimulation and produce a larger number of eggs, whereas women with low AMH may produce fewer eggs.
  4. Diagnosis of Polycystic Ovary Syndrome (PCOS): Women with PCOS often have elevated levels of AMH. Though AMH testing is not the primary diagnostic tool for PCOS, it can be part of the diagnostic work-up in conjunction with other clinical and laboratory findings.
    1. Treatment Monitoring in PCOS: In women with PCOS undergoing treatment with certain medications (like metformin), AMH levels might be used to monitor the response to therapy.
  5. Monitoring After Ovarian Surgery: AMH levels can be used to assess ovarian function after surgeries that might impact the ovaries, such as cyst removal.
  6. Assessment in Certain Pediatric Conditions: AMH can be used to assess gonadal presence in cases of intersex conditions or to evaluate the function of testicles in young boys with cryptorchidism (undescended testicles).
  7. Evaluating Ovarian Tumors: Some ovarian tumors, particularly granulosa cell tumors, can produce AMH. Measuring AMH levels can be useful in the diagnosis and monitoring of these tumors.

While AMH is a valuable tool in many clinical scenarios, it’s essential to understand its limitations. AMH levels provide information about the quantity of eggs, not their quality. Also, while AMH can give an estimate about the ovarian reserve, it doesn’t predict the likelihood of natural conception. Clinical decisions should be based on a combination of AMH levels, other tests, and overall clinical evaluation.