Skip to main content
SpringerLink
Log in

Anti-Müllerian hormone as a marker of ovarian reserve: What have we learned, and what should we know?

  • Review Article
  • Published:
Reproductive Medicine and Biology

Abstract

Ovarian reserve reflects the quality and quantity of available oocytes. This reserve has become indispensable for the better understanding of reproductive potential. Measurement of the serum anti-Müllerian hormone (AMH) level allows quantitative evaluation of ovarian reserve. It has been applied to a wide range of clinical conditions, and it is well established that the measurement of serum AMH levels is more useful than qualitative evaluation based on the menstrual cycle. AMH levels are monitored during infertility treatments; in patients undergoing medically assisted reproductive technology; and in the diagnosis of ovarian failure, polycystic ovarian syndrome, and granulosa cell tumor. It is also useful in the evaluation of iatrogenic ovarian damage. Population-based studies have indicated a potential role for serum AMH in the planning of reproductive health management. While AMH is currently the best measure of ovarian reserve, its predictive value for future live births remains controversial. Furthermore, there is a serious practical issue in the interpretation of test results, as currently available assay kits use different assay ranges and coefficients of variation due to the absence of an international reference standard. The pros and cons of the serum AMH level as a definitive measure of ovarian reserve merits further review in order to guide future research.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Broekmans FJ, Kwee J, Hendriks DJ, Mol BW, Lambalk CB. A systematic review of tests predicting ovarian reserve and IVF outcome. Hum Reprod Update. 2006;12(6):685–718.

    Article  CAS  PubMed  Google Scholar 

  2. Durlinger AL, Gruijters MJ, Kramer P, Karels B, Ingraham HA, Nachtigal MW, Uilenbroek JT, Grootegoed JA, Themmen AP. Anti-Müllerian hormone inhibits initiation of primordial follicle growth in the mouse ovary. Endocrinology. 2002;143(3):1076–84.

    CAS  PubMed  Google Scholar 

  3. Weenen C, Laven JS, Von Bergh AR, Cranfield M, Groome NP, Visser JA, Kramer P, Fauser BC, Themmen AP. Anti-Müllerian hormone expression pattern in the human ovary: potential implications for initial and cyclic follicle recruitment. Mol Hum Reprod. 2004;10(2):77–83.

    Article  CAS  PubMed  Google Scholar 

  4. Anderson RA, Nelson SM, Wallace WH. Measuring anti-Müllerian hormone for the assessment of ovarian reserve: when and for whom is it indicated? Maturitas. 2012;71(1):28–33.

    Article  CAS  PubMed  Google Scholar 

  5. de Vet A, Laven JS, de Jong FH, Themmen AP, Fauser BC. Anti-Müllerian hormone serum levels: a putative marker for ovarian aging. Fertil Steril. 2002;77(2):357–62.

    Article  PubMed  Google Scholar 

  6. Fanchin R, Schonauer LM, Righini C, Guibourdenche J, Frydman R, Taieb J. Serum anti-Müllerian hormone is more strongly related to ovarian follicular status than serum inhibin B, estradiol, FSH and LH on day 3. Hum Reprod. 2003;18(2):323–7.

    Article  CAS  PubMed  Google Scholar 

  7. van Rooij IA, Broekmans FJ, Scheffer GJ, Looman CW, Habbema JD, de Jong FH, Fauser BJ, Themmen AP, te Velde ER. Serum anti-Müllerian hormone levels best reflect the reproductive decline with age in normal women with proven fertility: a longitudinal study. Fertil Steril. 2005;83(4):979–87.

    Article  PubMed  CAS  Google Scholar 

  8. La Marca A, Sighinolfi G, Radi D, Argento C, Baraldi E, Artenisio AC, Stabile G, Volpe A. Anti-Müllerian hormone (AMH) as a predictive marker in assisted reproductive technology (ART). Hum Reprod Update. 2010;16(2):113–30.

    Article  PubMed  CAS  Google Scholar 

  9. van Disseldorp J, Lambalk CB, Kwee J, Looman CW, Eijkemans MJ, Fauser BC, Broekmans FJ. Comparison of inter- and intra-cycle variability of anti-Müllerian hormone and antral follicle counts. Hum Reprod. 2010;25(1):221–7.

    Article  PubMed  Google Scholar 

  10. Loh JS, Maheshwari A. Anti-Müllerian hormone–is it a crystal ball for predicting ovarian ageing? Hum Reprod. 2011;26(11):2925–32.

    Article  CAS  PubMed  Google Scholar 

  11. Nelson SM. Biomarkers of ovarian response: current and future applications. Fertil Steril. 2013;99(4):963–9.

    Article  CAS  PubMed  Google Scholar 

  12. Pandian Z, Marjoribanks J, Ozturk O, Serour G, Bhattacharya S. Number of embryos for transfer following in vitro fertilisation or intra-cytoplasmic sperm injection. Cochrane Database Syst Rev. 2013;7:CD003416.

    PubMed  Google Scholar 

  13. Seifer DB, MacLaughlin DT, Christian BP, Feng B, Shelden RM. Early follicular serum Müllerian-inhibiting substance levels are associated with ovarian response during assisted reproductive technology cycles. Fertil Steril. 2002;77(3):468–71.

