Anti Müllerian Hormone (AMH)

AMH is a peptide secreted by the Sertoli cells of the fetal testis and, later in gestation, by the granulosa cells of the fetal ovary. It starts to be secreted by the seventh week of intrauterine life and continues until puberty. It inhibits the development of the Müllerian system. Absence of AMH results in hermaphrodite.  

1.0AMH Blood Test

AMH test is a blood test. It needs a thin needle to take a blood sample from a  vein in your arm.

2.0AMH Normal Level/Range

• Normal value is 2–6.8 ng/mL
• Lower levels:1 ng/mL shows poor  ovarian reserve.
• Higher level :10 ng/mL is seen in PCOD and hyperstimulation syndrome.

3.0AMH Level and Fertility

• In the female, AMH is secreted by the granulosa cells after puberty. It helps in the follicular development and oocyte maturation. 
• Its level is related to precocious and delayed puberty, infertility and premature menopause.
• Its level is related and reflects the number of growing follicles. This test can provide an idea about the remaining quantity of eggs and duration of fertility but does not provide information about egg quality.
• Estimation of serum AMH is used in the study of ovarian reserve in an infertile woman and a woman with secondary amenorrhoea.
• In vitro fertilization programmes carry a prognostic value and help decide on donor eggs. 

4.0AMH Level and Other Related Conditions

• Immunoassay Able concentrations of AMH rise from birth to relatively high levels in the first year in newborn males, decrease by age 10, and decrease further during puberty.
• Newborn females have low or undetectable serum levels of AMH, which rise only slightly after that; serum AMH concentrations are virtually undetectable in most girls just before puberty.
•  Values are elevated in males with primitive Sertoli-like tumors and girls and women with granulosa cells; AMH is a useful gonadal tumor marker.
• Concentrations of AMH are slightly higher in individuals with delayed puberty than in pubertal age-matched control subjects and lower in those with testicular dysgenesis associated with impaired virilization than in normal boys. 
• However, boys with isolated cryptorchidism have normal values of AMH. The serum concentration of AMH is useful in determining the presence of testicular tissue and differentiating anorchia from bilateral cryptorchidism in prepubertal boys; in the former, AMH is absent, and in the latter, AMH is in the normal range.
• Patients with dysgenetic testes often have low serum levels of AMH, and measuring the testosterone response to hCG is indicated to assess the presence of testicular tissue.
• There is an inverse relationship between serum AMH and androgen concentrations in pubertal boys and in boys with true precocious puberty, in whom values were appropriate for the pubertal stage rather than chronological age; in addition, patients with androgen resistance have elevated serum AMH concentrations in the newborn period and again at puberty and after that.