Anti-Mullerian Hormone: Above and Beyond Conventional Ovarian Reserve Markers

Figure 1

Schematic representation of hormonal surges across the follicular phase of ovarian cycle. 1: initial recruitment; 2: cyclic recruitment; 3: selection; 4: dominance; 5: ovulation. (−) non/poorly visualized; (+) well visualized. AMH is secreted by all growing follicles but its serum levels reflect only the secretion from follicles lying close to the vascular bed. It has an inhibitory effect on steps 1 and 2, thus maintaining the ovarian pool. The emphasis is on AMH production in early stages of follicle development as opposed to all other hormones that are released at later stages. Follicular fluid AMH levels show a better correlation with oocyte competence and hence can prove to be a reliable marker of embryo transfer outcomes.