    Article  PubMed  Google Scholar 

  14. Broer SL, Dolleman M, Opmeer BC, Fauser BC, Mol BW, Broekmans FJ. AMH and AFC as predictors of excessive response in controlled ovarian hyperstimulation: a meta-analysis. Hum Reprod Update. 2011;17(1):46–54.

    Article  CAS  PubMed  Google Scholar 

  15. Broer SL, Dolleman M, van Disseldorp J, Broeze KA, Opmeer BC, Bossuyt PM, Eijkemans MJ, Mol BW, Broekmans FJ. Prediction of an excessive response in in vitro fertilization from patient characteristics and ovarian reserve tests and comparison in subgroups: an individual patient data meta-analysis. Fertil Steril. 2013;100(2):420–9 (e7).

    Article  PubMed  Google Scholar 

  16. Broer SL, Mol BW, Hendriks D, Broekmans FJ. The role of anti-Müllerian hormone in prediction of outcome after IVF: comparison with the antral follicle count. Fertil Steril. 2009;91(3):705–14.

    Article  CAS  PubMed  Google Scholar 

  17. Broer SL, van Disseldorp J, Broeze KA, Dolleman M, Opmeer BC, Bossuyt P, Eijkemans MJ, Mol BW, Broekmans FJ. Added value of ovarian reserve testing on patient characteristics in the prediction of ovarian response and ongoing pregnancy: an individual patient data approach. Hum Reprod Update. 2013;19(1):26–36.

    Article  PubMed  Google Scholar 

  18. Nelson SM, Yates RW, Lyall H, Jamieson M, Traynor I, Gaudoin M, Mitchell P, Ambrose P, Fleming R. Anti-Müllerian hormone-based approach to controlled ovarian stimulation for assisted conception. Hum Reprod. 2009;24(4):867–75.

    Article  CAS  PubMed  Google Scholar 

  19. Anckaert E, Smitz J, Schiettecatte J, Klein BM, Arce JC. The value of anti-Müllerian hormone measurement in the long GnRH agonist protocol: association with ovarian response and gonadotrophin-dose adjustments. Hum Reprod. 2012;27(6):1829–39.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. La Marca A, Sunkara SK. Individualization of controlled ovarian stimulation in IVF using ovarian reserve markers: from theory to practice. Hum Reprod Update. 2014;20(1):124–40.

    Article  PubMed  CAS  Google Scholar 

  21. Lan VT, Linh NK, Tuong HM, Wong PC, Howles CM. Anti-Müllerian hormone versus antral follicle count for defining the starting dose of FSH. Reprod Biomed Online. 2013;27(4):390–9.

    Article  CAS  PubMed  Google Scholar 

  22. La Marca A, Papaleo E, Grisendi V, Argento C, Giulini S, Volpe A. Development of a nomogram based on markers of ovarian reserve for the individualisation of the follicle-stimulating hormone starting dose in in vitro fertilisation cycles. BJOG. 2012;119(10):1171–9.

    Article  PubMed  CAS  Google Scholar 

  23. Yates AP, Rustamov O, Roberts SA, Lim HY, Pemberton PW, Smith A, Nardo LG. Anti-Müllerian hormone-tailored stimulation protocols improve outcomes whilst reducing adverse effects and costs of IVF. Hum Reprod. 2011;26(9):2353–62.

    Article  CAS  PubMed  Google Scholar 

  24. La Marca A, Argento C, Sighinolfi G, Grisendi V, Carbone M, D’Ippolito G, Artenisio AC, Stabile G, Volpe A. Possibilities and limits of ovarian reserve testing in ART. Curr Pharm Biotechnol. 2012;13(3):398–408.

    Article  PubMed  Google Scholar 

  25. Eldar-Geva T, Ben-Chetrit A, Spitz IM, Rabinowitz R, Markowitz E, Mimoni T, Gal M, Zylber-Haran E, Margalioth EJ. Dynamic assays of inhibin B, anti-Müllerian hormone and estradiol following FSH stimulation and ovarian ultrasonography as predictors of IVF outcome. Hum Reprod. 2005;20(11):3178–83.

    Article  CAS  PubMed  Google Scholar 

  26. Nelson SM, Yates RW, Fleming R. Serum anti-Müllerian hormone and FSH: prediction of live birth and extremes of response in stimulated cycles–implications for individualization of therapy. Hum Reprod. 2007;22(9):2414–21.

    Article  CAS  PubMed  Google Scholar 

  27. Silberstein T, MacLaughlin DT, Shai I, Trimarchi JR, Lambert-Messerlian G, Seifer DB, Keefe DL, Blazar AS. Müllerian inhibiting substance levels at the time of HCG administration in IVF cycles predict both ovarian reserve and embryo morphology. Hum Reprod. 2006;21(1):159–63.

    Article  CAS  PubMed  Google Scholar 

  28. Fanchin R, Mendez Lozano DH, Frydman N, Gougeon A, Di Clemente N, Frydman R, Taieb J. Anti-Müllerian hormone concentrations in the follicular fluid of the preovulatory follicle are predictive of the implantation potential of the ensuing embryo obtained by in vitro fertilization. J Clin Endocrinol Metab. 2007;92(5):1796–802.

    Article  CAS  PubMed  Google Scholar 

  29. Ficicioglu C, Kutlu T, Baglam E, Bakacak Z. Early follicular anti-Müllerian hormone as an indicator of ovarian reserve. Fertil Steril. 2006;85(3):592–6.

