Anti-Mullerian Hormone

Aka: Anti-Mullerian Hormone, Anti Mullerian Hormone, Mullerian-Inhibiting Hormone, AMH

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II. Physiology

  1. Anti-Mullerian Hormone (AMH) is secreted by granulosa cells in follicles (small antral and preantral)
    1. AMH increases from birth to age 25 years
    2. After peaking, AMH gradually decreases until Menopause
  2. Considered a stable marker of ovarian reserve
    1. Menstrual Cycle may result in some cyclical variation (esp. young women)
    2. Oral Contraceptives may also decrease AMH levels

III. Indications

  1. Marker of ovarian reserve
    1. Premature Ovarian Failure confirmation
    2. Predict Menopause onset
  2. Ovarian Tumor Marker
    1. Folliculoma

IV. Interpretation

  1. AMH <1 suggests decreased ovarian reserve

V. Calculations: Prediction of Age at Menopause

  1. Original Tehrani et. al. Model Calculation (using python, numpy)
    1. MenopauseAge = np.power(-np.log(0.5),0.060388) * exp(3.18019 + 0.1608897 * amh + 0.016068 * age)
  2. Simplified Calculation (approximates the formula above, for age 25 years old and older)
    1. MenopauseAge = 35.2 + 0.7*((age-25)+(amh*10))
    2. Python code demonstrating a comparison of the simplified model versus the original model (Jupyter Lab)
      1. MenopauseAgePredictor.html

VI. References

  1. David S. Johnson, MD email communication 3/2/2020
  2. kruszynska (2017) Prz Menopauzalny 16(2): 47-50 +PMID:28721129 [PubMed]
    1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5509971/
  3. Tehrani (2013) J Clin Endocrinol Metab 98(2):729-35 +PMID:23316087 [PubMed]
    1. https://academic.oup.com/jcem/article/98/2/729/2833229

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