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AMH: a marker for ovarian reserve

AMH is secreted by preantral follicles and small antral follicles in the ovary, and its level is directly related to the number of follicles in the ovary. Schematic model of AMH actions in the ovary that is shown in Figure 1. 

Figure 1

Schematic model of AMH actions in the ovary

AMH is an indicator familiar to experts in gynecological endocrinology and assisted reproductive technology and is commonly used in ovarian reserve, ovarian responsiveness prediction, and PCOS disease diagnosis. AMH is the earliest hormone to change with age and is therefore a more accurate predictor of ovarian reserve in women at an earlier stage.

ESHRE consensus on the definition of‘poor response’to ovarian stimulation for in vitro fertilization.

AMH had the best sensitivity and specificity for predicting ovarian response.(Figure 2)

Figure 2

Clinical significance: 

• Evaluation of ovarian reserve

• Prediction of reproductive ovarian reactivity

• Predicting menopause

• Auxiliary diagnosis of ovarian related diseases in women (PCOS/POI)

Applicable departments: 

Physical examination center, reproductive center, gynecology, oncology, pediatrics

References:

1.NICE Clinical Guideline 156, 2013

2.Visser JA.et,al. Nat Rev Endocrinol. 2012 Jan 10;8(6):331-41.

3.Fleming R.et,al.Reprod Biomed Online. 2015 Oct;31(4):486-96.

4.Dumont A.et,al. Curr Opin Endocrinol Diabetes Obes. 2018 Dec;25(6):377-384.