    Article  CAS  PubMed  Google Scholar 

  30. Penarrubia J, Fabregues F, Manau D, Creus M, Carmona F, Casamitjana R, Vanrell JA, Balasch J. Previous cycle cancellation due to poor follicular development as a predictor of ovarian response in cycles stimulated with gonadotrophin-releasing hormone agonist-gonadotrophin treatment. Hum Reprod. 2005;20(3):622–8.

    Article  CAS  PubMed  Google Scholar 

  31. Smeenk JM, Sweep FC, Zielhuis GA, Kremer JA, Thomas CM, Braat DD. Anti-Müllerian hormone predicts ovarian responsiveness, but not embryo quality or pregnancy, after in vitro fertilization or intracytoplasmic sperm injection. Fertil Steril. 2007;87(1):223–6.

    Article  CAS  PubMed  Google Scholar 

  32. van Rooij IA, Broekmans FJ, Hunault CC, Scheffer GJ, Eijkemans MJ, de Jong FH, Themmen AP, te Velde ER. Use of ovarian reserve tests for the prediction of ongoing pregnancy in couples with unexplained or mild male infertility. Reprod Biomed Online. 2006;12(2):182–90.

    Article  PubMed  Google Scholar 

  33. Iliodromiti S, Kelsey TW, Wu O, Anderson RA, Nelson SM. The predictive accuracy of anti-Müllerian hormone for live birth after assisted conception: a systematic review and meta-analysis of the literature. Hum Reprod Update. 2014;20(4):560–70.

    Article  CAS  PubMed  Google Scholar 

  34. Tal R, Tal O, Seifer BJ, Seifer DB. Anti-Müllerian hormone as predictor of implantation and clinical pregnancy after assisted conception: a systematic review and meta-analysis. Fertil Steril. 2015;103(1):119–30 (e3).

    Article  CAS  PubMed  Google Scholar 

  35. Arce JC, La Marca A, Klein BM, Andersen AN, Fleming R. Anti-Müllerian hormone in gonadotropin releasing-hormone antagonist cycles: prediction of ovarian response and cumulative treatment outcome in good-prognosis patients. Fertil Steril. 2013;99(6):1644–53.

    Article  CAS  PubMed  Google Scholar 

  36. Brodin T, Hadziosmanovic N, Berglund L, Olovsson M, Holte J. Anti-Müllerian hormone levels are strongly associated with live-birth rates after assisted reproduction. J Clin Endocrinol Metab. 2013;98(3):1107–14.

    Article  CAS  PubMed  Google Scholar 

  37. La Marca A, Spada E, Grisendi V, Argento C, Papaleo E, Milani S, Volpe A. Normal serum anti-Müllerian hormone levels in the general female population and the relationship with reproductive history. Eur J Obstet Gynecol Reprod Biol. 2012;163(2):180–4.

    Article  PubMed  CAS  Google Scholar 

  38. Leader B, Hegde A, Baca Q, Stone K, Lannon B, Seifer DB, Broekmans F, Baker VL. High frequency of discordance between anti-Müllerian hormone and follicle-stimulating hormone levels in serum from estradiol-confirmed days 2 to 4 of the menstrual cycle from 5,354 women in U.S. fertility centers. Fertil Steril. 2012;98(4):1037–42.

    Article  CAS  PubMed  Google Scholar 

  39. Nelson SM, Iliodromiti S, Fleming R, Anderson R, McConnachie A, Messow CM. Reference range for the anti-Müllerian hormone Generation II assay: a population study of 10,984 women, with comparison to the established Diagnostics Systems Laboratory nomogram. Fertil Steril. 2014;101(2):523–9.

    Article  CAS  PubMed  Google Scholar 

  40. Nelson SM, Messow MC, McConnachie A, Wallace H, Kelsey T, Fleming R, Anderson RA, Leader B. External validation of nomogram for the decline in serum anti-Müllerian hormone in women: a population study of 15,834 infertility patients. Reprod Biomed Online. 2011;23(2):204–6.

    Article  PubMed  Google Scholar 

  41. Nelson SM, Messow MC, Wallace AM, Fleming R, McConnachie A. Nomogram for the decline in serum anti-Müllerian hormone: a population study of 9,601 infertility patients. Fertil Steril. 2011;95(2):736–41 (e1–3).

    Article  CAS  PubMed  Google Scholar 

  42. Steiner AZ, Herring AH, Kesner JS, Meadows JW, Stanczyk FZ, Hoberman S, Baird DD. Anti-Müllerian hormone as a predictor of natural fecundability in women aged 30–42 years. Obstet Gynecol. 2011;117(4):798–804.

    Article  CAS  PubMed  Google Scholar 

  43. Hagen CP, Vestergaard S, Juul A, Skakkebaek NE, Andersson AM, Main KM, Hjollund NH, Ernst E, Bonde JP, Anderson RA, et al. Low concentration of circulating anti-Müllerian hormone is not predictive of reduced fecundability in young healthy women: a prospective cohort study. Fertil Steril. 2012;98(6):1602–8 (e2).

    Article  CAS  PubMed  Google Scholar 

  44. Burger HG, Dudley EC, Hopper JL, Groome N, Guthrie JR, Green A, Dennerstein L. Prospectively measured levels of serum follicle-stimulating hormone, estradiol, and the dimeric inhibins during the menopausal transition in a population-based cohort of women. J Clin Endocrinol Metab. 1999;84(11):4025–30.

