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Endocrine Abstracts (2018) 56 D4.2 | DOI: 10.1530/endoabs.56.D4.2

ECE2018 Debates AMH as the Primary Marker for Fertility (2 abstracts)

Debate: AMH as the primary marker for fertility

Joop Laven


The Netherlands.


AMH is a dimeric protein hormone and a member of the TGF-β superfamily. AMH is first expressed in granulosa cells of primary follicles and expression persists in growing follicles up to 6 mm in diameter. In follicle stages beyond 8 mm, AMH expression diminishes and ultimately becomes undetectable once the follicle becomes FSH-dependent1. Its measurement is strongly correlated with antral follicle count and represents a reliable marker of ovarian function. It is reproducible since it has little variation within and between cycles. However AMH assays may display differential results due to pre-analytical proteolysis, conformational changes of the AMH dimer, interfering substances, sample handling, transport and storage conditions, factors underreported in the literature. Finally, there is a urgent need for an international reference standard. Although AMH seems to be a good quantitative reflection of ovarian reserve, it does not assess oocyte quality. This drawback precludes any good prediction of female fertility in any patient population. Although, AMH constitutes a promising marker for age at natural menopause (ANM). As such AMH does not predict the extremes of menopause very well and predicted ages show wide confidence intervals. Hence AMH as a marker for ANM clearly needs improvement before they can be used in the clinical setting. On the contrary AMH assays might become an indirect marker of ovarian function in some women at risk for premature ovarian failure or in the polycystic ovary syndrome. Its interest is no more to be proven in assisted reproductive technology where it is a valuable aid in determining gonadotrophin dosage. AMH is finally very informative in monitoring cancer patients after gonadotoxic drugs or having undergone mutilating ovarian surgeries. In conclusion, although AMH assays are widely used AMH itself is not a reliable predictor of pregnancy in women and therefore it does not predict fertility!

Volume 56

20th European Congress of Endocrinology

Barcelona, Spain
19 May 2018 - 22 May 2018

European Society of Endocrinology 

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