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; in an infant, to evaluate the presence of external sex organs that are not clearly male or female (ambiguous genitalia) and/or function of the testicles in an infant boy
When to Get Tested?
When a health practitioner 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?
Anti-Müllerian hormone (AMH) is a hormone produced by reproductive tissues, including the testicles in males and the ovaries in females. The role of AMH and the amount normally present varies depending upon sex and age. This test measures AMH in the blood.
Very early in the development of a baby boy, 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 puberty, when it begins to taper off.
In girls, low levels of AMH are produced, thus allowing 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. AMH will then steadily decline in women over their reproductive years, becoming very low and eventually undetectable after menopause.
AMH is important for a woman during her childbearing years. At birth, a female has about one million eggs (oocytes), which then decrease naturally in number during childhood to about 500,000. Only a tiny number of these remaining eggs will go through follicle maturation – one at a time as part of a woman's monthly menstrual cycle. AMH has a balancing effect on the monthly cyclical actions of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) during the process of egg maturation and release (ovulation). 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 almost undetectable after menopause. Determining the AMH level may be 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.
AMH also plays a vital part in sexual differentiation in the fetus. During the first few weeks of pregnancy, a developing 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 Müllerian 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.
AMH may be elevated in some ovarian tumors (benign or cancerous). If a tumor produces the hormone, then the AMH test can be used as a tumor marker to monitor the effectiveness of treatment and to monitor for recurrence.
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.
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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.
Sources Used in Current Review
(Updated 2013 March 22). How is infertility diagnosed? Eunice Kennedy Shriver National Institute of Child Health and Human Development [On-line information]. Available online at http://www.nichd.nih.gov/health/topics/infertility/conditioninfo/Pages/diagnosed.aspx through http://www.nichd.nih.gov. Accessed January 2015.
(2014). What You Should Know About Your Reproductive Time Span. The North American Menopause Society, Menopause, v21 (1) [On-line information]. Available online at http://www.menopause.org/docs/default-source/for-women/what_you_should_know_about_your_reproductive_time-16.pdf through http://www.menopause.org. Accessed January 2015.
Storck, S. (Updated 2014 February 24). Infertility. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/001191.htm through http://www.nlm.nih.gov. Accessed January 2015.
(Updated 2013 June 20). Infertility FAQs. Centers for Disease Control and Prevention, Reproductive Health [On-line information]. Available online at http://www.cdc.gov/reproductivehealth/Infertility/ through http://www.cdc.gov. Accessed January 2015.
Shifren, J. and Gass, M. (2014). The North American Menopause Society Recommendations for Clinical Care of Midlife Women. Menopause. v21 (10):1038-1062 [On-line information]. Available online at http://www.medscape.com/viewarticle/832641 through http://www.medscape.com. Accessed January 2015.
Puscheck, E. and Woodard, T. (Updated 2014 November 17). Infertility. Medscape Drugs & Diseases [On-line information]. Available online at http://emedicine.medscape.com/article/274143-overview#showall through http://emedicine.medscape.com. Accessed January 2015.
(© 1995–2014). Anti Müllerian Hormone (AMH), Serum. Mayo Clinic Mayo Medical Laboratories [On-line information]. Available online at http://www.mayomedicallaboratories.com/test-catalog/Overview/89711 through http://www.mayomedicallaboratories.com. Accessed January 2015.
Sources Used in Previous Reviews
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.
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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.