    CAS  PubMed  Google Scholar 

  45. Dolleman M, Faddy MJ, van Disseldorp J, van der Schouw YT, Messow CM, Leader B, Peeters PH, McConnachie A, Nelson SM, Broekmans FJ. The relationship between anti-Müllerian hormone in women receiving fertility assessments and age at menopause in subfertile women: evidence from large population studies. J Clin Endocrinol Metab. 2013;98(5):1946–53.

    Article  CAS  PubMed  Google Scholar 

  46. Broer SL, Eijkemans MJ, Scheffer GJ, van Rooij IA, de Vet A, Themmen AP, Laven JS, de Jong FH, Te Velde ER, Fauser BC, et al. Anti-Müllerian hormone predicts menopause: a long-term follow-up study in normoovulatory women. J Clin Endocrinol Metab. 2011;96(8):2532–9.

    Article  CAS  PubMed  Google Scholar 

  47. Tehrani FR, Solaymani-Dodaran M, Azizi F. A single test of anti-Müllerian hormone in late reproductive-aged women is a good predictor of menopause. Menopause. 2009;16(4):797–802.

    Article  PubMed  Google Scholar 

  48. Dolleman M, Depmann M, Eijkemans MJ, Heimensem J, Broer SL, van der Stroom EM, Laven JS, Van Rooij IA, Scheffer GJ, Peeters PH, et al. Anti-Müllerian hormone is a more accurate predictor of individual time to menopause than mother’s age at menopause. Hum Reprod. 2014;29(3):584–91.

    Article  CAS  PubMed  Google Scholar 

  49. Ramezani Tehrani F, Dolleman M, van Disseldorp J, Broer SL, Azizi F, Solaymani-Dodaran M, Fauser BC, Laven JS, Eijkemans MJ, Broekmans F. Predicting menopausal age with anti-Müllerian hormone: a cross-validation study of two existing models. Climacteric. 2014;17(5):583–90.

    Article  CAS  PubMed  Google Scholar 

  50. Baker VL. Primary ovarian insufficiency in the adolescent. Curr Opin Obstet Gynecol. 2013;25(5):375–81.

    Article  PubMed  Google Scholar 

  51. Chao KC, Ho CH, Shyong WY, Huang CY, Tsai SC, Cheng HY, Chou LC, Lin CH, Li HY. Anti-Müllerian hormone serum level as a predictive marker of ovarian function in Taiwanese women. J Chin Med Assoc. 2012;75(2):70–4.

    Article  CAS  PubMed  Google Scholar 

  52. Kallio S, Aittomaki K, Piltonen T, Veijola R, Liakka A, Vaskivuo TE, Dunkel L, Tapanainen JS. Anti-Müllerian hormone as a predictor of follicular reserve in ovarian insufficiency: special emphasis on FSH-resistant ovaries. Hum Reprod. 2012;27(3):854–60.

    Article  CAS  PubMed  Google Scholar 

  53. Visser JA, Schipper I, Laven JS, Themmen AP. Anti-Müllerian hormone: an ovarian reserve marker in primary ovarian insufficiency. Nat Rev Endocrinol. 2012;8(6):331–41.

    CAS  PubMed  Google Scholar 

  54. Knauff EA, Eijkemans MJ, Lambalk CB, ten Kate-Booij MJ, Hoek A, Beerendonk CC, Laven JS, Goverde AJ, Broekmans FJ, Themmen AP, et al. Anti-Müllerian hormone, inhibin B, and antral follicle count in young women with ovarian failure. J Clin Endocrinol Metab. 2009;94(3):786–92.

    Article  CAS  PubMed  Google Scholar 

  55. La Marca A, Marzotti S, Brozzetti A, Stabile G, Artenisio AC, Bini V, Giordano R, De Bellis A, Volpe A, Falorni A. Primary ovarian insufficiency due to steroidogenic cell autoimmunity is associated with a preserved pool of functioning follicles. J Clin Endocrinol Metab. 2009;94(10):3816–23.

    Article  PubMed  CAS  Google Scholar 

  56. Dewailly D, Lujan ME, Carmina E, Cedars MI, Laven J, Norman RJ, Escobar-Morreale HF. Definition and significance of polycystic ovarian morphology: a task force report from the Androgen Excess and Polycystic Ovary Syndrome Society. Hum Reprod Update. 2014;20(3):334–52.

    Article  CAS  PubMed  Google Scholar 

  57. Overbeek A, Lambalk CB. Phenotypic and pharmacogenetic aspects of ovulation induction in WHO II anovulatory women. Gynecol Endocrinol. 2009;25(4):222–34.

    Article  PubMed  Google Scholar 

  58. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19–25.

    Article  Google Scholar 

  59. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19(1):41–7.

    Article  Google Scholar 

  60. Dewailly D, Gronier H, Poncelet E, Robin G, Leroy M, Pigny P, Duhamel A, Catteau-Jonard S. Diagnosis of polycystic ovary syndrome (PCOS): revisiting the threshold values of follicle count on ultrasound and of the serum AMH level for the definition of polycystic ovaries. Hum Reprod. 2011;26(11):3123–9.

