The Anti-Mullerian hormone: What are different AMH levels?

What are the different AMH levels?

The anti-Mullerian hormone or AMH was discovered in the 1950s by researcher Alfred Jost. Present from the very first weeks of gestation, it plays a key role in the formation of the sexual organs of the unborn child. Indeed, between the 8th and the 10th week of pregnancy, the Mullerian Inhibiting Substance (MIS) as it is also known, is secreted by Sertoli cells in the gonads (future testes) of male embryos. The objective: to inhibit the development of the Mullerian ducts which constitute the outline of the uterus, the fallopian tubes, and part of the vagina? In parallel, the gonads secrete testosterone which promotes differentiation towards a male genital tract (development of the Wolffian channels).
Conversely, in female embryos, the Mullerian ducts develop into the female genital tract, in the absence of AMH.

After birth, the anti-Mullerian hormone (AMH levels) can be detected:
• In the man in whom it is secreted from uterine life to puberty. During adulthood, AMH remains expressed in the seminal fluid.
• In the woman in whom it appears, after birth, under the action of the granulosa cells of the follicles. Present in very small quantities, it nevertheless plays an important role in folliculogenesis and is, as such, an indicator of the follicular reserve (or ovarian reserve).

What is the AMH test and why do we require an AMH level test?

The analysis of AMH or the AMH test is a key element of the infertility assessment, in the 2 members of the couple.

In fact, in women, the level of AMH in the blood tends to decrease with age in parallel with the number of follicles, unlike other pituitary hormones (FSH and Inhibin B). As such, the anti-Mullerian hormone is considered to be the best reflection of the ovarian reserve. In addition, AMH is a good indicator of the success rate of certain protocols for ART and of possible risks of ovarian hyperstimulation. Indeed, there is a correlation between the AMH level (high) and the number of oocytes punctured after ovarian stimulation. Finally, even if its evaluation is not recommended for diagnostic purposes (no threshold value established), the level of anti-Mullerian hormone can be, when it is high, an indicator of polycystic ovary syndrome (PCOS). This increase is explained in particular by the increased number of small follicles growing in patients with this syndrome.

In humans, the level of AMH is a good indicator of spermatogenesis. Indeed, according to some research, the level of AMH in the seminal fluid is considerably lower in men with azoospermia than in patients not experiencing fertility problems. Furthermore, this same rate is correlated with the number of sperm and the volume of the testes. The evaluation of the level of AMH is therefore not only important in the context of a fertility check-up but also extremely useful for specifying a treatment protocol in azoospermic patients since the azoospermia is non-obstructive. Finally, the level of AMH is useful in the research of certain male pediatric pathologies (ectopic testicles, precocious puberty, etc.).

What is the AMH test: Interpretation of the results of the AMH analysis?

Recommended in the context of the infertility assessment of the two members of the couple, the analysis of the serum markers of the anti-Mullerian hormone must be studied with great caution for several reasons:

• In women, it should be observed with regard to the age of the patient and the count of antral follicles (MFF) by ultrasound. Thus, if certain studies have shown that there is a threshold AMH value below which pregnancies become exceptional for certain women (aged 41/42), others have put forward that a low rate AMH is not a factor excluding young couples (under 30), candidates for IVF. Another special feature to note: the rate of AMH is not an indicator of the quality of ovulation.

• In humans, the analysis of AMH must be observed in relation to the spermogram and the patient's history in particular.

To know more about what is AMH test, AMH levels, AMH  level test, or AMH test, visit the best fertility clinic in India.