What is an Anti-Mullerian Hormone (AMH) test?

An AMH test evaluates the amount of anti-Mullerian hormone present in the blood. AMH is produced in both males and females in the reproductive tissues. Its levels vary with gender and age groups. Development of sex organs in an unborn baby is greatly dependant on AMH.

  1. Why is an AMH test performed?
  2. How do you prepare for an AMH test?
  3. How is an AMH test performed?
  4. AMH test results and normal range

An AMH test is performed to evaluate the functioning of ovaries and fertility of a woman and predict the onset of menarche or menopause. This test is performed when a woman experiences signs and symptoms of polycystic ovarian syndrome (PCOS), which include:

  • Irregular or abnormal bleeding during menses
  • Skin of the neck becomes dark coloured and thick (acanthosis nigricans)
  • Pus-filled eruptions on face, neck and upper back (acne)
  • Amenorrhoea (absence of menstrual bleeding)
  • Altered or reduced breast size
  • Enlarged ovaries with presence of multiple cysts
  • Excess hair on body parts, such as face (hirsutism), including chin and upper lip; chest; inner thigh; areola; and pelvic area
  • Thinning of scalp hair and male-type baldness
  • Unexplained weight gain or obesity

AMH test is also helpful in diagnosing delayed puberty, early menopause and ovarian cancer (AMH producing) and determining the gender of ambiguous genitalia or in case of a male child with undescended testes to determine whether testicles are functioning normally.

An AMH test is done along with assisted reproductive techniques, such as in vitro fertilisation (IVF) to evaluating the responsiveness of the treatment.

In case of AMH-producing ovarian cancer, the effectiveness of the therapy and recurrence rate can also be determined.

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No special preparations are needed for this test.

It is a simple test that takes less than five minutes. An experienced laboratory specialist collects a small amount of blood in a sterile vial from a vein in your arm by inserting a small needle. A momentary pricking pain is felt when the needle goes into the vein.

Some people may experience, light-headedness and bruising at the site of injection with this test. However, at most times, these symptoms disappear quickly. Rarely, an infection may occur at the site of withdrawal of blood.

Normal results: Normal levels of AMH vary in males, females and different age groups. It indicates normal functioning of testicles in male infants with undescended testes; normal functioning of ovaries and absence of AMH-secreting ovarian cancer in females; along with absence of testicular tumour in males.

Abnormal results:

In women

  • Low levels indicate a reduced number of egg cells or poor quality of egg cells, which means diminishing fertility and poor response to IVF treatment.
  • Decreasing levels or significant reduction in levels indicate menopause or onset of menopause.
  • High levels indicate PCOS and poor response to the treatment or recurrence in AMH-producing ovarian cancer; in case of a woman who develops male-like characters, it can also indicate tumour of the adrenal glands.

In infants

  • Low levels or absence of AMH in male infants indicates poor functioning of testes or absence of testes or ambiguous genitalia.

In men

  • High levels indicate tumours of the testes (teratomas).

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational perspective and is in no way a substitute for medical advice from a qualified doctor.

References

  1. MedlinePlus Medical Encyclopedia: US National Library of Medicine; Anti-Müllerian Hormone Test
  2. Marie Lindhardt Johansen et al. Anti-Müllerian Hormone and Its Clinical Use in Pediatrics with Special Emphasis on Disorders of Sex Development. International Journal of Endocrinology Volume 2013, Article ID 198698, 10 pages.
  3. Inthrani R. Indran et al. Simplified 4-Item Criteria for Polycystic Ovary Syndrome A Bridge Too Far?. Clin Endocrinol. 2018;89:202-211.
  4. National Health and Medical Research Council: Australian Government; International evidence-based guideline for the assessment and management of polycystic ovary syndrome 2018
  5. Grynnerup AG, Lindhard A, Sørensen S. The role of anti-Müllerian hormone in female fertility and infertility - an overview.. Acta Obstet Gynecol Scand. 2012 Nov;91(11):1252-60. doi: 10.1111/j.1600-0412.2012.01471.x.
  6. Aleksandra Kruszyńska and Jadwiga Słowińska-Srzednicka. Anti-Müllerian hormone (AMH) as a good predictor of time of menopause. Prz Menopauzalny. 2017 Jun; 16(2): 47–50. PMID: 28721129
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