Anti Mullerian Hormone (AMH)
Anti-Mullerian Hormone (AMH) is a dimeric glycoprotein hormone structurally related to inhibin and activin, and a member of the transforming growth factor-β (TGF-β) family. It has also been called Mullerian Inhibiting Factor (MIF), Mullerian Inhibiting Hormone (MIH), and Mullerian Inhibiting Substance (MIS).
AMH is encoded by the AMH gene on chromosome 19p13.3, while the gene AMHR2 codes for its receptor on chromosome 12. AMH works by interacting with specific receptors on the surfaces of the cells of target tissues. The best known and most specific effect, mediated through the AMH type II receptors, includes programmed cell death (apoptosis) of the target tissue (the fetal mullerian ducts).
AMH is secreted by Sertoli cells of the testes during embryogenesis of the fetal male and prevents the development of the mullerian ducts into the uterus and other mullerian structures. The effect is ipsilateral, that is each testis suppresses mullerian development only on its own side. This action takes place by 8 weeks gestation. In female embryogenesis the absence of AMH allows for the development of upper vagina, uterus and cervix, and oviducts.
Amounts of AMH that are measurable in the blood vary by age and sex. While AMH is measurable in males during childhood and adulthood, AMH cannot be detected in women until puberty.
Indications for AMH Assay:
In men, inadequate embryonal AMH activity can lead to the