Developing anti-Müllerian hormone as an ovarian reserve biomarker

The first anti-Müllerian hormone (AMH) radioimmunoassay became available for clinical use in the early 2000s. This MHR Legacy Series review discusses key contributions from our own group towards establishing AMH as a robust ovarian reserve biomarker. Initial studies in female volunteers demonstrated decreasing serum AMH concentrations with increasing female age, along with a direct correlation between AMH levels and the number of antral follicles. The most relevant clinical conditions where measurements of serum AMH appear to be of great value include the diagnosis of various forms of ovarian dysfunction, especially polycystic ovary syndrome and premature ovarian insufficiency. In addition, a close correlation between initial serum AMH levels and ovarian response to standard stimulation for IVF has been firmly established, resulting in the development of a safe and effective AMH-based algorithm for individualized ovarian stimulation. Another area, beyond our own research, where AMH serum measurements have proven to be of great clinical significance is oncofertility. The capacity of AMH levels to predict fecundity—either spontaneous or following infertility treatment—or forecast age of menopause later in life remains uncertain and needs more well-designed, prospective, follow-up studies.