AMH - ANTI MULLERIAN HORMONE

The AMH - ANTI MULLERIAN HORMONE test measures anti-Müllerian hormone in the blood. In females, AMH is produced by the granulosa cells surrounding small developing follicles in the ovaries. Its concentration provides an estimate of the remaining pool of recruitable ovarian follicles and is commonly used as a marker of ovarian reserve. The test is frequently included in fertility assessments and may help specialists plan assisted reproductive treatments such as ovarian stimulation and in vitro fertilisation.

AMH does not directly count eggs, assess egg quality or guarantee whether natural conception will occur. Fertility is influenced by age, ovulation, fallopian-tube health, uterine factors, sperm quality and other medical considerations. The result therefore needs to be interpreted together with clinical history, ultrasound findings and additional reproductive hormone tests.

Benefits of the Test

• Provides an estimate of ovarian reserve.
• Supports fertility evaluation and reproductive planning.
• Helps predict the likely ovarian response to fertility medicines.
• Assists specialists in individualising ovarian-stimulation protocols.
• May contribute to the evaluation of polycystic ovary syndrome.
• Can be used to monitor selected ovarian conditions or treatments.

Why Doctors Recommend This Test

A gynaecologist or fertility specialist may recommend AMH testing when a woman has difficulty conceiving, is considering fertility treatment, plans to preserve fertility, has irregular menstrual cycles or has risk factors for reduced ovarian reserve. These risk factors can include increasing reproductive age, ovarian surgery, endometriosis, chemotherapy, radiotherapy or a family history of early menopause.

Lower AMH levels may suggest a reduced number of remaining recruitable follicles, but they do not prove that pregnancy is impossible. Some individuals with low AMH can still ovulate and conceive naturally. Higher AMH levels may be seen in people with a larger follicle pool and are often associated with polycystic ovary syndrome, but AMH alone does not diagnose PCOS. A higher value may also indicate a greater risk of an excessive response to ovarian-stimulation medicines, so fertility specialists use it to help select treatment doses.

AMH can also serve as a tumour marker in selected patients with granulosa-cell tumours of the ovary and may assist with monitoring after treatment. In males and children, specialist doctors may use AMH as part of the evaluation of testicular function, sexual development, undescended testes or differences of sex development.

Preparation Before Test

Fasting is generally not required. AMH changes less during the menstrual cycle than hormones such as FSH and can often be measured on any cycle day. However, patients should follow the collection timing recommended by their fertility specialist because the result may be reviewed with cycle-specific tests or ultrasound.

Inform the doctor about pregnancy, hormonal contraceptives, fertility medicines, previous ovarian surgery and all current treatments. Hormonal contraception and certain medical factors may influence AMH concentration. Do not stop prescribed medication unless advised by the treating doctor. A routine venous blood sample is required.

Normal Reporting Time

The AMH test is a specialized hormone immunoassay, and the result is commonly available within one to two working days. Turnaround time may vary according to the collection centre, testing schedule, sample transportation, instrument availability and need for repeat analysis. Focus Diagnostics will provide the applicable reporting estimate during sample collection.

Who Should Take This Test?

• Women undergoing fertility or ovarian-reserve assessment.
• Patients preparing for IVF or another assisted reproductive procedure.
• Women considering egg or embryo freezing.
• Patients with irregular periods or suspected polycystic ovary syndrome.
• Women with endometriosis, previous ovarian surgery or gonadotoxic treatment.
• Patients being monitored for selected ovarian tumours.
• Children or males undergoing specialist evaluation of testicular function or sexual development.

Detailed Information

AMH levels are generally higher during the years of greatest reproductive potential and decline as the number of ovarian follicles decreases with age. Levels usually become very low around menopause. A result should be compared with an age-appropriate, assay-specific reference interval. Different laboratories and testing platforms may produce results that are not directly interchangeable, so follow-up measurements are preferably performed using the same method.

AMH is useful for predicting ovarian response during assisted reproduction, including the likelihood of a low or excessive response to stimulation. It is less reliable for predicting egg quality, embryo quality, natural conception, pregnancy outcome or the exact age at menopause. Age remains a major factor affecting egg quality, even when AMH is within a favourable range.

Doctors may interpret AMH alongside an antral follicle count performed by ultrasound, FSH, LH, estradiol, thyroid tests, prolactin and other fertility investigations. In suspected PCOS, evaluation also includes menstrual history, evidence of androgen excess and ovarian morphology. In male or paediatric assessment, testosterone, LH, FSH, imaging, genetic studies or other tests may be required.

A low or high result should not be treated without considering the complete clinical picture. The most appropriate next step may include fertility counselling, ultrasound, additional laboratory tests, modification of an IVF protocol or monitoring by a gynaecologist, reproductive endocrinologist or other specialist.