Anti-Müllerian hormone (AMH) TechNotes

Anti-Mullerian hormone (AMH) is a dimeric glycoprotein of the TGF-β protein family, and it is produced by granulosa cells and Sertoli cells in women and men respectively. AMH is a gonadal hormone that regulates the primordial follicle transition rate and
follicle-stimulating hormone (FSH) sensitivity in the smaller antral follicles in females (1). AMH is secreted by granulosa cells of small antral and preantral follicles, and it reflects the size of the pool of these follicles in women (2). AMH levels are stable during the menstrual cycle (3).

In females, AMH secretion by ovarian granulosa cells starts at approximately the 36 week point of gestation, reaching a peak at approximately 25 years of age. It then gradually declines until menopause, at which point it becomes undetected in the bloodstream. However, in males, AMH levels are high after birth and they remain so in the pre-pubertal period, before lower and stable AMH levels occur in adult life (4).

AMH as a biomarker in diagnostics

AMH is currently considered to be among the most reliable biomarkers for the assessment of ovarian reserve in women (5). The measurement of AMH can be used in fertility investigations in order to help to predict the response of women to ovarian stimulation, as well as to estimate the time to menopause and also to diagnose and monitor women with polycystic ovary syndrome (6).

Biochemistry of AMH

AMH has two forms circulating in the blood. The first is proAMH homodimer, which does not bind to AMH receptors. The second is the cleaved, AMH type 2 receptor–binding form, known as AMHN,C. The 140-kDa proAMH homodimer can be cleaved by proteases, yielding a 25-kDa C-terminal dimer (AMHC) and a 120-kDa N-terminal dimer(AMHN), which remain associated as a noncovalent complex (AMHN,C) (7) (see Figure 1 on page 2). The majority of modern day immunoassays are able to detect both
forms of AMH in the human blood (8).

Reagents for assay development

Hytest provides several well-characterized murine monoclonal antibodies (MAbs) that are specific to human AMH. The antibodies were developed against a recombinant human AMH. In addition, we provide a recombinant AMH protein that could be used as a calibrator or a standard in assay development.

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