    Article  CAS  PubMed  Google Scholar 

  61. Eilertsen TB, Vanky E, Carlsen SM. Anti-Müllerian hormone in the diagnosis of polycystic ovary syndrome: can morphologic description be replaced? Hum Reprod. 2012;27(8):2494–502.

    Article  CAS  PubMed  Google Scholar 

  62. Li L, Chen X, Mo Y, Chen Y, Wenig M, Yang D. Elevated serum anti-Müllerian hormone in adolescent and young adult Chinese patients with polycystic ovary syndrome. Wien Klin Wochenschr. 2010;122(17–18):519–24.

    Article  CAS  PubMed  Google Scholar 

  63. Pigny P, Jonard S, Robert Y, Dewailly D. Serum anti-Müllerian hormone as a surrogate for antral follicle count for definition of the polycystic ovary syndrome. J Clin Endocrinol Metab. 2006;91(3):941–5.

    Article  CAS  PubMed  Google Scholar 

  64. Lin YH, Chiu WC, Wu CH, Tzeng CR, Hsu CS, Hsu MI. Anti-Müllerian hormone and polycystic ovary syndrome. Fertil Steril. 2011;96(1):230–5.

    Article  CAS  PubMed  Google Scholar 

  65. Hart R, Doherty DA, Norman RJ, Franks S, Dickinson JE, Hickey M, Sloboda DM. Serum anti-Müllerian hormone (AMH) levels are elevated in adolescent girls with polycystic ovaries and the polycystic ovarian syndrome (PCOS). Fertil Steril. 2010;94(3):1118–21.

    Article  CAS  PubMed  Google Scholar 

  66. Woo HY, Kim KH, Rhee EJ, Park H, Lee MK. Differences of the association of anti-Müllerian hormone with clinical or biochemical characteristics between women with and without polycystic ovary syndrome. Endocr J. 2012;59(9):781–90.

    Article  CAS  PubMed  Google Scholar 

  67. Homburg R, Ray A, Bhide P, Gudi A, Shah A, Timms P, Grayson K. The relationship of serum anti-Müllerian hormone with polycystic ovarian morphology and polycystic ovary syndrome: a prospective cohort study. Hum Reprod. 2013;28(4):1077–83.

    Article  CAS  PubMed  Google Scholar 

  68. Li HW, Anderson RA, Yeung WS, Ho PC, Ng EH. Evaluation of serum anti-Müllerian hormone and inhibin B concentrations in the differential diagnosis of secondary oligoamenorrhea. Fertil Steril. 2011;96(3):774–9.

    Article  CAS  PubMed  Google Scholar 

  69. Iliodromiti S, Kelsey TW, Anderson RA, Nelson SM. Can anti-Müllerian hormone predict the diagnosis of polycystic ovary syndrome? A systematic review and meta-analysis of extracted data. J Clin Endocrinol Metab. 2013;98(8):3332–40.

    Article  CAS  PubMed  Google Scholar 

  70. Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, Janssen OE, Legro RS, Norman RJ, Taylor AE, et al. The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril. 2009;91(2):456–88.

    Article  PubMed  Google Scholar 

  71. Sahmay S, Aydin Y, Atakul N, Aydogan B, Kaleli S. Relation of anti-Müllerian hormone with the clinical signs of hyperandrogenism and polycystic ovary morphology. Gynecol Endocrinol. 2014;30(2):130–4.

    Article  CAS  PubMed  Google Scholar 

  72. Laven JS, Mulders AG, Visser JA, Themmen AP, De Jong FH, Fauser BC. Anti-Müllerian hormone serum concentrations in normoovulatory and anovulatory women of reproductive age. J Clin Endocrinol Metab. 2004;89(1):318–23.

    Article  CAS  PubMed  Google Scholar 

  73. Piouka A, Farmakiotis D, Katsikis I, Macut D, Gerou S, Panidis D. Anti-Müllerian hormone levels reflect severity of PCOS but are negatively influenced by obesity: relationship with increased luteinizing hormone levels. Am J Physiol Endocrinol Metab. 2009;296(2):E238–43.

    Article  CAS  PubMed  Google Scholar 

  74. Thomson RL, Buckley JD, Moran LJ, Noakes M, Clifton PM, Norman RJ, Brinkworth GD. The effect of weight loss on anti-Müllerian hormone levels in overweight and obese women with polycystic ovary syndrome and reproductive impairment. Hum Reprod. 2009;24(8):1976–81.

    Article  CAS  PubMed  Google Scholar 

  75. Farquhar C, Brown J, Marjoribanks J. Laparoscopic drilling by diathermy or laser for ovulation induction in anovulatory polycystic ovary syndrome. Cochrane Database Syst Rev. 2012;6:CD001122.

    PubMed  Google Scholar 

  76. Amer SA, Li TC, Ledger WL. The value of measuring anti-Müllerian hormone in women with anovulatory polycystic ovary syndrome undergoing laparoscopic ovarian diathermy. Hum Reprod. 2009;24(11):2760–6.

    Article  CAS  PubMed  Google Scholar 

  77. Elmashad AI. Impact of laparoscopic ovarian drilling on anti-Müllerian hormone levels and ovarian stromal blood flow using three-dimensional power Doppler in women with anovulatory polycystic ovary syndrome. Fertil Steril. 2011;95(7):2342–6 (2346 e1).

