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​Anti-Müllerian hormone (AMH) is a protein produced by granulosa cells in ovarian follicles. A blood test for AMH is most commonly used to assess the reserve of ovarian follicles and to predict response to controlled ovarian stimulation during in vitro fertilization (IVF).

Test at a glance

Clinical Utility

​AMH levels circulating in blood may be used to 1-4:  

  • evaluate ovarian reserve
  • predict age  of menopause
  • confirm diagnosis of premature ovarian failure and
  • predict likelihood of IVF success

Additionally, AMH levels may be used to assess risk of ovarian hyperstimulation syndrome (OHSS) caused by exaggerated response to gonadotropin treatment 2,3 and to help diagnose polycystic ovary syndrome (PCOS). 3,5

Ordering
​Healthcare provider needs to indicate ‘AMH’ in the ‘Other Tests’ section of the requisition form.

Patient instructions
​Patient needs to bring the completed requisition form to a Patient Service Centre. 

Turnaround Time
​Test results will be available within 2 weeks.

Cost
​This test is not currently covered by provincial health plans, but may be covered by the patient’s private insurance.

Healthcare Professional Information

​What is Being Tested?

Anti-Müllerian hormone (AMH) is a proteins produced by granulosa cells in ovarian follicles. Circulating levels of AMH plateau at approximately 25 years of age, begin to decline at approximately 30 years of age, and continue to decline throughout reproductive life. There is a positive correlation between circulating AMH levels and the number of remaining antral ovarian follicles.1,3 Therefore, circulating AMH levels may be used to provide an indication of the ovarian reserve. 1-4

The AMH levels are also used to predict age of menopause, confirm diagnosis of premature ovarian failure and predict likelihood of IVF success.1-4 AMH levels correlate positively with number of retrieved oocytes1 and low AMH levels predict a lower likelihood of follicle response. 1,3

Additionally, AMH levels may be used to assess risk of ovarian hyperstimulation syndrome (OHSS) caused by exaggerated response to gonadotropin treatment 2,3 and to help diagnose polycystic ovary syndrome (PCOS). 3,5

Patient Frequently Asked Questions(FAQs)

​How is it used?

Circulating AMH can be used to determine the amount of ovarian reserve (number of eggs remaining) and progression to menopause.

AMH can also help predict the success and some complications of in vitro fertilization (IVF) treatment. Circulating AMH levels could predict the number of follicles (eggs) that can be harvested following hormone treatment for IVF - low AMH levels predict a lower likelihood of positive response to hormone treatment. Hormone treatment can sometimes also result in ovarian hyperstimulation syndrome (OHSS). High AMH levels are associated with an increased risk of developing OHSS. AMH is also elevated in polycystic ovary syndrome (PCOS). 

When is it ordered?

The AMH test is commonly ordered for women experiencing difficulty getting pregnant , those considering undergoing IVF treatment or those suspected to be at risk of PCOS and OHSS.

What does the test result mean?

The higher the AMH level the higher the number of remaining follicles (eggs). Decline in AMH potentially reflects progression to menopause.

Is there a charge for the test?

This test may not be covered by provincial health insurance plans, but it may be covered by patient's extended private health insurance plan. Contact us to find out about the current fee for the test.

References:


1.  Broer SL, Broekmans FJ, Laven JS, and Fauser BC. Anti-Müllerian hormone: ovarian reserve testing and its potential clinical implications. Hum Reprod Update 2014;20:688-701.

2. Dewailly D, Andersen CY, Balen A et al. The physiology and clinical utility on anti-Müllerian hormone in women. Hum Reprod Update 2014;20:370-385.

3. Green JA, and Graves G. Is there a place for AMH testing in Canada? J Obstet Gyneacol Can 2011;33:628-632.

4. Ledger WL. Clinical utility of measurement of anti-Müllerian hormone in reproductive endocrinology. J Clin Endocrinol Metab 2010;95:5144-5154.

5. Iliodromiti S, Kelsey TW, Anderson RA et al. Can anti-Müllerian hormone predict the diagnosis of polycystic ovary syndrome? A systematic review and meta-analysis of extracted data. J Clin Endocrinol Metab 2013;98:3332-3340.

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