What is AMH?

Anti-Mullerian Hormone (MIS) is a glycoprotein secreted from ovum directly. Ovum up to 6 mm is secreted from ovular cells (granulose cells). AMH secretion starts at 36th gestational week in girls and continue until menopause. AMHmeasurement becomes common to present current ovum reserve and it is considered to have a strong relationship with ovum count. When ovum count decreases, blood levels of this indicator reduces. AMH secretion is not associated with Follicle Stimulating Hormone (FSH) which is another marker.

AMH measurement has some advantages when compared with FSH. - AMH measurement may be performed in anytime during the month; however, FSH levels vary. - AMH is not affected by blood estrogen levels; FSH is suppressed with high dose estrogen; low doses may be deceptive. – AMH does not have great changes between months; single measurement is sufficient; FSH reduces by age. - AMH may provide a preliminary information for ovary response to be obtained in the treatment; it may be helpful in bad response or over stimulation may be helpful. However, it should be reminded that AMH levels does not provide an exact result for pregnancy and it is not a determinant for menopause age as well; pregnancies have been obtained with very low AMH levels. Blood AMH values performed on a healthy woman under 38 years with normal ovum count at 3rd day of menstrual cycle is 2.0 to 6.8 ng/ml; however it was found higher in patients with polycystic ovary.

Fertility Potential (Fertility: AMH levels ng/ml)

  • Optimal Fertility 4.0- 6.8
  • Sufficient Fertility 2.2 – 4.0
  • Low fertility 0.3 – 2.2
  • Very Low fertility 0.0 – 0.3
  • High Level (Risk for over stimulation) >6.8

AMH measurements may be used to determined fertility potential and treatment response of the woman. Serum AMH levels are associated with ovum count in the ovary; a woman with low AMH levels will probably give bad response to the treatment. Furthermore, AMH levels will provide a warning about reduced ovum reserve.

There is a relation between increased ovum cells (granulose) and AMH in women with polycystic ovary. AMH levels have been found 6.8 ng/ml in women with PCO; this value helps to diagnose polycystic ovary and inform Over Hyperstimulation Syndrome (OHSS) risk that may be developed during the treatment before. 


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