Premature ovarian insufficiency: current point of view

Ovarian AMH expression seems to be absent in primordial follicles, theca cells or oocytes, but is highest in granulosa cells of pre-antral and small antral follicles. Interestingly, AMH is expressed in follicles that have undergone recruitment from the primordial follicle pool but have not been selected for dominance. Serum AMH concentrations, being stable and consistent throughout the menstrual cycle, constitute a reliable marker of ovarian reserve; thus, AMH has already found a role in the clinical practice, particularly when combined with classic markers of ovarian reserve such as age, Follicle Stimulating Hormone (FSH) and antral follicle count (AFC). AMH has emerged as a marker of ovarian reserve and a possible surrogate marker of reproductive aging. There is recent evidence that AMH is a strong predictor of time to menopause in women of late reproductive agewomen (20–49 years). For thosewho reached menopause, serum AMH concentrations six years before the event provided fairly accurate estimates of the age at menopause. Age and smoking are additional, independent predictors of this event.