    Article  CAS  PubMed  Google Scholar 

  78. Bath LE, Wallace WH, Shaw MP, Fitzpatrick C, Anderson RA. Depletion of ovarian reserve in young women after treatment for cancer in childhood: detection by anti-Müllerian hormone, inhibin B and ovarian ultrasound. Hum Reprod. 2003;18(11):2368–74.

    Article  CAS  PubMed  Google Scholar 

  79. Iwase A, Nakamura T, Nakahara T, Goto M, Kikkawa F. Anti-Müllerian hormone and assessment of ovarian reserve after ovarian toxic treatment: a systematic narrative review. Reprod Sci. 2015;22(5):519–26.

    Article  CAS  PubMed  Google Scholar 

  80. Anders C, Marcom PK, Peterson B, Gu L, Unruhe S, Welch R, Lyons P, Behera M, Copland S, Kimmick G, et al. A pilot study of predictive markers of chemotherapy-related amenorrhea among premenopausal women with early stage breast cancer. Cancer Invest. 2008;26(3):286–95.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  81. Anderson RA, Themmen AP, Al-Qahtani A, Groome NP, Cameron DA. The effects of chemotherapy and long-term gonadotrophin suppression on the ovarian reserve in premenopausal women with breast cancer. Hum Reprod. 2006;21(10):2583–92.

    Article  CAS  PubMed  Google Scholar 

  82. Yu B, Douglas N, Ferin MJ, Nakhuda GS, Crew K, Lobo RA, Hershman DL. Changes in markers of ovarian reserve and endocrine function in young women with breast cancer undergoing adjuvant chemotherapy. Cancer. 2010;116(9):2099–105.

    CAS  PubMed  PubMed Central  Google Scholar 

  83. Decanter C, Morschhauser F, Pigny P, Lefebvre C, Gallo C, Dewailly D. Anti-Müllerian hormone follow-up in young women treated by chemotherapy for lymphoma: preliminary results. Reprod Biomed Online. 2010;20(2):280–5.

    Article  CAS  PubMed  Google Scholar 

  84. Bozza C, Puglisi F, Lambertini M, Osa EO, Manno M, Del Mastro L. Anti-Müllerian hormone: determination of ovarian reserve in early breast cancer patients. Endocr Relat Cancer. 2014;21(1):R51–65.

    Article  CAS  PubMed  Google Scholar 

  85. Gracia CR, Sammel MD, Freeman E, Prewitt M, Carlson C, Ray A, Vance A, Ginsberg JP. Impact of cancer therapies on ovarian reserve. Fertil Steril. 2012;97(1):134–40 (e1).

    Article  PubMed  Google Scholar 

  86. Rosendahl M, Andersen CY, la Cour Freiesleben N, Juul A, Lossl K, Andersen AN. Dynamics and mechanisms of chemotherapy-induced ovarian follicular depletion in women of fertile age. Fertil Steril. 2010;94(1):156–66.

    Article  CAS  PubMed  Google Scholar 

  87. Cancer Research UK [Internet]. A trial looking at ovarian protection for premenopausal women having chemotherapy for breast cancer (OPTION). http://www.cancerresearchuk.org/about-cancer/find-a-clinical-trial/a-trial-looking-at-ovarian-protection-for-premenopausal-women-having-chemotherapy-for-breast-cancer. Accessed 28 Sept 2009.

  88. Anderson RA, Hindmarsh PC, Wallace WH. Induction of puberty by autograft of cryopreserved ovarian tissue in a patient previously treated for Ewing sarcoma. Eur J Cancer. 2013;49(13):2960–1.

    Article  PubMed  Google Scholar 

  89. Wallace WH, Smith AG, Kelsey TW, Edgar AE, Anderson RA. Fertility preservation for girls and young women with cancer: population-based validation of criteria for ovarian tissue cryopreservation. Lancet Oncol. 2014;15(10):1129–36.

    Article  PubMed  PubMed Central  Google Scholar 

  90. Somigliana E, Vercellini P, Vigano P, Ragni G, Crosignani PG. Should endometriomas be treated before IVF-ICSI cycles? Hum Reprod Update. 2006;12(1):57–64.

    Article  PubMed  Google Scholar 

  91. Chang HJ, Han SH, Lee JR, Jee BC, Lee BI, Suh CS, Kim SH. Impact of laparoscopic cystectomy on ovarian reserve: serial changes of serum anti-Müllerian hormone levels. Fertil Steril. 2010;94(1):343–9.

    Article  CAS  PubMed  Google Scholar 

  92. Iwase A, Hirokawa W, Goto M, Takikawa S, Nagatomo Y, Nakahara T, Manabe S, Kikkawa F. Serum anti-Müllerian hormone level is a useful marker for evaluating the impact of laparoscopic cystectomy on ovarian reserve. Fertil Steril. 2010;94(7):2846–9.

    Article  CAS  PubMed  Google Scholar 

  93. Ercan CM, Duru NK, Karasahin KE, Coksuer H, Dede M, Baser I. Ultrasonographic evaluation and anti-Müllerian hormone levels after laparoscopic stripping of unilateral endometriomas. Eur J Obstet Gynecol Reprod Biol. 2011;158(2):280–4.

