Anti-Mullerian Hormone (AMH)

In men, anti-Müllerian hormone (AMH) is secreted by the Sertoli cells of the testes. During embryonic development, AMH secretion is responsible for the regression of the Müllerian duct and the normal development of the male reproductive system. AMH secretion begins during embryogenesis and continues throughout life. AMH is produced continuously by the testes until puberty when it slowly declines to post-pubertal levels.

In women, at the start of foetal development, the absence of AMH allows the Müllerian ducts to develop.

AMH concentrations in adult women reflect the number of small follicles entering the growth phase. It is proportional to the number of primordial follicles still present in the ovary, or ovarian reserve.AMH decreases throughout a woman's reproductive life, reflecting the continuing decline in the pool of oocytes and follicles with age and, consequently, ovarian ageing.

Measurement of serum AMH is mainly used clinically to assess ovarian reserve in terms of the number of antral and pre-antral follicles, known as the antral follicle count (AFC), and to predict response to controlled ovarian stimulation.

AMH levels decrease progressively with age and provide an indication of the approximate age of menopause. This can be invaluable for women wishing to plan a pregnancy or anticipate the effects of perimenopause.

In Polycystic Ovarian Syndrome, AMH levels are often elevated due to an increase in the number of small antral follicles. Combined with the clinic, it aids diagnosis, particularly in the case of irregular cycles and high androgen levels.