Anti-Müllerian hormone: clinical implications in Gynecological Endocrinology. An update review

Anti-Müllerian hormone (AMH) is produced by the granulosa cells of the ovary with serum levels that grow until puberty, remain stable up to 30 years and then begin to decline until menopause. It is mainly produced by pre- and early antral follicles with an average diameter of 5-8 mm and it indirectly represents the ovarian reserve (OR). The purpose of this review is to identify what can currently be done with AMH, according to the most recent scientific evidence. AMH does not appear to be a marker for fertility as it does reflect the quantity but not the quality of follicles. It is not able to predict the spontaneous onset of pregnancy, nor the pregnancy rate in cycles of assisted reproduction technology (ART) but is a good predictor of ovarian response to hyperstimulation and it is useful in planning a couple’s fertility treatment even in the case of women undergoing chemotherapy, radiotherapy and ovarian surgery. It helps to identify women suffering from mild forms of polycystic ovary syndrome (PCOS) and diagnose and manage menopause and premature ovarian failure (POF). Finally, AMH levels may be used in case of granulosa cells tumors, both for diagnosis and follow up after surgery.