At a Glance
Why Get Tested?
In women, to evaluate ovarian function and fertility; sometimes in the evaluation of polycystic ovarian syndrome (PCOS), or to evaluate the effectiveness of ovarian cancer treatment; to evaluate the presence of ambiguous genitals and/or function of the testicles in an infant boy
When to Get Tested?
When a doctor wants to evaluate a woman's fertility, predict onset of menopause, or suspects PCOS; sometimes prior to some assisted reproductive procedures; periodically when a woman is undergoing treatment for an AMH-producing ovarian cancer; when it is suspected that the testicles of an infant boy are absent or not functioning properly
A blood sample drawn from a vein in your arm
Test Preparation Needed?
The Test Sample
What is being tested?
This test measures anti-Mullerian hormone (AMH) in the blood. AMH is a hormone produced by reproductive tissues; it is produced in the testicles in males and in the ovaries in females. The role of AMH and the amount normally present varies depending upon gender and age.
Very early in the development of a male fetus, AMH is produced by the testicles, inhibiting the development of female reproductive organs while promoting the development of other male reproductive organs. In boys, the level of AMH remains high until about 2 years of age, when it begins to taper off, and then it drops considerably at puberty.
Since female fetuses have no testicles, no AMH is produced at this stage and the absence of AMH allows the development of female reproductive structures. The AMH level in young girls remains low until puberty, when the ovaries begin to produce it, and levels increase significantly. In women, AMH will then steadily decline over their reproductive years, becoming very low and then undetectable after menopause.
AMH is important for a woman during her childbearing years. At birth, a female has about 1 million eggs (oocytes), which decrease in number during childhood to about 500,000. While many of these eggs do not mature due to natural degradation, a finite number of them are rescued by the follicle-stimulating hormone (FSH) to form mature follicles. AMH has a balancing effect on the cyclical actions of FSH during the monthly process of egg maturation and release (ovulation) as influenced by the presence of luteinizing hormone (LH). The amount of AMH present is a reflection of this follicular growth.
Studies have shown that the AMH level may be useful in determining a woman's remaining egg maturation potential (ovarian reserve) and her likelihood of conceiving. AMH declines over time during childbearing years, drops significantly as menopause approaches, and typically becomes undetectable after menopause. Determining the AMH level is useful in evaluating a woman's current fertility status and may predict the onset of menopause.
Elevated AMH levels have been associated with a condition affecting the ovaries known as polycystic ovarian syndrome (PCOS). The excess follicles that occur in this syndrome produce abnormally large amounts of AMH, as also may be found in certain types of ovarian tumors.
As stated earlier, AMH also plays a vital part in sexual differentiation in the fetus. During the first few weeks of pregnancy, a baby has the potential to develop either male or female reproductive organs. Production of AMH and androgens by the two testicles that are present in a baby boy inhibits development of female reproductive organs (the Mullerian ducts found in both male and female fetuses) and promotes the formation of other male reproductive organs. If a sufficient amount of AMH is not available or absent during this process, then both male and basic female organs may develop. A baby born with ambiguous genitalia may not be instantly recognized as either male or female.
How is the sample collected for testing?
A blood sample is obtained by inserting a needle into a vein in the arm.
NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.
Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.
Is any test preparation needed to ensure the quality of the sample?
No test preparation is needed.
Ask a Laboratory Scientist
This form enables you to ask specific questions about your tests. Your questions will be answered by a laboratory scientist as part of a voluntary service provided by one of our partners, American Society for Clinical Laboratory Science. If your questions are not related to your lab tests, please submit them via our Contact Us form. Thank you.
* indicates a required field
NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.
Douglas, D. (2010 December 9). Anti-Mullerian Hormones Drop as Women Age. Medscape Today from Reuters Health Information [On-line information]. Available online at http://www.medscape.com/viewarticle/733995 through http://www.medscape.com. Accessed May 2011.
Pasquali, R. et. al. (2011 March 29). Research in Polycystic Ovary Syndrome Today and Tomorrow. Medscape Today from Clin Endocrinol. 2011;74(4):424-433 [On-line information]. Available online at http://www.medscape.com/viewarticle/739208 through http://www.medscape.com. Accessed May 2011.
Vorvick, L. (Updated 2010 September 3). Anorchia. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/001185.htm. Accessed May 2011.
Bayrak-Toydemir, P. (Updated 2010 July). Infertility. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/Infertility.html?client_ID=LTD#tabs=0 through http://www.arupconsult.com. Accessed May 2011.
(© 1995–2011). Unit Code 89711: Antimullerian Hormone (AMH), Serum. Mayo Clinic Mayo Medical Laboratories [On-line information]. Available online at http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/89711 through http://www.mayomedicallaboratories.com. Accessed May 2011.
Sowers, M. et. al. (2008 September) Anti-Mullerian Hormone and Inhibin B in the Definition of Ovarian Aging and the Menopause Transition. Journal of Clinical Endocrinology & Metabolism Vol. 93, No. 9 3478-3483. [On-line information]. Available online at http://jcem.endojournals.org/cgi/content/full/93/9/3478 through http://jcem.endojournals.org. Accessed May 2011.
Achermann, J. Editor et. al. (2011 March). Ambiguous Genitalia. The Hormone Foundation [On-line information]. PDF available for download at http://www.hormone.org/Resources/upload/Ambiguous-Genitalia-Bilingual-WEB.pdf through http://www.hormone.org. Accessed May 2011.
Woznicki, K. (2010 June 28). Blood Test Helps Predict Menopause. Medscape Today from WebMD Health News [On-line information]. Available online at http://www.medscape.com/viewarticle/724256 through http://www.medscape.com. Accessed May 2011.
Eckman, A. (Updated 2010 August 31). Androgen insensitivity syndrome. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/001180.htm. Accessed May 2011.
Kronenberg, H. et. al. (© 2008). Williams Textbook of Endocrinology, 11th Edition: Saunders Elsevier, Philadelphia, PA. Pp 793, 800, 828.
Visser JA, et. Al: Anti-Mullerian hormone: a new marker for ovarian function. Reproduction 131:1-9, 2006.
Durlinger ALL, et. Al: Regulation of ovarian function: the role of anti-Mullerian hormone. Reproduction 124:601-609, 2002.
La Marca A, Volpe A: Anti-Mullerian hormone (AMH) in female reproduction: Is measurement of circulating AMH a useful tool? Clin Endrocrinol 64:603-610, 2006.
La Marca A, Volpe A: The anti-Mullerian hormone and ovarian cancer. Human Reproduction Update 13:265-273, 2007.