Anti-Mullerian Hormone

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Also known as: AMH; Mullerian-inhibiting hormone; MIH; Mullerian inhibiting factor; MIF; Mullerian-inhibiting substance; MIS
Formal name: Anti-Müllerian Hormone
Related tests: FSH, LH, Inhibin B, Estradiol (E2), Testosterone, Progesterone, Clomiphene Citrate Challenge

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

Sample Required?

A blood sample drawn from a vein in your arm

Test Preparation Needed?

None

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 sex 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 two 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 one 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.

The Test

Common Questions

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Article Sources

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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.

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