Using Anti-Müllerian Hormone to Determine Ovarian Reserve

Globally, infertility impacts millions of couples. For women, one challenge can be a lack of ovulation. Learn how AMH testing is used to determine egg reserve and help couples achieve their dream of parenthood.
Using Anti-Müllerian Hormone to Determine Ovarian Reserve

Evaluating Anti-Müllerian Hormone (AMH) levels is the first step to understand ovarian reserve, predict response to fertility treatments like in-vitro fertilization (IVF), and monitor the effectiveness of medications for fertility awareness. While AMH plays many other roles in human biology, its role in fertility assessment is especially germane for those striving to start a family.

Roughly 18% of the global population struggles with infertility—approximately 1 of every 6 people.1,2 While there are many potential causes of infertility, around 40% of cases are caused by anovulation or low ovarian reserve.3 Ovarian reserve, an estimate of the egg count, declines with age but also can decline due to certain disease treatments4 or simply genetics. For couples struggling with infertility, knowing the level of AMH present is a starting point on the journey to parenthood.

AMH Levels and Ovulation

The process of ovulation is a delicate balance of hormones. Hormones released by the hypothalamus, pituitary gland, and ovaries regulate the menstrual cycle. Follicle Stimulating Hormone (FSH) stimulates the development of follicles in the ovary, while Luteinizing Hormone (LH) triggers ovulation. Estradiol and progesterone are involved in producing and maintaining the uterine lining. AMH, a protein hormone produced by granulosa cells, serves as an indicator of ovarian reserve and overall reproductive health. In fertility treatments, higher AMH levels indicate that there are more eggs available for stimulation in in-vitro fertilization (IVF).5

AMH levels vary by age and can be used as both an indicator of fertility and a guide for fertility treatments. While a lower AMH level does not preclude successful pregnancy, women with higher levels have been shown to have more useable oocytes and improved oocyte quality in IVF treatment.5 AMH levels are used to determine ovarian response and adjust IVF medication dosages.

Other Applications for AMH testing

Recently, AMH levels were also incorporated in the workup to help diagnose conditions like polycystic ovary syndrome (PCOS)6 and to assess the risk of premature ovarian insufficiency (POI) or staging of menopause.4,5,7,8 Women with PCOS often require IVF due to irregular cycles and lower or lack of ovulation. In cases of POI with uncertain FSH-based testing results, AMH levels can also provide valuable insights.

In addition to its role in women’s health and fertility, AMH testing is used in counseling cancer patients about potential fertility loss, assessing ovarian function following chemotherapy or radiation treatment,7 to understand certain developmental anomalies,9–11 and monitoring the presence of granulosa tumors.12

The Future of AMH Diagnostic Testing

High-sensitivity AMH testing is expected to continue playing a vital role in helping couples achieve their dream of starting a family and assisting in monitoring and understanding women’s ovarian health. With further research and advancements, high-sensitivity AMH testing has the potential to fill the current gap where extremely low levels of AMH might have clinical significance to provide earlier and more complete information and lead to better understanding of the patient’s condition.

Our Commitment to Diagnostic Testing

Beckman Coulter and its proven high-sensitivity immunoassay capabilities are empowering healthcare providers, research organizations, and laboratories to address emerging diagnostic challenges across diverse specialties, from fertility to infectious diseases. We are revolutionizing the next generation in specialized diagnostics through high-sensitivity immunoassays, driving innovation, advancing medical insights, and enhancing diagnostic availability and adaptability to better serve patients in a variety of disease states. We remain committed to innovating high-sensitivity AMH testing to provide better health opportunities for a broader patient population.

Learn how to bring high-sensitivity immunoassay testing solutions to your laboratory.

The information in this blog is for educational purposes only and should not be taken as medical advice. If you are experiencing fertility challenges or would like more information about fertility testing, please contact your healthcare provider.

References:

1. Liu X, Zhang J, Wang S. Global, regional, and national burden of infertility attributable to PCOS, 1990-2019. Hum Reprod. 2024;39(1):108-118. doi:10.1093/humrep/dead241

2. World Health Organization. Infertility Prevalence Estimates, 1990-2021. (Safreed-Harmon K, ed.). World Health Organization; 2023.

3. Jose-Miller AB, Boyden JW, Frey KA. Infertility. Am Fam Physician. 2007;75(6):849-856.

4. Nelson SM, Davis SR, Kalantaridou S, Lumsden MA, Panay N, Anderson RA. Anti-Müllerian hormone for the diagnosis and prediction of menopause: a systematic review. Hum Reprod Update. 2023;29(3):327-346. doi:10.1093/humupd/dmac045

5. Vijay AS, Gopireddy MMR, Fyzullah S, et al. Association between AMH levels and fertility/reproductive outcomes among women undergoing IVF: A retrospective study. J Reprod Infertil. 2022;23(1):54-60. doi:10.18502/jri.v23i1.8453

6. Teede HJ, Tay CT, Laven JJE, et al. Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Eur J Endocrinol. 2023;189(2):G43-G64. doi:10.1093/ejendo/lvad096

7. Anderson RA, Cameron D, Clatot F, et al. Anti-Müllerian hormone as a marker of ovarian reserve and premature ovarian insufficiency in children and women with cancer: a systematic review. Hum Reprod Update. 2022;28(3):417-434. doi:10.1093/humupd/dmac004

8. Cappola AR, Auchus RJ, El-Hajj Fuleihan G, et al. Hormones and aging: an endocrine society scientific statement. J Clin Endocrinol Metab. 2023;108(8):1835-1874. doi:10.1210/clinem/dgad225

9. Josso N, Rey RA. What does AMH tell us in pediatric disorders of sex development? Front Endocrinol (Lausanne). 2020;11:619. doi:10.3389/fendo.2020.00619

10. Lee PA, Nordenström A, Houk CP, et al. Global Disorders of Sex Development Update since 2006: Perceptions, Approach and Care. Horm Res Paediatr. 2016;85(3):158-180. doi:10.1159/000442975

11. Renu D, Rao BG, Ranganath K, Namitha. Persistent mullerian duct syndrome. Indian J Radiol Imaging. 2010;20(1):72-74. doi:10.4103/0971-3026.59761

12. Shrikhande L, Shrikhande B, Shrikhande A. AMH and its clinical implications. J Obstet Gynaecol India. 2020;70(5):337-341. doi:10.1007/s13224-020-01362-0

Dr. Lindsay Sun, M.D., M.S.
Dr. Lindsay Sun, M.D., M.S.
Dr. Sun joined Beckman Coulter in 2009 and has focused on bringing clinical insights into product development for Immunoassay projects, currently working on biomarkers in heart failure, blood virus, and Reproductive Endocrinology. Her expertise in statistics and knowledge of medical needs ensure the quality of research study design and analysis.

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