Anti-Müllerian Hormone

July 6, 2022

What is AMH?

Anti-Müllerian hormone (AMH) is produced by granulosa cells of the ovaries in women and can be tested at home to help identify ovarian reserve or conditions such as PCOS.

Granulosa cells help develop eggs in the ovaries. As egg sacs develop, they secrete AMH, the more eggs there are in the ovaries, the higher the level of AMH in the blood.

AMH is used to measure the quantity of eggs produced by the ovaries, known as ovarian reserve. In women, it’s used to gather information about fertility.

AMH plays a significant role in the development of sex organs in a baby within the first few weeks of pregnancy.

In women, the levels of AMH are low at birth but rise during puberty as the ovaries begin to make AMH, before peaking in early adulthood. AMH levels tend to stay consistent throughout a woman’s menstrual cycle.

As women age, their ovarian reserve declines and as a result, AMH levels also fall. So, AMH is thought to be the best hormonal biomarker of a woman’s future reproductive lifespan.

How does AMH affect by wellbeing?

Low levels of AMH can indicate a low ovarian reserve which may affect a woman’s ability to get pregnant.

Recent research also shows that it is a good indicator of other ovarian-related conditions such as PCOS, granulosa cell tumours, and premature ovarian failure.

Ovarian conditions such as PCOS as well as granulosa cell tumours can also cause AMH levels to increase. Sometimes blood AMH levels are used to monitor the response of ovarian tumours to treatment. However, not all ovarian cancers produce detectable levels of AMH.

High levels of AMH are indicative of PCOS, with the most commons symptoms being:

  • acne or oily skin
  • difficulty getting pregnant
  • excessive hair growth especially on the face, chest, back or buttocks
  • irregular or absent periods
  • thinning hair and hair loss on the head
  • weight gain

Low levels of AMH are associated with premature ovarian failure, symptoms include:

  • anxiety
  • difficulty getting pregnant
  • difficulty sleeping
  • hot flushes
  • low mood
  • low sex drive
  • night sweats
  • vaginal dryness

Why take an AMH blood test?

An AMH blood test can help provide information about a woman’s fertility. It is used to identify the number of eggs in the ovaries, known as ovarian reserve.

It can also identify conditions related to the ovaries such as PCOS, tumours or premature ovarian failure.

In women, normal levels range from <50 pmol/L in young adults, gradually decreasing until menopause is reached where levels are undetectable.

The levels of AMH in women are linked with the number of follicles in the ovary. High levels of AMH may indicate polycystic ovary syndrome (PCOS) while low levels may indicate how many eggs there are in the ovaries, also known as ovarian reserve.

References

  • Grynnerup, A, G, A et al. The role of anti- Müllerian hormone in female fertility and infertility – an overview. Acta Obstet Gynecol Scand: 91(11), pp 1252-60.
  • Abbara, A et al. (2019) Anti-Müllerian hormone (AMH) in the diagnosis of menstrual disturbance due to polycystic ovarian syndrome. Frontiers in Endocrinology: 10.
  • Finkelstein, J, S et al. (2020). Antimullerian hormone and impending menopause in late reproductive age: the study of women’s health across the nation. J Clin Endocrinol Metab: 105(4), pp e1862-1871.
  • National Health Service. (2019). Symptoms Polycystic Ovary Syndrome. Available at: https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/symptoms/ [Accessed 02 June 2021].
  • National Health Service. (2021]. Early Menopause. Available at: https://www.nhs.uk/conditions/early-menopause/ [Accessed 02 June 2021].
    Lim, S, S et al. (2019). Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database Syst Rev: 3(3).
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This information has been medically reviewed by Dr Nicky Keay

Nicola has extensive clinical and research experience in the fields of endocrinology and sport and exercise medicine. Nicky is a member of the Royal College of Physicians, Honorary Fellow in the Department of Sport and Exercise Sciences at Durham University and former Research Fellow at St. Thomas' Hospital.

Dr Nicky Keay

Dr Nicky Keay

BA, MA (Cantab), MB, BChir, MRCP.