AMH (Anti-Mullerian Hormone)
Understanding AMH (Anti-Mullerian Hormone)
What is AMH (Anti-Mullerian Hormone)?
An AMH (Anti-Mullerian Hormone) test measures the level of anti-Mullerian hormone (AMH) in your body. Though both men and women produce AMH, this test is frequently used in women to determine their reproductive health. AMH levels provide insights into ovarian reserve (the number and quality of eggs in the ovaries) and help assess fertility.
Anti-Mullerian hormone (AMH), also known as Mullerian-inhibiting hormone (MIH), is produced by the testes in males and ovaries in females. The role of AMH and its amount in the body varies by gender and age. This hormone helps in determining the development and functioning of the reproductive organs.
In women, AMH is produced by the ovaries and is one of the best markers to assess a woman’s ovarian reserve (the number and quality of eggs in the ovaries). Ovarian reserve affects a woman’s ability to conceive naturally or through assisted reproductive methods, such as in vitro fertilization (IVF). Though their ovarian reserve and AMH levels decline as they age, measuring these levels can provide insights into a woman's reproductive health and status. Your doctor may suggest an AMH test to monitor the response to injectable fertility drugs during IVF and diagnose menstruation abnormalities.
Higher-than-normal AMH levels are often associated with fertility issues, polycystic ovarian syndrome (PCOS), or conditions that can lead to anovulation (when an egg doesn’t release from the ovaries) and irregular menstrual cycles. In contrast, low AMH levels may suggest diminished ovarian reserve, which can concern fertility, especially in women over 35.
In men, AMH is produced by the testes in high amounts before puberty. After puberty, the level of this hormone decreases and thus can be used as a marker to check for issues related to fertility. In infants, this test may help learn more about a baby's genital parts that are not clearly defined (a condition known as ambiguous genitalia).
Usually, no special preparation is required for taking an AMH (Anti-Mullerian Hormone) test. You can eat and drink at your convenience. However, it is recommended not to take birth control pills before this test as they can interfere with your test results. Furthermore, AMH levels do not change during the menstrual cycle; hence, the blood sample can be given at any time of the month.
Test result ranges are approximate and may differ slightly between labs. Talk to your doctor about your specific test results. It is important to note that AMH levels are just one aspect of fertility assessment, and a comprehensive evaluation considering other factors, such as age, medical history, and lifestyle factors, is recommended to assess and manage reproductive health.
What is AMH (Anti-Mullerian Hormone) used for?
An AMH (Anti-Mullerian Hormone) test is done:
- To assess ovarian reserve (the quantity and quality of eggs remaining in a woman's ovaries).
- As a part of the initial fertility evaluation for individuals or couples experiencing difficulty conceiving.
- To determine the effectiveness of assisted reproductive procedures, like in vitro fertilization (IVF).
- To help diagnose polycystic ovarian syndrome (PCOS) and menstruation abnormalities.
- To evaluate testicular function in male infants and children with ambiguous/abnormal genitalia.
- To help estimate where an individual is in their reproductive aging process and make informed decisions about family planning.
- To provide some insight into the timing of menopause for women.
What does AMH (Anti-Mullerian Hormone) measure?
An AMH (Anti-Mullerian Hormone) test evaluates the amount of AMH available in your body. AMH is produced by the granulosa cells of the ovarian follicles in females and the Sertoli cells of the testes in males. During the early development of a baby boy, AMH levels are high, which inhibits the development of female reproductive organs while promoting the development of male reproductive organs. On the contrary, in a girl child, low levels of AMH are produced, thus allowing the development of female reproductive structures. The AMH level in young girls remains low until puberty but increases significantly, reaching a peak in early adulthood. AMH levels tend to decrease with age and are undetectable in postmenopausal women.
AMH plays a vital role in developing ovarian follicles in women and is considered an important marker of ovarian reserve, which can be essential in assessing fertility. In men, this hormone is involved in the development and functioning of the testes. Measuring AMH levels in the blood provides critical information about reproductive health in both men and women, which can help assess fertility and guide treatment.
