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Anti-Mullerian Hormone
Principle
Anti-Müllerian hormone (AMH) is a protein produced exclusively by the granulosa cells of the ovaries in women. Serum or plasma AMH levels reflect the number of antral follicles, serving as an indicator of ovarian reserve (egg supply) and helping predict response to fertility treatment. Unlike FSH and other hormones, serum AMH levels are relatively stable throughout the menstrual cycle.
AMH levels peak around age 25 and gradually decline thereafter, but values vary significantly between women of the same age. AMH is therefore particularly useful in assessing pregnancy potential and predicting age at menopause.
- AMH <0.7 ng/mL is associated with reduced (but not negligible) potential for pregnancy.
- AMH >3.4 ng/mL is associated with increased risk for ovarian hyperstimulation syndrome (OHSS).
- Women with polycystic ovary syndrome (PCOS) typically have AMH levels 2–5 times higher than the general population.
- In IVF patients experiencing OHSS, AMH may drop significantly due to antral follicle maturation.
Specimen Requirements
Specimen
Collection
Processing
Storage and Transport
≤ –20 °C; avoid repeated freeze–thaw cycles. For short-term storage (≤24 hours), samples may be kept at room temperature (15–30 °C). If testing will occur within 6 days, refrigerate at 2–8 °C.
Unacceptable Specimens
Lipemic or hemolyzed specimens (may yield inaccurate results)
Method
Enhanced chemiluminescence
Normal Range
| Women Age | AMH (ng/mL) |
| 13–45 | 0.9–9.5 (95% confidence interval) |
| >45 | <1.0 |
Turnaround Time
References
- Humaidan P, Quartarolo J, Papanikolaou EG. Preventing ovarian hyperstimulation syndrome: guidance for the clinician. Fertil Steril. 94(2):389–400; 2010.
- Weghofer A, Dietrich W, Barad DH, Gleicher N. Live birth chances in women with extremely low serum anti-Müllerian hormone levels. Hum Reprod. 26(7):1905–1909; 2011.
- Lie Fong S, Visser JA, Welt CK, et al. Serum anti-Müllerian hormone levels in healthy females: a nomogram ranging from infancy to adulthood. J Clin Endocrinol Metab. 97(12):4650–4655; 2012.
- Dewailly D, Anderson CY, Balen A, et al. The physiology and clinical utility of anti-Müllerian hormone in women. Hum Reprod Updates. 20(3):370–385; 2014.
- Broer S, Broekmans FJM, Laven JSE, Fraser BCJM. Anti-Müllerian hormone: ovarian reserve testing and its potential clinical implications. Hum Reprod Updates. 20(5):688–701; 2014.