The measurement of AMH is used for the assessment of the ovarian reserve, representing the number of antral follicles, pre-antral follicles, the antral follicle count and prediction of response in patients undergoing ovarian stimulation. Such requests are generally only received from reproductive medicine. AMH may also be useful in diagnosis of disorders of sex development in paediatric patients.
AMH is a homodimeric glycoprotein belonging to the transforming growth factor family. In males, AMH is secreted by the Sertoli cells of the testes. During embryonic development in males, secretion of AMH from testicular Sertoli cells is responsible for the regression of the Mullerian duct and the normal development of the male reproductive tract. The secretion of AMH by the Sertoli cells starts during the embryogenesis and continues throughout life. AMH is continuously produced by the testicles until puberty and then decreases slowly to post-puberty values. In females AMH plays an important role in the ovarian folliculogenesis. Follicle development in the ovaries comprises two distinct stages: initial recruitment, by which primordial follicles start to mature, and cyclic recruitment, which leads to the growth of a cohort of small antral follicles, among which the dominant follicle is subsequently selected. Serum levels of AMH are barely detectable at birth in females, reach their highest levels after puberty, decrease progressively thereafter with age, and become undetectable at menopause.
A specific reference range is not quoted as the AMH concentration is interpreted by reproductive medicine to predict response to IVF therapy.
SST (yellow top) serum specimen required
Biochemistry department, The James Cook University Hospital, Middlesbrough