Introduction
Infertility affects millions of couples worldwide and is defined as the inability to conceive after 12 months of regular, unprotected intercourse. Among the various biomarkers used to assess female fertility, Anti-Müllerian Hormone (AMH) has emerged as one of the most reliable indicators of ovarian reserve. Measuring AMH provides valuable insights into a woman’s reproductive potential and helps guide Fertility treatment strategies.
What Is AMH?
Anti-Müllerian Hormone (AMH) is a glycoprotein hormone produced by the granulosa cells of pre-antral and small antral follicles in the ovaries. It plays a key role in folliculogenesis, the process by which ovarian follicles mature and prepare for ovulation.
Unlike other reproductive hormones such as FSH (Follicle-Stimulating Hormone) or LH (Luteinizing Hormone), AMH levels remain relatively stable throughout the menstrual cycle, making it a convenient and reliable marker for Assessing ovarian reserve at any time.
AMH and Ovarian Reserve
- The ovarian reserve refers to the number and quality of remaining oocytes (eggs) in a woman’s ovaries. As a woman ages, her ovarian reserve naturally decline
- High AMH levels usually indicate a large pool of developing follicles, suggesting good ovarian reserve.
- Low AMH levels suggest a diminished ovarian reserve (DOR), which may be associated with reduced fertility potential.
- AMH levels typically begin to decline several years before menopause, making it a useful early indicator of reduced fertility.
Clinical Applications of AMH in Infertility
Assessment of Ovarian Reserve
AMH is widely used to evaluate a woman’s reproductive lifespan and predict her response to fertility treatments such as controlled ovarian stimulation in in vitro fertilization (IVF).
Predicting Response to Ovarian Stimulation
Women with higher AMH levels tend to respond well to gonadotropin stimulation and produce more oocytes during IVF cycles, while those with low AMH may have a poor response and require individualized treatment protocols.
Diagnosis of Polycystic Ovary Syndrome (PCOS)
AMH is often elevated in women with PCOS due to an increased number of small antral follicles. It can serve as a supportive biomarker in diagnosing PCOS, especially when ultrasound findings are inconclusive.
Prediction of Menopause
Long-term studies suggest that AMH can help estimate the time to menopause, offering useful information for family planning and fertility preservation counseling.
Fertility Preservation and Counseling
AMH testing helps identify women at risk of premature ovarian insufficiency (POI) or those who may benefit from fertility preservation strategies such as egg freezing, particularly before chemotherapy or radiotherapy.
Conclusion
Anti-Müllerian Hormone (AMH) has revolutionized the evaluation and management of infertility by providing a reliable estimate of ovarian reserve. Its stability throughout the menstrual cycle and predictive value in assisted reproductive techniques make it an invaluable biomarker in reproductive medicine. However, AMH should be interpreted within the broader clinical context to ensure accurate diagnosis and optimal treatment planning.
