Anti-Mullerian Hormone (AMH) as a Novel Marker for Ovarian Function A Review

Background: Anti-Mullerian Hormone (AMH) is a homodimeric glycoprotein linked by disulfide bonds which belongs to the Transforming Growth Factor (TGF) beta superfamily. AMH is produced by gonadal tissue namely testicular Sertoli cells and ovarian granulosa cells especially pre-antral and antral follicles. AMH involved in embryonic sexual differentiation in male, while it has an inhibitory effect on primordial follicle recruitment and responsiveness of the growing follicles to FSH, in female. Current studies show promising clinical utilities of AMH measurement in predicting ovarian function. Objective: This review aims to explore further about the physiology of AMH and its role as a novel marker for ovarian function. Method: A review of relevant literature was performed to elaborate AMH involvement in ovarian function. A total of 14 qualified published literature of all years until 2018 were collected from several electronic database and manual search and included in this review. Results: AMH level reflected ovarian follicular reserve, an important indicator in infertility treatment (assisted reproduction technique) and a sensitive marker for ovarian aging. AMH is also a valuable tool in diagnosis and recognition of recurrence granulosa cell tumors, and a marker of ovarian dysfunction particularly polycystic ovary syndrome. A low circulating AMH level is observed in obesity and male with fertility problems. Conclusion: AMH level can be used as primary or supplementary markers to aid in the diagnosis and treatment of several reproductive related conditions in males and females. A set of guidelines about sample storage and handling and age-specific standardized reference values are needed to optimize clinical application of AMH. Keyword: Anti-Mullerian hormone, marker, ovarian function