Test Details
Anti-Mullerian Hormone (AMH)
Anti-Mullerian hormone (AMH) is a product of follicular cells in the ovaries of women of child-bearing age. As such, AMH is only present in the ovary until menopause. The assay is intended to assess ovarian reserve in women of child-bearing age.
Methodology
Chemiluminescent Immunoassay
Patient Preparation
None
Preferred Specimen
1.0 mL serum (0.5 mL minimum) collected in serum separator tube (SST / Tiger Top)
Alternate Specimen
None
Transport Temperature
Room temperature
Stability
14 days at room temperature
Lab Values
Anti-Mullerian Hormone (AMH)
Females
Optimal Values
| Age | ng/mL |
| <20 | Not established |
| 20 – 24 | 1.52 – 9.95 |
| 25 – 29 | 1.20 – 9.05 |
| 30 – 34 | 0.71 – 7.59 |
| 35 – 39 | 0.41 – 6.96 |
| 40 – 44 | 0.06 – 4.44 |
| >44 | Not established |
Clinical Significance
Anti-Mullerian Hormone (AMH)
Median values in women decline with age from about 4.0 ng/ml to about 0.50 ng/mL between age groups 26-30 years and 40-45 years. AMH is undetectable (<0.08 ng/mL) in post-menopausal women.
In one study which assessed ovarian follicle or egg count based on ultrasound analysis, 91.5% women with AMH values of ≤1.77 ng/mL had follicle count of ≤15 (low or normal ovarian reserve) and 8.5% had a follicle count of >15 (high ovarian reserve). In contrast, 51.6% of women with AMH values of >1.77 ng/mL, had a follicle count of >15, and 48.4% had a follicle count of ≤15. Therefore the AMH assay serves as a measure of ovarian reserve and follicle count as well as menopausal status.
References:
- Beckman ACCESS Anti-Muellerian Hormone Package Insert Reference B13127.
- Ledger WL. Clinical utility of measurement of anti-müllerian hormone in reproductive endocrinology. J Clin Endocrinol Metab. 2010;95::5144-54.
- 3. Fiçicioglu C, Kutlu T, Baglam E, Bakacak Z. Early follicular antimüllerian hormone as an indicator of ovarian reserve. Fertil Steril.2006;85:592-6.
- 4. Freeman EW, Sammel MD, Lin H, Boorman DW, Gracia CR. Contribution of the rate of change of antimüllerian hormone in estimating time to menopause for late reproductive-age women. Fertil Steril. 2012; 98:1254-9.
Treatment Options
Anti-Mullerian Hormone (AMH)
Clinicians may consider consultation with a fertility specialist or a reproductive endocrinologist if clinically indicated.
