Anti-Müllerian hormone (AMH) is secreted by ovarian follicles as it prepares to release eggs during the menstrual cycle. This hormone is also known as a Müllerian inhibitory substance.
AMH levels are directly related to how many small follicles are found on the ovaries each month. These are called antral follicles.
This article will describe how AMH can be used to help diagnose people with polycystic ovary syndrome (PCOS).
What does the ovary do
Follicles and AMH
Antral follicles are also called resting follicles. Throughout the menstrual cycle, follicles appear on the ovaries and undergo changes. Antral follicles are at a later stage of development.
Eventually, follicle development ends and becomes mature. A mature follicle has the potential to release an egg. This is called ovulation.
The more antral follicles a person has, the higher their AMH levels will be. Doctors can use a person’s AMH level to estimate how many follicles a person has. This is called ovarian reserve.
Knowing this number may be helpful in some fertility situations.For example, if one would have In vitro fertilization (IVF), knowing how many follicles they have can give them an idea of their chances of success.
The more antral follicles a person has, the higher their AMH levels will be. A person’s AMH level can help their doctor estimate how many follicles they have. This information can give them clues about a person’s fertility.
Uterus, ovaries and fallopian tubes
AMH and PCOS
People with polycystic ovary syndrome (PCOS) have many antral follicles. This means they also have high levels of AMH. High AMH levels may indicate PCOS in people who may not have symptoms.
Too much AMA can prevent ovulation. In normal ovaries, AMH prevents premature follicle development. If this happens, they will release an egg that is not yet ready.
However, when AMH levels are too high, they “hit the brakes” and prevent the ready eggs from being released.
People with PCOS tend to have high AMH and a large number of antral follicles on the ovaries. High levels of AMH prevent the egg from being released from the ovary even when the egg is ready. This means that ovulation will not occur.
How to know if you have PCOS Ovulation
What does AMH level mean
AMH levels can be measured with a blood test. A person can have blood drawn any day of the menstrual cycle. Samples are sent to a lab for analysis to determine whether a person has low, normal, or high levels of AMH.
High levels alone are not sufficient to diagnose PCOS, as AMH levels change throughout life and typically decrease with age. Doctors compare a person’s age with their AMH results to make a diagnosis.
How AMH Helps Diagnose PCOS
AMH is very helpful in recommending the diagnosis of PCOS in people over 35 years of age. To confirm a PCOS diagnosis, a person also needs to meet at least two of the following criteria:
- Irregular or missed periods indicate delayed or no ovulation (oligomenorrhea)
- Ultrasound showing multiple cysts on the ovary (polycystic)
- Laboratory results showing elevated levels or signs of high levels of hormones called androgens (eg, abnormal hair growth, acne)
Meeting diagnostic criteria may be more difficult for people over 35. In this age group, polycystic ovaries are rarely seen on ultrasound. If a person does not have the typical signs and symptoms of PCOS, the diagnosis may be missed.
Signs of PCOS
However, if doctors find that a person has high levels of AMH, they may be pointing them to a possible diagnosis of PCOS.
The AMH test is also useful for people who know they have PCOS. PCOS patients with higher AMH levels tend to have more severe symptoms.
High AMH levels can be a clue that a person may have PCOS, even if they don’t have the typical signs and symptoms of the disease. PCOS patients with higher AMH levels also tended to have more severe symptoms.
Antral follicles on the ovary release anti-Müllerian hormone (AMH) when the ovary prepares to release an egg. The more antral follicles a person has, the higher their AMH levels.
AMH levels can help diagnose polycystic ovary syndrome (PCOS). People with this disorder usually have high levels of AMH.
Sometimes, it can be difficult to diagnose PCOS because a person may not have specific symptoms. They may also think that common PCOS symptoms, such as acne, are caused by other causes.
People with PCOS may experience more severe symptoms if AMH levels are high.
Talk to your doctor if you have symptoms of PCOS. If you are over 35, it may be more difficult to diagnose PCOS because you may not meet all the criteria. Checking your AMH levels can help your doctor determine if you may have PCOS.
Discuss PCOS with your doctor