    Article  CAS  PubMed  Google Scholar 

  94. Kitajima M, Khan KN, Hiraki K, Inoue T, Fujishita A, Masuzaki H. Changes in serum anti-Müllerian hormone levels may predict damage to residual normal ovarian tissue after laparoscopic surgery for women with ovarian endometrioma. Fertil Steril. 2011;95(8):2589–91 (e1).

    Article  CAS  PubMed  Google Scholar 

  95. Lee DY, Young Kim N, Jae Kim M, Yoon BK, Choi D. Effects of laparoscopic surgery on serum anti-Müllerian hormone levels in reproductive-aged women with endometrioma. Gynecol Endocrinol. 2011;27(10):733–6.

    Article  CAS  PubMed  Google Scholar 

  96. Tsolakidis D, Pados G, Vavilis D, Athanatos D, Tsalikis T, Giannakou A, Tarlatzis BC. The impact on ovarian reserve after laparoscopic ovarian cystectomy versus three-stage management in patients with endometriomas: a prospective randomized study. Fertil Steril. 2010;94(1):71–7.

    Article  CAS  PubMed  Google Scholar 

  97. Hirokawa W, Iwase A, Goto M, Takikawa S, Nagatomo Y, Nakahara T, Bayasula B, Nakamura T, Manabe S, Kikkawa F. The post-operative decline in serum anti-Müllerian hormone correlates with the bilaterality and severity of endometriosis. Hum Reprod. 2011;26(4):904–10.

    Article  CAS  PubMed  Google Scholar 

  98. Kwon SK, Kim SH, Yun SC, Kim DY, Chae HD, Kim CH, Kang BM. Decline of serum anti-Müllerian hormone levels after laparoscopic ovarian cystectomy in endometrioma and other benign cysts: a prospective cohort study. Fertil Steril. 2014;101(2):435–41.

    Article  CAS  PubMed  Google Scholar 

  99. Raffi F, Metwally M, Amer S. The impact of excision of ovarian endometrioma on ovarian reserve: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2012;97(9):3146–54.

    Article  CAS  PubMed  Google Scholar 

  100. Somigliana E, Berlanda N, Benaglia L, Vigano P, Vercellini P, Fedele L. Surgical excision of endometriomas and ovarian reserve: a systematic review on serum anti-Müllerian hormone level modifications. Fertil Steril. 2012;98(6):1531–8.

    Article  CAS  PubMed  Google Scholar 

  101. Sugita A, Iwase A, Goto M, Nakahara T, Nakamura T, Kondo M, Osuka S, Mori M, Saito A, Kikkawa F. One-year follow-up of serum anti-Müllerian hormone levels in patients with cystectomy: are different sequential changes due to different mechanisms causing damage to the ovarian reserve? Fertil Steril. 2013;100(2):516–22 (e3).

    Article  CAS  PubMed  Google Scholar 

  102. Sonmezer M, Taskin S, Gemici A, Kahraman K, Ozmen B, Berker B, Atabekoglu C. Can ovarian damage be reduced using hemostatic matrix during laparoscopic endometrioma surgery? A prospective, randomized study. Arch Gynecol Obstet. 2013;287(6):1251–7.

    Article  PubMed  Google Scholar 

  103. Zaitoun MM, El Behery MM. Comparing long-term impact on ovarian reserve between laparoscopic ovarian cystectomy and open laprotomy for ovarian endometrioma. J Ovarian Res. 2013;6(1):76.

    Article  PubMed  PubMed Central  Google Scholar 

  104. Hart RJ, Hickey M, Maouris P, Buckett W. Excisional surgery versus ablative surgery for ovarian endometriomata. Cochrane Database Syst Rev. 2008;2:CD004992.

    PubMed  Google Scholar 

  105. Jang WK, Lim SY, Park JC, Lee KR, Lee A, Rhee JH. Surgical impact on serum anti-Müllerian hormone in women with benign ovarian cyst: A prospective study. Obstet Gynecol Sci. 2014;57(2):121–7.

    Article  PubMed  PubMed Central  Google Scholar 

  106. Mohamed ML, Nouh AA, El-Behery MM, Mansour SA. Effect on ovarian reserve of laparoscopic bipolar electrocoagulation versus laparotomic hemostatic sutures during unilateral ovarian cystectomy. Int J Gynaecol Obstet. 2011;114(1):69–72.

    Article  PubMed  Google Scholar 

  107. Ni L, Sadiq S, Mao Y, Cui Y, Wang W, Liu J. Influence of various tubal surgeries to serum anti-Müllerian hormone level and outcome of the subsequent IVF-ET treatment. Gynecol Endocrinol. 2013;29(4):345–9.

    Article  PubMed  Google Scholar 

  108. Ercan CM, Sakinci M, Coksuer H, Keskin U, Tapan S, Ergun A. Ovarian reserve testing before and after laparoscopic tubal bipolar electrodesiccation and transection. Eur J Obstet Gynecol Reprod Biol. 2013;166(1):56–60.

    Article  PubMed  Google Scholar 

  109. Hehenkamp WJ, Volkers NA, Broekmans FJ, de Jong FH, Themmen AP, Birnie E, Reekers JA, Ankum WM. Loss of ovarian reserve after uterine artery embolization: a randomized comparison with hysterectomy. Hum Reprod. 2007;22(7):1996–2005.

