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What is Anti-Müllerian Hormone (also known as AMH)?

AMH is a hormone produced by follicles that each house an oocyte (a cell from which an egg develops) as it matures within the ovaries. Testing Anti-Mullerian Hormone (AMH) levels provides an indirect measurement of a woman’s egg supply which is also known as ovarian reserve.

What does Anti-Müllerian Hormone (AMH) do?

AMH is involved in the process of ovarian follicle development, which is referred to as folliculogenesis. There are several distinct stages involved in the growth and development of follicles within the ovaries.


Follicular Growth


Under normal conditions all follicles in the Pre-antral stage produce AMH to minimize the effects of Follicle Stimulating Hormone (FSH) on follicles during the basal growth phase.

 

AMH and FSH Graph


Why is Anti-Müllerian Hormone (AMH) a good test?

One of the most significant things that makes AMH a good test is the fact that it is produced directly from the follicles found within the ovaries. What better way of trying to assess ovarian reserve (egg supply) status than by measuring a hormone produced directly from the oocytes that make up the ovarian reserve. And, as the follicles develop into mature eggs or die off (a normal process called atresia), they no longer produce AMH. This loss of follicles over time will be reflected in a progressively lower AMH value.



AMH vs Age Graph


 

What are the Benefits of Anti-Müllerian Hormone (AMH) Testing?

Overall this test empowers you to be an active and informed participant in the management of your reproductive health. Our detailed report explains what the result means and we provide phone support for further explanation if needed.

Specific benefits include:

  • Comprehensive Results Report (exclusive to Unilab of Dade)

    Includes standard ranges for normal versus abnormal as well as an age-specific interpretation to show how your AMH score compares to the average woman (in your age group) who seeks assistance from a reproductive specialist.

  • Convenient

    Can be drawn on any day of the menstrual cycle, other hormone tests must be drawn on day 3.
    Can be performed while taking an oral contraceptive, other hormone tests require you to discontinue.

  • Aid in the Diagnosis of Multiple Medical Conditions

    Scientific studies have shown AMH levels can be used to help identify reproductive issues related to egg supply such as: Premature Ovarian Failure (POF), Polycystic Ovarian Syndrome (PCOS) and onset of Menopause.

  • Aid in the Diagnosis and Treatment of Infertility

    Egg supply is one of several factors* that influence the ability to get pregnant. AMH can identify your egg supply status and help predict how you would react to ovarian stimulation with drugs.



    How can the result from an Anti-Müllerian Hormone (AMH) test be used?



    Family Planning


    Providing information that can assist you in the decision making process.


    Preventative Medicine


    Provide information to you and your physician that you may need to seek infertility treatment early rather than waiting to fulfill the clinical definition of infertility which is the inability to conceive after 1 year of unprotected sex. Potentially aid in the early diagnosis of conditions that may affect your fertility. Proactively identify the onset of menopause to prepare and treat the symptoms and conditions that are associated with this event.


    Ovarian Reserve Monitoring


    Periodic AMH testing can provide a picture of how your ovarian reserve status may change over time.


    Egg Donor Qualification

    You can use the AMH test as an indicator of how well qualified you would be as an egg donor. It has the added advantage of not requiring you to discontinue birth control like other tests.


    IVF Treatment Selection


    By measuring the amount of this hormone in a woman’s body, a physician can get a good estimate as to the supply of eggs remaining or ovarian reserve. This information can be used to determine odds for success with various IVF procedures and help to determine the optimal ovarian stimulation protocol.




    More Information on AMH, Ovarian Reserve, Folliculogenesis and Ovulation.


    To completely understand how AMH, folliculogenesis and ovulation tie into ovarian reserve you must start at the very beginning.


    Ovarian Reserve – The Beginning


    At birth a woman has a predefined number of oocytes (cells from which an eggs develop) capable of developing into mature eggs. From birth up until puberty this number is reduced further as a portion of the oocytes are lost. The number of oocytes present in the ovaries (referred to as ovarian reserve) at the onset of puberty marks the total number available for development into mature eggs. This number can vary from woman to woman, does not increase and will decrease over time as the follicles mature and are lost either to ovulation or atresia (degeneration). [see figure]



    Folliculogenesis – Initiation and Growth


    At the very beginning of folliculogenesis, a cluster of immature follicles transition from a quiescent (non-active) state into the growth phase. During this period the follicles produce AMH which inhibits the effects (acceleration of growth and development) of FSH.


    The selection and growth process takes place over an extended period of time. (>120 days). Essentially it takes 3 menstrual cycles for a follicle to be recruited, grow and develop into a preovulatory follicle. You may be asking the question right now; if it takes 3 menstrual cycles to fully develop and ovulate an egg then how do I ovulate every month? Here is the answer to that question; folliculogenesis is a continuous process in which the ovaries have follicles at various stages of development. What this means is at any one point in time the ovaries will have immature follicles being recruited, some at the beginning of the growth phase, some at the middle, some at the end and normally there is always one dominant follicle that is ready for ovulation.



    Folliculogenesis – Pre-antral to Antral Transition


    At the Pre-antral and early antral stages follicles still produce AMH but become more sensitive to FSH which counteracts the inhibitory effects of AMH. This puts many, but not all, of the follicles on track to develop into mature antral follicles. The degree of sensitivity to FSH varies from follicle to follicle. For those follicles that don’t have the proper degree or don’t respond properly to the FSH stimulation, they will be lost to atresia (degradation). The follicles that do respond properly now become dependent on FSH for their growth and development. As these follicles grow they will start to produce estrogen which prepares the uterus for ovulation. At a certain point during this stage one follicle is selected as the dominant follicle to go on to the next stage and develop into an ovulatory follicle. See the entire process in this diagram.



    Dominant Follicle Selection and Ovulation


    Once the follicles are near the end of the antral stage their development begins to coincide with a single menstrual cycle. The following diagram and video provide a good summary of the process that occurs at this point.

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    How do I order an AMH test from Unilab?


    Purchase Process

    Simply click the purchase button on the main page and provide the necessary payment and shipping information.



    Specimen Collection

    Since the AMH test can only be performed using blood, a sample will be needed. Upon purchasing the test, we will send you a kit with all of the supplies and instructions needed to collect a blood sample and ship it to our facility. Upon receipt of the kit you will need to visit a draw station (click here for a list of draw stations) or make an appointment with a medical professional (Primary Care, OB/Gyn, Reproductive Endocrinologist) whose office has the ability to draw blood*. It is very important we receive the blood within 72 hours of collection. Specimen integrity becomes questionable after this time period which may result in rejection of the specimen.

    * There may be an additional fee charged by the facility to have your blood drawn.


    Results

    You can expect to receive your results within 3-6 days. You may choose to receive your results by fax, or mail.



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    Contact Us

    For questions or comments about AMH-Test.com, you may contact us by mail, phone, or online using the form below. When completing the form, please provide as many details as possible so that we can quickly respond to your request.

    Location: 2145 W. Davie Blvd, Suite 106
    Fort Lauderdale, Florida 33312

    E-mail: lab@infertilitylab.com

    Phone: 877-522-5678

    Fax: 954-797-9494