Anti-Müllerian Hormone (AMH) Anti-Müllerian Hormone (AMH) is a glycoprotein hormone structurally related to inhibin and activin and is part of the transforming growth factor beta superfamily. It is expressed by granulosa cells of the ovary during a female’s reproductive years and plays a key role in growth differentiation and folliculogenesis. Specifically, AMH expression inhibits primordial follicle recruitment and decreases the sensitivity of follicles for the FSH-dependent selection. Besides its functional role in the ovary, AMH serum levels also serve as a biomarker for ovarian reserve. AMH is a dimeric glycoprotein molecule that consists of two identical subunits linked by sulfide bridges. Each subunit contains a pro-region (pro-AMH or N-terminal) and a C-terminal domain (also called the “mature” region) which is cleaved at monobasic sites between the two domains. After cleavage, the pro-region (110-kDa) and C-terminal (25 kDa) homodimers remain associated in a noncovalent complex that bind to AMH Receptor II to activate signaling. AMH is considered an extremely sensitive marker of ovarian function and ovarian aging. It is useful to assess conditions such as polycystic ovary syndrome and premature ovarian failure. AMH is also a predictor for ovarian response in in vitro fertilization (IVF). Overall, a higher level of AMH in normal, healthy women aged 30-44 has a positive
correlation with natural fertility for spontaneous conception. Diagnostic tests that measure AMH levels in serum or plasma are usually quantitative sandwich-ELISA that use antibodies directed against epitopes in the stable pro- region and mature region.
Anti-Müllerian Hormone (AMH) Protein Structure
Mature (C-Terminal)
Pro-AMH (N-Terminal)
Cleavage (a.a. 451)
Figure based from C. Heule, W. Salzburger, and A. Böhn, Genetics. 196: 579–591 (2014)
AMH levels can predict Ovarian Reserve
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Endocrine Disorders- Reagents for Assay Development
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