    Article  CAS  PubMed  Google Scholar 

  110. Arthur R, Kachura J, Liu G, Chan C, Shapiro H. Laparoscopic myomectomy versus uterine artery embolization: long-term impact on markers of ovarian reserve. J Obstet Gynaecol Can. 2014;36(3):240–7.

    Article  PubMed  Google Scholar 

  111. Chong YH, Campbell AJ, Farrand S, McLennan IS. Anti-Müllerian hormone level in older women: detection of granulosa cell tumor recurrence. Int J Gynecol Cancer. 2012;22(9):1497–9.

    PubMed  Google Scholar 

  112. Lane AH, Lee MM, Fuller AF Jr, Kehas DJ, Donahoe PK, MacLaughlin DT. Diagnostic utility of Müllerian inhibiting substance determination in patients with primary and recurrent granulosa cell tumors. Gynecol Oncol. 1999;73(1):51–5.

    Article  CAS  PubMed  Google Scholar 

  113. Long WQ, Ranchin V, Pautier P, Belville C, Denizot P, Cailla H, Lhomme C, Picard JY, Bidart JM, Rey R. Detection of minimal levels of serum anti-Müllerian hormone during follow-up of patients with ovarian granulosa cell tumor by means of a highly sensitive enzyme-linked immunosorbent assay. J Clin Endocrinol Metab. 2000;85(2):540–4.

    CAS  PubMed  Google Scholar 

  114. La Marca A, Volpe A. The Anti-Müllerian hormone and ovarian cancer. Hum Reprod Update. 2007;13(3):265–73.

    Article  PubMed  Google Scholar 

  115. Hudson PL, Dougas I, Donahoe PK, Cate RL, Epstein J, Pepinsky RB, MacLaughlin DT. An immunoassay to detect human Müllerian inhibiting substance in males and females during normal development. J Clin Endocrinol Metab. 1990;70(1):16–22.

    Article  CAS  PubMed  Google Scholar 

  116. Nelson SM, La Marca A. The journey from the old to the new AMH assay: how to avoid getting lost in the values. Reprod Biomed Online. 2011;23(4):411–20.

    Article  CAS  PubMed  Google Scholar 

  117. Rustamov O, Smith A, Roberts SA, Yates AP, Fitzgerald C, Krishnan M, Nardo LG, Pemberton PW. The measurement of anti-Müllerian hormone: a critical appraisal. J Clin Endocrinol Metab. 2014;99(3):723–32.

    CAS  PubMed  Google Scholar 

  118. Li HW, Ng EH, Wong BP, Anderson RA, Ho PC, Yeung WS. Correlation between three assay systems for anti-Müllerian hormone (AMH) determination. J Assist Reprod Genet. 2012;29(12):1443–6.

    Article  PubMed  PubMed Central  Google Scholar 

  119. Reichman DE, Goldschlag D, Rosenwaks Z. Value of anti-Müllerian hormone as a prognostic indicator of in vitro fertilization outcome. Fertil Steril. 2014;101(4):1012–8 (e1011).

    Article  CAS  PubMed  Google Scholar 

  120. Kedem A, Haas J, Geva LL, Yerushalmi G, Gilboa Y, Kanety H, Hanochi M, Maman E, Hourvitz A. Ongoing pregnancy rates in women with low and extremely low AMH levels. A multivariate analysis of 769 cycles. PLoS One. 2013;8(12):e81629.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  121. Su HI, Sammel MD, Homer MV, Bui K, Haunschild C, Stanczyk FZ. Comparability of anti-Müllerian hormone levels among commercially available immunoassays. Fertil Steril. 2014;101(6):1766–72 (e1761).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  122. Welsh P, Smith K, Nelson SM. A single-centre evaluation of two new anti-Müllerian hormone assays and comparison with the current clinical standard assay. Hum Reprod. 2014;29(5):1035–41.

    Article  PubMed  Google Scholar 

  123. Chai J, Howie AF, Cameron DA, Anderson RA. A highly-sensitive anti-Müllerian hormone assay improves analysis of ovarian function following chemotherapy for early breast cancer. Eur J Cancer. 2014;50(14):2367–74.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  124. Decanter C, Peigne M, Mailliez A, Morschhauser F, Dassonneville A, Dewailly D, Pigny P. Toward a better follow-up of ovarian recovery in young women after chemotherapy with a hypersensitive anti-Müllerian hormone assay. Fertil Steril. 2014;102(2):483–7.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Akira Iwase, Tomoko Nakamura, Satoko Osuka, Sachiko Takikawa, Maki Goto & Fumitaka Kikkawa

  2. Department of Maternal and Perinatal Medicine, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Akira Iwase

Authors
  1. Akira Iwase
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tomoko Nakamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Satoko Osuka
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sachiko Takikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Maki Goto
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Fumitaka Kikkawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Akira Iwase.

Ethics declarations

Conflict of interest

Akira Iwase, Tomoko Nakamura, Satoko Osuka, Sachiko Takikawa, Maki Goto, and Fumitaka Kikkawa declare that they have no conflicts of interest.

Human/animal studies

This article does not contain any studies with human or animal subjects performed by any of the authors.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Iwase, A., Nakamura, T., Osuka, S. et al. Anti-Müllerian hormone as a marker of ovarian reserve: What have we learned, and what should we know?. Reprod Med Biol 15, 127–136 (2016). https://doi.org/10.1007/s12522-015-0227-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12522-015-0227-3

Keywords

Search

Navigation