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Anti-Mullerian Hormone (AMH), also known as Mullerian-Inhibiting Hormone (MIH), is a glycoprotein hormone from the transforming growth factor-beta superfamily that plays a function in growth differentiation and folliculogenesis. It is structurally linked to inhibin and activin. It is created by reproductive tissues, specifically the testes in males and the ovaries in females, prior to birth. AMH also has a function in puberty, as well as the ovaries and testes of adults. AMH (Anti-Müllerian Hormone) is a hormone that regulates fertility and reproductive development. The role of AMH, as well as the amount that is generally present, differ depending on gender and age. The AMH is important for the development of sexual differentiation in the foetus.
Key Terms: Anti Mullerian Hormone, Puberty, Folliculogenesis, AMH Test, Testes, Ovaries, Pregnancy, Foetus, Hormones, Sexual Differentiation, Reproductive Organs
Definition of Anti Mullerian Hormone
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Anti-Mullerian hormone (AMH) is a hormone produced and secreted by reproductive tissues such as the testicles and ovaries in males and females, respectively. Mullerian Inhibiting Factor (MIF), Mullerian Inhibiting Hormone (MIH), or Mullerian Inhibiting Substance are all names for the same substance. Anti Mullerian hormone is a protein that aids in the development of the male foetus' reproductive tract.
The role of AMH, as well as the amount that is generally present, differ depending on gender and age. The AMH is important for the development of sexual differentiation in the foetus. These hormones are created in the first trimester of pregnancy and before the baby is born.
Anti Mullerian Hormone
Read More: Human Development, Pregnancy Stages, Embryogenesis
Prognosis of AMH in Boys and Girls
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The testes release AMH early in a boy's development, which inhibits the development of female reproductive organs while promoting the development of male reproductive organs. AMH levels in boys stay high until adolescence, following which they begin to decline.
Girls, on the other hand, produce low levels of AMH at first, allowing the development of female reproductive systems. Until adolescence, the amount of AMH is low, but as the ovaries start to generate eggs and follicles, the developing follicles create more AMH, and the levels rise. As the reproductive phase of a person's life comes to an end, the level of AMH decreases until it is undetectable.
Read More: Difference between Adolescence and Puberty
Functions of Anti Mullerian Hormone
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The important functions of the Anti-Mullerian Hormone are as follows:
- In the foetus, AMH is important for sexual differentiation.
- In women, AMH helps to keep the monthly menstrual cycle in check.
- During the process of egg maturation and release, it promotes the activity of the follicle-stimulating hormone (FSH) and luteinizing hormone (LH) during ovulation.
- AMH encourages the development of additional male reproductive organs.
Actions of Anti-Mullerian Hormone in Ovary
Role of Anti Mullerian Hormone in the Human Body
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AMH is produced in the foetal testis and ovary before birth. The foetus has both Mullerian (female) and Wolffian (male) ducts about the seventh week after conception, which can develop into either the male or female reproductive system. The testes will produce AMH and the Mullerian ducts will vanish if the embryo has XY or male chromosomes. A lack of testosterone will cause the Wolffian duct to disappear and the Mullerian duct to develop into a female reproductive system if the embryo has XX or female chromosomes.
AMH aids in the early growth of follicles and plays a function in puberty. The number of follicles in a woman's ovaries can be determined by measuring AMH levels.
Read More: Hormonal Imbalance
Significance of Anti Mullerian Hormone
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The significance of Anti Mullerian Hormone is as follows:
- Both male and female organs may develop if a significant amount of AMH is not accessible or lacking during the foetal development process.
- Some ovarian cancer produces more AMH than others, therefore testing can be used to detect ovarian malignancies.
- Polycystic ovarian syndrome (PCOS) is linked to high AMH levels. A significant amount of AMH is produced as a result of the extra follicle in PCOS.
- The level of AMH can be used to determine a female's egg reserve and chances of conceiving.
- When follicles deteriorate or approach menopause, AMH is no longer generated. The level of AMH is used to determine if a woman is fertile or has reached menopause.
- Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) have a cyclical effect that is regulated by AMH.
Read More: Sex Hormones and Reproductive Functions
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Anti Mullerian Hormone: Disorders
Both male and primary female organs may develop if an adequate amount of AMH is not available during the development of a kid in the pregnancy. A baby with ambiguous genitalia may not be recognised as male or female right away.
Anti Mullerian Hormone Test (AMH Test)
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An Anti-Mullerian Hormone test, commonly known as an AMH test, is a type of blood test used to evaluate the function of the ovaries in women.
This test determines a woman's ability to produce eggs and fertilise them for pregnancy. It can also be used to determine a woman's ovarian reserve, or how many potential egg cells she has left.
AMH tests are used in women for a variety of diagnoses, including
- To be able to forecast when menopause will begin.
- To determine the cause of early menopause.
- This test aids in the detection of several kinds of ovarian cancer in women.
