Anti-Mullerian Hormone:Above and Beyond Conventional Ovarian Reserve Markers

Abstract

Management of ovarian dysfunctions requires accurate estimation of ovarian reserve (OR). Therefore, reproductive hormones and antral follicle count (AFC) are assessed to indicate OR. Serum anti-Mullerian hormone (AMH) is a unique biomarker that has a critical role in folliculogenesis as well as steroidogenesis within ovaries. Secretion from preantral and early antral follicles renders AMH as the earliest marker to show OR decline. In this review we discuss the dynamics of circulating AMH that remarkably vary with sex and age. As it emerges as a marker of gonadal development and reproductive disorders, here we summarize the role of AMH in female reproductive physiology and provide evidence of higher accuracy in predicting ovarian response to stimulation. Further, we attempt to compile potential clinical applications in children and adults. We propose that AMH evaluation has a potential role in effectively monitoring chemotherapy and pelvic radiation induced ovarian toxicity. Furthermore, AMH guided ovarian stimulation can lead to individualization of therapeutic strategies for infertility treatment. However future research on AMH levels within follicular fluid may pave the way to establish it as a marker of “quality” besides “quantity” of the growing follicles.

Assessment of ovarian reserve: Anti-Mullerian hormone versus follicle stimulating hormone

“…These include the requirement of latest equipment and skilled personnel, biasness due to operator’s variability, incapability to visualize follicles in female with ovarian cysts or prior surgery, and counting both healthy and atretic follicles as capable to respond to treatment. [14] Therefore, we compared the strength of FSH; mostly commonly used OR in secondary care clinics and AMH; recently acclaimed as the best solo marker to reflect ovarian pool, in segregating infertile population. As blood test has a clear advantage of sample collection and avoidance of human error, these tests may be easily used in setups lacking the sophisticated technology to assess AFC.…”

“…As blood test has a clear advantage of sample collection and avoidance of human error, these tests may be easily used in setups lacking the sophisticated technology to assess AFC. [14]…”

Age and anti‐Müllerian hormone levels predict the success of in vitro maturation of cat oocytes

“…A similar decline in AMH levels has also been seen in women where they even become undetectable after the menopause (La Marca et al., ). In women aged between 25 and 40 years, AMH levels of 1.0–3.0 μg/L are classified as normal, between 0.7 and 0.9 μg/L as low normal, from 0.3 to 0.6 μg/L as low and <0.3 μg/L are considered to be very low (Jamil, Fatima, Ahmed, & Malik, ). It has not yet been investigated whether queens also experience such a decline where AMH becomes undetectable after a certain age.…”

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

“…In previous studies decrease of AMH concentration has been observed as a result of oncological chemotherapy [19,[22][23][24]. Additionally, lower serum AMH concentrations are linked to obesity [25]. In women with CKD the aforementioned fertility disturbances may be caused by the damage of the ovaries by uremia, but no studies concerning the serum AMH concentration in women with CKD have been conducted so far.…”