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This test analyzes the level of anti-Müllerian hormone (AMH) in the blood. This Anti-Mullerian Hormone (AMH) is made in the reproductive tissues of both males and females. It plays a very important role in the development of sex organs in an unborn baby. In women, the AMH levels can provide valuable information about egg counts and whether they have the ability to get pregnant or not. A woman's ovaries may produce thousands of eggs during her childbearing years. This number can decline as a woman gets older. The AMH levels will help in determining the potential of egg cells remaining in a woman's ovaries.
A high level of AMH indicates your chances are better of getting pregnant. A higher value is also an indication of polycystic ovary syndrome (PCOS). A low value means that you may have low ovarian reserve and a low chance of reproductive success.
The other names are AMH hormone test, Mullerian-inhibiting hormone, MIH, Mullerian inhibiting factor, MIF, Mullerian-inhibiting substance, and MIS.
There is only one parameter.
This anti-Müllerian hormone (AMH) is a hormone that is produced by reproductive tissues, including the testicles in males and the ovaries in females. The role of AMH and the amount that is normally present may vary depending upon sex and age. This test analyzes the AMH in the blood.
AMH is produced by the testicles at a very early stage in the development of a baby boy. AMH inhibits the development of female reproductive organs while promoting the development of other male reproductive organs. In boys, the level of the AMH remains high until puberty, after which it begins to taper off.
In girls, low levels of AMH are produced, thus allowing the development of the female reproductive structures. The AMH level in young girls remains low until puberty, when the ovaries begin to produce it and levels increase steadily. The AMH levels will then steadily decline in women over their reproductive years and become very low and eventually undetectable after menopause.
AMH is very important for a woman during her childbearing years. At birth, a female has about one million eggs (oocytes), which will then naturally decrease in number during her childhood to about 500,000. Only a small number of these remaining eggs will go through a follicle maturation one at a time as part of a woman’s monthly menstrual cycle. AMH has a balancing effect on the monthly cyclical actions of follicle-stimulating hormone and luteinizing hormone during the process of egg maturation and release (ovulation). The amount of Anti-Mullerian Hormone (AMH) present is a reflection of this follicular growth.
Elevated AMH levels have been associated with a condition affecting the ovaries known as polycystic ovary syndrome (PCOS).
If a sufficient amount of the AMH is not available or absent during this process, both the male and basic female organs might develop. The baby is born with ambiguous genitalia and may not be instantly recognized as either male or female.
This AMH can be elevated in some ovarian tumors (benign or cancerous). If a tumor manufactures the hormone, then this AMH test can be used as a tumor marker to monitor the effectiveness of treatment and to monitor the recurrence.
An AMH test can be recommended in women when evaluating ovarian function and fertility issues. This is especially important when considering assisted reproduction procedures such as in vitro fertilisation (IVF). It can be recommended when a healthcare practitioner wants to determine whether a woman has entered menopause.
The AMH can be ordered when a woman has signs and symptoms of polycystic ovary syndrome (PCOS). Some of these include:
Abnormal uterine bleeding
A benign overgrowth of the stratum spinosum of the skin.
Absence of the menstrual cycle (amenorrhea)
Decreased breast size
Excessive face and body hair (hirsutism) involving male hair growth patterns, such as hair on the face, sideburn area, chin, upper lip, lower abdominal midline, chest, areola, lower back, buttock, and inner thigh.
Weight gain and obesity with fat distribution in the center of the body
Skin tags in the armpits or neck
Thinning hair with male pattern baldness
AMH may be recommended periodically for a woman with an AMH-producing ovarian cancer to monitor the effectiveness of treatment and to monitor for recurrence.
An AMH test might be ordered when an infant has ambiguous genitalia or when a male child’s testicles have not descended properly.
An AMH test might be recommended when a female begins to develop male characteristics (virilization).
No special preparation is required and fasting is not required.
This test requires a blood sample.
A healthcare provider, who is also called a phlebotomist, usually performs blood draws, including those for an Anti-Mullerian Hormone (AMH) test, but any healthcare provider trained in drawing blood can perform this task. These samples are sent to a lab where a medical laboratory scientist prepares the samples and performs the tests on analyzers or manually.
You may expect to experience the following during the blood test or a blood draw:
You have to sit comfortably on the chair, and the phlebotomist will check your arms for an easily accessible vein. It is the inner part of the arm on the other side of your elbow.
Once they have found the vein, they will disinfect the area with an alcohol swab.
They will insert a needle into your vein to draw a blood sample. This may feel like a small pinch.
After the needle is inserted, the required amount of blood will be collected in a test tube.
When the blood has been collected for the test, they’ll remove the needle and hold a cotton ball or gauze on the site to stop any bleeding.
They will apply a band-aid over the pricked site, and the blood collection is finished.
This process takes less than five minutes.
Once the phlebotomist has collected the blood sample, it will be sent to the laboratory for processing or testing. When the reports are ready, your healthcare provider will share the results with you.
These blood tests are common and don’t carry any significant risks. You might have a slight pain like an ant bite when the needle gets pricked, and a small bruise can develop there.
The reports are available via email or WhatsApp within 6 hours of the collection of the blood sample.
During the woman’s childbearing years, a decreased value of AMH can indicate a low number and quality of eggs (low ovarian reserve) with diminishing fertility, resulting in minimal or less responsiveness to IVF treatment. This can also indicate that the ovaries are not functioning normally (premature ovarian failure). Increased AMH can indicate increased or even more excessive responsiveness to IVF and it is needed to tailor the procedure accordingly.
A decreasing value and/or a significant decline in the AMH might signal the imminent onset of the menopause or that the woman has entered the menopause stage. Negative to low levels of AMH are normal in a female during infancy and after menopause.
Increased levels of AMH are often seen with PCOS but are not diagnostic of this condition.
When AMH is used as a tool to monitor an AMH-producing ovarian cancer, a decrease in AMH indicates a response to treatment, while an increase may indicate cancer recurrence.
In the male infant, the absence or low amount of AMH might indicate a problem with the AMH gene that is located on chromosome 19; it directs AMH production and can be seen with absent or dysfunctional testicles. A lack of male hormones might result in ambiguous genitalia and can cause an abnormal internal reproductive structure. The normal levels of AMH and the androgens in a male infant whose testicles have not descended indicate that they are present and functional but they are not physically located as they are supposed to be.
In a female who has developed male characteristics, if the AMH values are in the male reference range, they are most likely coming from a tumor or testicular tissue, and if the levels are in the female range, they are likely from the adrenal glands.
Ultrasound abdomen (USG), FSH, LH
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An AMH value of less than 1.6 ng/mL predicts a smaller number of eggs retrieved with IVF. Levels of less than 0.4ng/mL are severely low.
AMH values don't change significantly throughout the menstrual cycle. The normal AMH level reference range is 2.0 - 6.8 ng/mL in any phase of the cycle.
Low AMH does impact your overall reproductive window. You may still get pregnant and have a successful pregnancy if your egg supply is in the lower range for your age group. After all, you only need one healthy egg and one healthy sperm to conceive.
It is found to have significantly high levels of AMH in PCOS women compared to the normal range. The serum AMH level was 9.35, meaning that patients with higher AMH levels have a 9.35 times higher possibility of suffering from PCOS compared to patients with low AMH.