Interpreting AMH (Anti-Mullerian Hormone) results
Interpretations
Males:
|
Age |
Blood AMH Level |
|
Below 24 months |
14 to 466 ng/ml |
|
24 months to 12 years |
7.4 to 243 ng/ml |
|
Above 12 years |
0.7 to 19 ng/ml |
Females:
|
Age |
Blood AMH Level |
|
Below 24 months |
Below 4.7 ng/ml |
|
24 months to 12 years |
Below 8.8 ng/ml |
|
13 to 45 years |
0.9 to 9.5 ng/ml |
|
Above 45 years |
Below 1.0 ng/ml |
Results in the normal range indicate high fertility and ovarian reserve and a high chance of IVF success.
The low normal range results indicate low fertility and ovarian reserve and a reduced but fair chance of IVF success.
Results in the very low range indicate a very low ovarian reserve and low chances of reproductive success with IVF.
High AMH levels are usually seen in PCOS and some AMH-producing ovarian tumors.
Answers to Patient Concerns & Frequently Asked Questions (FAQs) about AMH (Anti-Mullerian Hormone)
Frequently Asked Questions about AMH (Anti-Mullerian Hormone)
Q. What is an AMH (Anti-Mullerian Hormone) test used for?
Q. How is an AMH (Anti-Mullerian Hormone) test performed?
Q. Can I take an AMH (Anti-Mullerian Hormone) test during the menstruation period?
Q. What do high AMH levels indicate?
Q. Does low AMH mean early menopause?
Q. Can men undergo AMH testing?
Q. What is the function of the anti-Mullerian hormone in males?
Q. How can I increase my AMH levels naturally?
Q. What additional tests can be done along with an AMH (Anti-Mullerian Hormone) test?
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References
- La Marca A, Broekmans FJ, Volpe A, Fauser BC, Macklon NS; ESHRE Special Interest Group for Reproductive Endocrinology--AMH Round Table. Anti-Mullerian hormone (AMH): what do we still need to know? Hum Reprod. 2009 Sep;24(9):2264-75. [Accessed 20 Sep. 2023]. Available from: https://pubmed.ncbi.nlm.nih.gov/19520713/
- Oh SR, Choe SY, Cho YJ. Clinical application of serum anti-Müllerian hormone in women. Clin Exp Reprod Med. 2019 Jun;46(2):50-59. [Accessed 20 Sep. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6572668/
- Banerjee K, Thind A, Bhatnagar N, Singla B, Agria K, Bajaj P, Jindal A, Arora S, Goyal P, Mittal B, Malhotra K, Pai H, Malhotra J, Goel P, Jindal N. Effect of Reproductive and Lifestyle Factors on Anti-Mullerian Hormone Levels in Women of Indian Origin. J Hum Reprod Sci. 2022 Jul-Sep;15(3):259-271. [Accessed 20 Sep. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9635372/
- Matuszczak E, Hermanowicz A, Komarowska M, Debek W. Serum AMH in Physiology and Pathology of Male Gonads. Int J Endocrinol. 2013 Oct. 24;2013:128907. [Accessed 20 Sep. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3824311/#:~:text=AMH%20is%20secreted%20by%20immature,in%20testicular%20development%20and%20function.
- La Marca A, Stabile G, Artenisio AC, Volpe A. Serum anti-Mullerian hormone throughout the human menstrual cycle. Hum Reprod. 2006 Dec;21(12):3103-7. [Accessed 20 Sep. 2023]. Available from: https://pubmed.ncbi.nlm.nih.gov/16923748/
- White ND. Influence of Sleep on Fertility in Women. Am J Lifestyle Med. 2016 Apr 3;10(4):239-241. [Accessed 20 Sep. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6125064/#:~:text=Sleep%2C%20sleep%20disturbance%2C%20and%2F,(AMH)%2C%20and%20progesterone.
- Dong YZ, Zhou FJ, Sun YP. Psychological stress is related to a decrease of serum anti-müllerian hormone level in infertile women. Reprod Biol Endocrinol. 2017 Jul 11;15(1):51. [Accessed 20 Sep. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5504612/
- Szczuko M, Kikut J, Szczuko U, Szydłowska I, Nawrocka-Rutkowska J, Ziętek M, Verbanac D, Saso L. Nutrition Strategy and Life Style in Polycystic Ovary Syndrome-Narrative Review. Nutrients. 2021 Jul 18;13(7):2452. [Accessed 20 Sep. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8308732/
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