Anti-Müllerian hormone in the assessment of ovarian reserve: possibilities and limitations

Baranouskaya E.I.

doi:https://doi.org/10.17116/rosakush20222202165

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Abstract:

The article presents current data on the advantages and limitations of using the test for measuring the concentration of anti-Müllerian hormone (AMH) in the blood in female infertility. There are two main applications of measuring AMH concentration — the assessment of ovarian reserve and the prediction of ovarian response to ovulation stimulation. The true ovarian reserve is the number of primordial (primordialis — initial) follicles that do not express AMH, involved in the process of folliculogenesis before reaching the state of a mature follicle. Primordial follicles can remain dormant for a long time before they develop to the primary preantral follicle stage, when AMH expression begins. To assess ovarian reserve, the measurement of AMH concentration should be supplemented by counting the number of antral follicles. The most objective factors in assessing ovarian reserve are the woman’s age, as well as previous ovarian surgery, poor response to ovulation stimulation with follicle-stimulating hormone during in vitro fertilization (IVF), and previous chemotherapy or radiation therapy. AMH can be used to predict poor or excessive ovarian response to ovulation stimulation in IVF, but there is no international standard for AMH as a diagnostic criterion, which limits its widespread use. In modern reproductive medicine, the diagnostic value of using the measurement of the concentration of anti-Müllerian hormone in the blood in female infertility is limited. Individual values of AMH concentration in the blood may vary, which should be especially taken into account at threshold values after the use of hormonal drugs. The measurement result may also depend on the diagnostic test system used. The concentration of AMH in the blood and the number of antral follicles do not provide information about the quality of oocytes, do not predict the birth of a live child, and are not criteria for assessing fertility.

Keywords:

anti-Müllerian hormone

ovarian reserve

antral follicle

assisted reproductive technologies

Authors:

Baranouskaya E.I.

Belarusian State Medical University

Received:

27.07.2021

Accepted:

27.08.2021

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References:

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