- To determine the cause of amenorrhea or the absence of menstruation.
- It is also conducted to find out what's causing missed or delayed menstruation in 15-year-old girls.
- It examines babies who have genitals that aren't clearly marked as male or female.
- In addition, the AMH test aids in the diagnosis of polycystic ovary syndrome (PCOS).
Hormone Levels and Risk Factors Related to AMH
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The hormone levels and the risk factors that are related to AMH are discussed below:
Hormone Levels
- Anti-Mullerian Hormone levels in girls are lower than in boys. The amount and function of AMH change based on sex and age. The anti-Mullerian hormone has a normal level of 1.2.
- The level of AMH in boys remains high until adolescence when it begins to decline.
- Low quantities of AMH are created in girls, allowing the female reproductive system to mature.
- The level of AMH in young girls remains low until adolescence when it rises when the ovaries begin to produce it.
Blood Level of AMH at the Normal Stage
| Range | AMH Blood Level |
|---|---|
| High | Above 3.0 ng/ml |
| Normal | Above 1.0 ng/ml |
| Low Normal | 0.6 — 0.9 ng/ml |
| Low | 0.4 — 0.7 ng/ml |
| Very Low | Less than 0.3 ng/ml |
Normal AMH Level in Females
| Age | Value |
|---|---|
| Younger than 24 months | Less than 5ng/mL |
| 24 months to 12 years | Less than 10ng/mL |
| 13–45 years | 1 to 10ng/mL |
| More than 45 years | Less than 1ng/mL |
Normal AMH Level in Males
| Age | Value |
|---|---|
| Younger than 24 months | 15 to 500 ng/mL |
| 24 months to 12 years | 7 to 240 ng/mL |
| More than 12 years | 0.7 to 20ng/mL |
Risk Factors
- Primary ovarian insufficiency is caused by low levels of AMH in women.
- Polycystic ovarian syndrome is caused by high amounts of AMH.
Polycystic Ovary
Read More: Androgen Hormone
Things to Remember
- Anti-Müllerian hormone (AMH) is a hormone produced and secreted by reproductive tissues in both males and females, including the testicles and ovaries.
- AMH is involved in the early development of follicles and plays a role in puberty. AMH levels can be used to determine the number of follicles in a woman's ovaries.
- High AMH levels have been associated with the polycystic ovarian syndrome (PCOS). As a result of the additional follicle in PCOS, a substantial amount of AMH is produced.
- An AMH test, or an Anti-Mullerian Hormone test, is a type of blood test used to assess the function of the ovaries in women. The ability of a woman to generate eggs and fertilise them for pregnancy is determined by this test.
- If an adequate amount of AMH is not available during the development of a child during pregnancy, both male and primary female organs may develop.
Sample Questions
Ques. Is vitamin D linked to an increase in AMH? Is it possible to improve AMH? (3 Marks)
Ans. Yes, vitamin D aids in the enhancement of anti-Müllerian hormone (AMH) production. Vitamin D supplementation may help to increase egg quality.
Yes, a well-balanced diet that contains whole grains, plenty of fruits and vegetables, and other organic foods can help with low-level AMH.
Ques. What role does AMH play in a man's development? (3 Marks)
Ans. The Sertoli cells of the male foetus produce AMH, which inhibits the development of the fallopian tube, uterus, and other female reproductive tissues. Furthermore, until puberty, the reproductive tissues of the testicles continue to produce AMH in males.
Ques. In females, where is AMH produced? (3 Marks)
Ans. It is produced solely in the gonads and is involved in follicular growth and development regulation. In the ovary, AMH is produced by the granulosa cells of early developing follicles and seems to be able to inhibit the initiation of primordial follicle growth and FSH-induced follicle growth.
Ques. Why is AMH so high in PCOS patients? (3 Marks)
Ans. AMH is a hormone produced by growing follicles or egg sacs that contain immature eggs. As the number of follicles decreases with age, AMH naturally decreases. We know that women with PCOS have high AMH levels, which is likely related to the high number of follicles they have at the start of their development.
Ques. What causes the anti-mullerian hormone to be produced? (3 Marks)
Ans. Anti-Müllerian hormone (AMH) is produced solely by granulosa cells in females. AMH has recently been identified as one of the most essential markers of ovarian reserve, with a strong link to ovarian follicular development.
Ques. Mullerian is what kind of inhibitor? (3 Marks)
Ans. The müllerian inhibitor, also known as müllerian-inhibiting substance (MIS) or anti-müllerian hormone (AMH), is a growth and differentiation factor that belongs to the transforming growth factor-beta (TGF-beta) family.
Ques. What occurs when AMH levels fluctuate? (3 Marks)
Ans. Insufficient quantities of AMH in males can result in the development of rudimentary feminine structures.
In females, high levels of AMH can cause tumours or polycystic ovarian syndrome (PCOS), as well as delayed puberty and irregular menstrual cycles.
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