Anti-Müllerian hormone: clinical insights into a promising biomarker of ovarian follicular status

Abstract

In contrast to most hormonal biomarkers of the follicular status, anti-Müllerian hormone (AMH) is exclusively produced by the granulosa cells of a wide range of follicles (primary to the early antral stages), presumably FSH-independently and with little susceptibility to disorders of antral follicle growth during the luteal-follicular transition. This paper summarizes the authors' clinical research on the role of AMH as a marker of ovarian functioning. It shows that the relationship between antral follicle counts and serum AMH concentrations is stronger than that observed with FSH, inhibin B and oestradiol on day 3, and that intercycle reproducibility of AMH measurements is better than the latter parameters. In addition, peripheral AMH concentrations decline during ovarian stimulation, thus confirming that maturing follicles loose progressively their ability to produce AMH. Indeed, follicular fluid (FF) AMH concentrations in small antral follicles are 3-fold as high as AMH in pre-ovulatory follicles. Further, human chorionic gonadotrophin-driven luteinization additionally curtails follicular AMH production. Finally, AMH production measured in FF from individual follicles is increased in women having normal follicular counts and responsiveness to ovarian stimulation. Together, these data reinforce the soundness of AMH measurements as a quantitative and possibly qualitative marker of granulosa cell activity and health.

The Anti Mullerian Hormone- A Novel Marker for Assessing the Ovarian Reserve in Women with Regular Menstrual Cycles

“…The concentration of AMH is higher in the small antral follicles than in the preovulatory follicles, suggesting that the circulating AMH levels reflect both the quantity and the quality of the remaining follicles [7]. Since, there is no change in the AMH levels in response to the gonodatrophins, it can be measured throughout the cycle in contrast to the other hormones-the AMH intracycle and the cycle to cycle variation is also negligible.…”

Study of ovarian reserve parameters in infertile women of different age groups

“…This positive correlation is confirmed by other researchers too. 11,12 Despite the fact, that at present there is no agreement on identification of the antral follicles by size, the majority of researchers imply the amount of 2-10 mm follicles counted in early follicular phase. 13,14 It has been reported that human antral follicles measuring <6 mm express the great amount of AMH, and levels decline with antral follicles increase in size.…”

Effects of conservative laparoscopic endometrial cystectomy and use of kidney-reinforcing and blood activating traditional Chinese medicine on ovarian functions

“…At present, the following indicators, markers, and tests are used to assess ovarian reserve: age, sex hormones (basal FSH, LH, and E2 levels), INHB, Mullerian duct antihormone levels, ovarian volume, and blood flow, clomiphene citrate challenge test (CCCT) and gonadotropin-releasing hormone agonist stimulation test (Vladimirov et al, 2005;Feyerisen et al, 2006;Dehghani-Firouzabadi et al, 2008;Busacca and Vignali, 2009).…”