Clinical application of serum anti‐Müllerian hormone as an ovarian reserve marker: A review of recent studies

Abstract

It has been more than 15 years since the measurement of serum anti-Müllerian hormone (AMH) first allowed the quantitative assessment of ovarian reserve. Meanwhile, the clinical implication of serum AMH has been expanding. The measurement of serum AMH has been applied in various clinical fields, including assisted reproduction, menopause, reproductive disorders and assessment of ovarian damage/toxicity. Well-known findings about the usefulness of serum AMH revealed by numerous studies executed in the early era include decline with aging, a good correlation with oocyte yield in assisted reproduction, upregulation in polycystic ovarian syndrome and a decrease on ovarian surgery and toxic treatment. More intensive research, including a meta-analysis, cutting-edge clinical trial and advances in AMH assays, has yielded newer findings and firmer clinical interpretations in serum AMH in the past few years. Variations in the AMH decline trajectory in the general population do not support the accurate prediction of menopause. The ability to predict pregnancy in infertility treatment and natural conception is poor, while a nomogram integrating serum AMH as a stimulation protocol is useful for avoiding poor and/or hyper-responses. On the other hand, improvements in measuring very low concentrations of serum AMH may be capable of distinguishing women with poor ovarian function. Age-independent standardization of AMH values may be helpful for comparing ovarian reserves among women at different ages.

Do dietary intakes influence the rate of decline in anti-Mullerian hormone among eumenorrheic women? A population-based prospective investigation

“…The numbers of ovarian follicles represent the reproductive age of women and their reproductive capacity [1]. Anti-mullerian hormone (AMH), now suggested as the best indirect measures of ovarian reserve [1], has different implications in clinical practice, from diagnosis of women with polycystic ovarian syndrome (PCOS) or those with diminished ovarian reserve to prediction of infertility treatment success rates and time to menopause [2–4]. Generally, AMH decreases gradually as the follicular pool declines and becomes undetectable when menopause occurs [1].…”

Spontaneous pregnancies in female survivors of childhood allogeneic haemopoietic stem cell transplant for haematological malignancies

“…Low anti‐Mullerian hormone (AMH) has been reported in 26/28 survivors of either autologous or allogeneic HSCT during childhood for a range of malignant and nonmalignant conditions 16 . Although low AMH predicts ovarian reserve, pregnancy is not infrequently reported in women with low AMH who have not been exposed to gonadotoxins, 17,18 as seen in 2 of our cohort where AMH levels were available.…”

Genes for anti-Müllerian hormone and androgen receptor are underexpressed in human cumulus cells surrounding morphologically highly graded oocytes

“…Although the serum AMH level might be considered as an indicator of ovarian reserve, as it reflects the size of the developing follicles pool, it is not associated with the AMH level in individual follicles, or with the quality of the associated oocytes. 45–47…”