Anti-Müllerian hormone: A unique biochemical marker of gonadal development and fertility in humans

Abstract

An ti-Mülle rian hor mo ne (AMH) is a glycop ro tein be lon gi ng to the tran sfor mi ng growth fac to rs (TGF-β). AMH plays a fun da men tal ro le in the regres sion of Mülle rian duc ts in ma le em bryo. In its ab sen ce, Mülle rian duc ts de ve lop in to fe ma le in ner rep ro duc ti ve or ga ns. In boys, it is sig ni fi can tly pro du ced in Ser to li cel ls of tes tes un til pu ber ty and then slowly dec rea ses to re si dual va lues for the re st of the me n's li fe. AMH ser ves as a bioc he mical mar ker of the pre sen ce of tes tes in cryptor chi dic ma les. In fe ma les, AMH is sec re ted by gra nu lo sa cel ls of sma ll fol lic les in the ova ry. Se rum va lues are al mo st un de tec tab le du ri ng in fan cy and then ra pid ly in crea se wi th the on set of pu ber ty, refl ec ti ng the ini tial rec ruit me nt of pri mor dial fol lic les. AMH is pro du ced in growi ng fol lic les un til they rea ch a sta ge when do mi na nt fol lic le is de tac hed from a co ho rt of an tral fol lic les. The mea su re me nt of se rum AMH le ve ls du ri ng wo ma n's rep ro duc ti ve li fe rep re sen ts an ideal tool for the as ses sme nt of the ova rian fol li cu lar re ser ve. The ad van ta ge of AMH in re la tion to the ova rian ste roid hor mo nes is that se rum le ve ls do not fl uc tua te sig ni fi can tly du ri ng the men strual cycle. In ad di tion, cir cu la ting AMH stron gly cor re la tes wi th an tral fol lic le cou nt (AFC), vi sua li zed by ul tra sou nd in the fol li cu lar pha se of the cycle. As the num ber and qua li ty of the oo cytes di mi ni sh throug hout the wo ma n's rep ro duc ti ve li fe, se rum con cen tra tio ns of AMH gra dual ly dec rea se and fa ll be low de tec tab le le ve ls in me no pau se. This cou ld be of par ti cu lar in te re st in sub fer ti le and in fer ti le wo men un der goi ng as sis ted rep ro duc ti ve tec hniques (ART) in ac hie vi ng preg nan cy. Key wor ds: an ti-Mülle rian hor mo ne; ova rian re ser ve; sper ma to ge ne sis; in fer ti li ty; sex-diff e ren tia tion Review In tro duc tionAn ti-Mülle rian hor mo ne (AMH) is a 140-kDa di meric glycop ro tein hor mo ne and be lon gs to the transfor mi ng growth fac to r-β (TGF-β) fa mi ly. AMH is synthe si zed as a lar ge pre cur sor wi th a sho rt sig nal sequen ce fol lowed by the pre-pro hor mo ne that for ms ho mo di me rs. Prior to sec re tion, the ma tu re hor mo ne un der goes glyco syla tion and di me ri zation to pro du ce a 144-kDa di mer com po sed of iden ti cal di sul phi de-lin ked 72-kDa mo no mer subu ni ts. Ea ch mo no mer con tai ns an N-ter mi nal domain (al so cal led the "pro re gio n") and a C-ter minal do main (al so cal led the "ma tu re re gio n"); it is be lie ved that N-ter mi nal do main ac cen tua tes the ac ti vi ty of the C-ter mi nal do main in whi ch re si des the bioac ti vi ty of the mo le cu le (1). Du ri ng cytoplas mic tran sit, be tween 5 and 20% of AMH is cleaved at a spe ci fi c si te be tween the N-ter mi nal and the C-ter mi nal do main of the 72-kDa mo no mer, to fo rm tw...

Increasing serum 25-hydroxyvitamin D is associated with reduced odds of long menstrual cycles in a cross-sectional study of African American women

“…AMH is produced in the granulosa cells of early-developing follicles, and its hypothesized actions include inhibition of primordial follicle recruitment, slowing of follicular growth and thus delaying or preventing atresia, and inhibiting granulosa cell differentiation (8, 45). AMH, antral follicle count and ovarian volume have been positively associated with menstrual cycle length in 200 healthy women and several lines of evidence support a role for AMH in menstrual cycle function (46).…”

Anti-Müllerian hormone in serum and seminal plasma in comparison with other male fertility parameters

“…In both genders AMH decreases with age [Zec et al 2011]. This fact has to be taken into account when evaluating the results and age adjustment has to be applied when the age difference between the assessed groups is statistically significant.…”

Serum Anti-Müllerian Hormone Concentration in Young Women with Chronic Kidney Disease on Hemodialysis, and After Successful Kidney Transplantation

“…Serum AMH is positively correlated with the number of antral follicles and decreases with age at a rate of 6% per year until it is virtually undetectable in postmenopausal women. This is related to the decrease of the quantity of growing follicles [17][18][19][20]. Thus, serum AMH concentration reflects the pool of follicles and is considered the best marker of ovarian reserve.…”