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Recommendations and guidelines   

La Rivista Italiana della Medicina di Laboratorio 2022 Jul 05

DOI: 10.23736/S1825-859X.22.00146-3


language: Italian

Anti-Müllerian hormone and infertility

Marina VITILLO 1, Renato TOZZOLI 2, 3

1 UOC Patologia clinica, Dipartimento dei Laboratori, Ospedale San Filippo Neri, ASL Roma 1, Roma, Italy; 2 Laboratorio Analisi Chimico-cliniche e Microbiologia, Ospedale Villa Salus, Venezia, Italy; 3 Unità di Endocrinologia, Policlinico San Giorgio, Pordenone, Italy


Circulating anti-Müllerian hormone (AMH) is considered the best biomarker for evaluating ovarian reserve, more reliable than other criteria such as age, antral follicle count or follicle stimulating hormone (FSH) levels. It is a glycoprotein produced by the granulosa cells of the ovarian follicles and plays a fundamental role in regulating the development of the follicle during fetal and adult life. Several generations of ELISA tests have been used since the 1990s for the measurement of AMH. More recently, automated chemiluminescence methods have been introduced which mostly use antibodies directed towards the pro region and the mature region of AMH therefore detecting the presence of both circulating forms proAMH and AMHN,C. The new methods have high levels of precision, linearity of the determinations and, although there is no international reference standard, they show an excellent correlation for concentrations above 1 ng / ml. The greater sensitivity of the automated methods allows to distinguish in the group of women with an antral follicle count value of 0-7, those who have the greatest possibility of procreating. Overall, the characteristics described above and the reduced execution time of the automated methods favour the use of the AMH measurement in medically assisted reproduction centres and in young women with neoplastic pathologies for the removal and preservation of follicles before chemotherapy. AMH levels increase in women with micropolicystic ovary syndrome.

KEY WORDS: Anti-Müllerian hormone; AMH; Fertility treatment; Ovarian reserve; Micropolicistic ovary; Menopause

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