AMH Hormon

What is AMH?

AMH, or anti-mullerian hormone is a substance that is produced by granulosa cells in ovarian follicles. It is first made in primary follicles after they advance from the primordial follicle stage. At these stages the follicles are microscopic in size and can not be seen by ultrasound.

AMH production is highest in the preantral and small antral stages (less than 4mm diameter) of follicle development. Production decreases and then stops as the follicles grow larger. There is almost no AMH made in human follicles over 8mm in size. Because of this, the levels are quite constant and the AMH test can be done on any day of a woman's cycle.

AMH and fertility

How can AMH hormone levels be a fertility test?

Since AMH is produced only in small ovarian follicles, blood levels of this substance have been used to attempt to measure the size of the pool of growing follicles in women.

Research shows that the size of the pool of growing follicles is heavily influenced by the size of the pool of remaining primordial follicles (microscopic follicles in "deep sleep"). Therefore, AMH blood levels are thought to reflect the size of the remaining egg supply - or ovarian reserve.

AMH levels and pregnancy chances with in vitro fertilization

Women with higher AMH values will tend to have better response to ovarian stimulation for IVF and have more eggs retrieved. In general, having more eggs with IVF gives a higher success rate.

Interpretation of anti-mullerian hormone levels and chances for conception

There are some problems involved with interpretation of AMH hormone levels. Because the test has not been in routine use for many years, the levels considered to be "normal" are not yet clarified and agreed on by the experts. Also, not all current commercial assays give equivalent results.

AMH levels vary from laboratory to laboratory, but 1.23 to 7.91 mg/ml in the age group 18 to 30 years is considered normal.