We have been utilising a test for anti-Mullerian hormone clinically for a while now to help assess ovarian reserve – it is a marker of egg quantity, not quality! Assessment of ovarian reserve may provide insight into the remaining number of fertile years a woman has or may predict ovarian reserve prior to IVF treatment.

Ovarian reserve, constituted by the size of the ovarian follicle pool and the quality of the oocytes therein, declines with increasing age, resulting in the decrease of a woman’s reproductive function. AMH is a hormone marker for quantitative prediction of ovarian reserve, ovarian aging, ovarian dysfunction and ovarian responsiveness.

AMH levels correlate with the number of antral follicles. It has been documented that women with lower AMH and antral follicular counts produce a significantly lower number of oocytes compared with women with higher levels. Women with low AMH levels have fewer oocytes, have lower fertilisation rates, generate fewer embryos, and have a higher incidence of miscarriage during fresh transfers, ultimately culminating in a halving of the pregnancy rate per IVF cycle compared with women with high AMH levels.  When compared to using FSH and age, AMH acts as a superior predictor of live birth and anticipated oocyte yield.

I find this easy test extremely useful in clinic as it helps women to make informed decisions regarding their fertility – whether that is to bring their pregnancy plans forward or pursue IVF sooner rather than later.

Comparing anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH) as predictors of ovarian function.

Barad DH, Weghofer A, Gleicher N.

Center for Human Reproduction, New York, New York 10021, USA. dbarad@thechr.com

We compared predictive values of anti-Müllerian hormone (AMH) and baseline FSH with respect to IVF cycle outcomes based on oocyte numbers retrieved and number of clinical pregnancies established. In 76 IVF cycles investigated, AMH was clearly superior in predicting IVF outcomes in comparison with FSH.

Fertil Steril. 2009 Apr;91(4 Suppl):1553-5

PMID: 19217095