The Anti-Müllerian hormone (AMH) is increasingly appearing on the blood tests of those patients visiting assisted reproduction centers. This hormone is being used in many clinical cases. It had been proved that it has a real predictive value when it comes to assisted reproduction treatments.
The different sections of this article have been assembled into the following table of contents.
The AMH is a homodimeric membrane glycoprotein and its main physiological action appears on the embryonic development when the sexual differentiation is taking place.
Its name refers to the fact that it inhibits the development of the Müllerian ducts in men. These ducts are responsible for the formation of the uterus and Fallopian tubes during the female’s embryonic development.
This hormone is found in both men and women. It is produced exclusively by the somatic cells that surround gametes (granule and Sertoli cells which involve both the eggs and the sperm), thus having a high level of specificity with them. This is the reason why the AMH is proposed as a biomarker for both the oocytes and the sperm action.
AMH in females
The AMH is conceived as a marker for the female’s ovarian reserve. This is very interesting since it provides more information about female fertility. Moreover, the assisted reproduction treatment that the couple should follow is determined according to the woman's ovarian reserve (among other data).
The AHM is produced by the granule cells of the preantral and the small antral follicles. Follicles are the group of cells which accompany and protect the oocyte while it grows within the ovaries.
Unlike other hormones that predict the ovarian reserve, such as FSH or estradiol, whose value depends on the menstrual cycle phase in which the female is, what makes this hormone's measuring particularly interesting is its independence from the menstrual cycle.
If all studies are confirmed and the predictive effect of the AMH is proved, it will become the ovarian marker per excellence. AMH levels are apparently very well-defined and its measuring is effective with patients with hyperstimulation and also those with a low ovarian response.
Within women, the AMH is an ideal endocrine marker of their ovarian reserve, reflecting not only the amount of ovarian follicles, but also the oocyte quality. It is said that the AMH is only produced by the "healthy follicles", which will give place to a high quality oocyte.
AMH in males
In men, the AMH is a good marker of the Sertoli cells (seminiferous tubule cells which give metabolic and structural support during the spermatogenesis) and it lets us evaluate the testicular function.
In the cases of males suffering from secreting azoospermia, this hormone's determination may help knowing whether sperm exist within the testicle, and whether these spermatozoids can be extracted through a biopsy in order to be used later on during an assisted reproduction technique such as the ICSI.
Within men before puberty, the AMH is a good marker for those Sertoli cells which work well. However, this hormone's determination has clinical relevance when evaluating the spermatogenic function of the adult testicle.
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