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Anti- Müllerian Hormone (AMH)

المؤلف:  Wass, J. A. H., Arlt, W., & Semple, R. K. (Eds.).

المصدر:  Oxford Textbook of Endocrinology and Diabetes

الجزء والصفحة:  3rd edition , p1279

2026-10-29

92

AMH is a homodimeric disulphide- linked glycoprotein of the transforming growth factor- β (TGF- β) superfamily. AMH level is lowest at birth and remains low during the prepubertal years; it then peaks during puberty and ultimately declines to undetectable levels at menopause. During ovarian follicle development, minimal AMH is produced by primordial follicles as was shown in immunohistochemistry studies in human ovarian tissue confirming the absence of AMH staining in primordial follicles. The pro duction of AMH increases in pre- antral and early antral follicles until a follicular diameter of 8 mm after which a sharp decline occurs. It was demonstrated that 5– 8 mm sized follicles contribute 60% of the circulating AMH. In contrast, granulosa cells of larger preovulatory follicles beyond 10 mm fail to produce AMH.

Anti- Müllerian hormone has been suggested as an ideal marker for assessing the remaining oocyte pool because it correlates with antral follicle counts (AFC), outcomes from ovarian stimulation, and the onset of menopause. AMH level can be an additional helpful assessment measure in women with PCOS, as it has been shown to correlate with polycystic ovaries. Serum AMH levels in women with PCOS are elevated 2- to 3- fold and are positively correlated with AFC and serum androgen levels. High serum AMH is specific but not sensitive to distinguish PCOS from asymptomatic women with polycystic ovaries.