Anti-Müllerian hormone level measurement in gynaecology: Myths and clinical utility

Anti-Mullerian hormone (AMH) is a glycoprotein implicated in the regulation of the pace of ovarian follicular recruitment and loss and follicle selection in adult females. AMH predicts the magnitude of the response to controlled ovarian stimulation for assisted reproductive techniques and is used to individualize treatments and avoid ovarian hyperstimulation syndrome. In contrast, AMH levels do not seem to be related to fecundability or time to pregnancy and do not predict the results intrauterine inseminations or natural cycle in vitro fertilisation. AMH fluctuates only in a minor way during the menstrual cycle allowing its measure without regard to the menstrual cycle phase. The impact of hormonal treatments such as the oral contraceptive pill is still debated. AMH levels can also be used to study the impact of medical treatments, surgical procedure or environmental factors on ovarian reserve.