AntiMullerian hormone (AMH plus)
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Studies have shown that the AMH level may be useful in determining a woman's remaining egg maturation potential (ovarian reserve) and her likelihood of conceiving. AMH declines overtime during childbearing years, drops significantly as menopause approaches, and typically becomes almost undetectable after menopause. Determining the AMH level may be useful in evaluating a woman's current fertility status and may predict the onset of menopause.
Elevated AMH levels have been associated with a condition affecting the ovaries known as polycystic ovary syndrome (PCOS). The excess follicles that occur in this syndrome produce abnormally large amounts of AMH.
AMH may be elevated in some ovarian tumours (benign or cancerous). If a tumour produces the hormone, then the AMH test can be used as a tumour marker to monitor the effectiveness of treatment and to monitor for recurrence.
Samples are processed via Roche Elecsys ANH Assay. Roche values are expected to be 25% lower than Beckman Coulter AMH Gen II Assay. Therefore for direct comparison between the two methods, any results prior to the 3rd November 2014 should be multiplied by 0.75 (x 0.75).
All reference intervals related to certain ages will be provided with the test report.
An AMH test may be ordered in women when evaluating ovarian function and fertility issues, especially when considering assisted reproduction procedures such as in vitro fertilization (IVF). It may be ordered when a healthcare practitioner wants to determine whether a woman has entered menopause.
AMH may be ordered when a woman has signs and symptoms of polycystic ovary syndrome (PCOS). Some of these include:
- Abnormal uterine bleeding
- Acanthosis nigricans
- Absence of menstrual cycle (amenorrhea)
- Decreased breast size
- Enlarged ovaries
- Excess face and body hair (hirsutism) involving male hair growth patterns, such as hair on the face, sideburn area, chin, upper lip, lower abdominal midline, chest, areola, lower back, buttock, and inner thigh
- Weight gain/obesity, with fat distribution in the centre of the body
- Skin tags in the armpits or neck
- Thinning hair, with male pattern baldness
An AMH test may be ordered when an infant has ambiguous genitalia or when a male child's testicles have not descended properly.
An AMH test may be ordered when a female begins to develop male characteristics (virilization).
During a woman's childbearing years, a decreased level of AMH may indicate a low number and quality of eggs (low ovarian reserve) with diminishing fertility, resulting in minimal or less responsiveness to IVF treatment. It can also indicate that the ovaries are not functioning normally (premature ovarian failure). Increased AMH may indicate increased or even excessive responsiveness to IVF and a need to tailor the procedure accordingly.
A decreasing level and/or significant decline in AMH may signal the imminent onset of menopause or that a woman has entered menopause. Negative to low levels of AMH are normal in a female during infancy and after menopause.
An increased level of AMH is often seen with PCOS but is not diagnostic of this condition.
When AMH is used as a tool to monitor an AMH-producing ovarian cancer, then a decrease in AMH indicates a response to treatment while an increase may indicate cancer recurrence.
In a male infant, absence or low levels of AMH may indicate a problem with the AMH gene located on chromosome 19 that directs AMH production and may be seen with absent or dysfunctional testicles. Lack of male hormones may result in ambiguous genitalia and may cause abnormal internal reproductive structures. Normal levels of AMH and androgens in a male infant whose testicles have not descended indicate that they are present and functional but not physically located where they are supposed to be.
In a female who develops male characteristics, if the AMH levels are in the male reference range, it is most likely coming from a tumour or testicular tissue and if the levels are in the female range, it is likely from the adrenal glands.
The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario. Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider of the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.
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