Anti Mullerian Hormone (AMH)
Anti-Mullerian Hormone (AMH) is a dimeric glycoprotein hormone structurally related to inhibin and activin, and a member of the transforming growth factor-β (TGF-β) family. It has also been called Mullerian Inhibiting Factor (MIF), Mullerian Inhibiting Hormone (MIH), and Mullerian Inhibiting Substance (MIS).
AMH is encoded by the AMH gene on chromosome 19p13.3, while the gene AMHR2 codes for its receptor on chromosome 12. AMH works by interacting with specific receptors on the surfaces of the cells of target tissues. The best known and most specific effect, mediated through the AMH type II receptors, includes programmed cell death (apoptosis) of the target tissue (the fetal mullerian ducts).
AMH is secreted by Sertoli cells of the testes during embryogenesis of the fetal male and prevents the development of the mullerian ducts into the uterus and other mullerian structures. The effect is ipsilateral, that is each testis suppresses mullerian development only on its own side. This action takes place by 8 weeks gestation. In female embryogenesis the absence of AMH allows for the development of upper vagina, uterus and cervix, and oviducts.
Amounts of AMH that are measurable in the blood vary by age and sex. While AMH is measurable in males during childhood and adulthood, AMH cannot be detected in women until puberty.
Indications for AMH Assay:
In men, inadequate embryonal AMH activity can lead to the Persistent Mullerian Duct Syndrome (PMDS), in which a rudimentary uterus is present and testes are usually undescended. The AMH gene or the gene AMH-R2 for its receptor are usually abnormal. AMH measurements have also become widely used in the evaluation of testicular presence and function in infants with intersex conditions, ambiguous genitalia and cryptorchidism.
In females, AMH is expressed by granulosa cells of the ovary in the reproductive age and controls the formation of primary follicles by inhibiting excessive follicular recruitment by FSH. It therefore has a role in folliculogenesis, and it is a measure of some aspects of ovarian function useful in assessing conditions such as polycystic ovary syndrome and premature ovarian failure.
AMH assessment is also useful in female fertility assessment as it provides a guide to ovarian reserve and identifies women who may need to consider trying for a pregnancy sooner rather than later if their long term future fertility is poor. Also, it could also be used to predict the prognosis of in vitro fertilization (IVF) cycles.
AMH is now done in Saridar Lab and the result will be ready after 48 hours.