ANTI-MULLERIAN HORMONE (AMH) ON FEMALE REPRODUCTION (Part 1)

Hormone is a chemical substance produced by the body that regulates and governs the functioning of specific cells or organs. Thyroid hormone, generated by the thyroid gland, is one of many hormones secreted by specific glands. Estrogen, insulin, progesterone, oxytocin, and testosterone are probably the ones you are most familiar with. Human Chorionic Gonadotropin (HCG) is another hormone that you may be familiar with if you have ever been pregnant. As a result, Anti-Mullerian Hormone (AMH) may not be the most well-known hormone in relation to reproductive health. But it is important to know, especially if you want to start a family in the future. Among all tests for infertility, hormone tests are important for fertility treatment. These tests are used to determine your ovaries’ efficiency and capacity. FSH, LH, and Estradiol hormones are among the available tests. In addition to these tests, an AMH test can be used to determine your reproductive potentials.

WHAT IS ANTI-MULLERIAN HORMONE?

Anti-mullerian Hormone can be referred to as Mullerian inhibiting substance. This hormone is a protein that aids in the development of the male fetal reproductive tract. It is synthesized by reproductive tissues, namely – the testes in males and the ovaries in females, prior to birth. The role of AMH, as well as the amount that is normally present, differs depending on gender and age. The AMH is important for the development of sexual differentiation in the fetus. AMH secretion changes as the ovarian follicle develops. When follicles deteriorate or approach menopause, AMH is no longer secreted. The level of AMH is used to determine if a female is fertile or has reached menopause.

Anti-Mullerian Hormone is produced by small developing follicles and is thus different from ovulation, allowing for a better assessment of genuine ovarian reserve. AMH can be measured from birth through menopause, with a peak in the mid-twenties. The AMH gene codes for a protein involved in growth differentiation and maturation of ovarian follicles.

ROLES OF ANTI-MULLERIAN HORMONE

The roles of AMH and determination of its normal levels depends on age and gender.

IN BABIES

AMH is produced in the testes and ovaries of the fetus before birth. Around eight weeks after conception, a fetus has both female (Müllerian) and male (Wollfian) ducts, which can develop into the female or male reproductive system.

·       For a male baby with (XY) genes, the levels of AMH are usually high alongside other male hormones, which prevents the development of females organs and promote the formation of male organs. The Mullerian ducts will disappear as the testes produce AMH. The growth of the male reproductive system will then be aided by testosterone produced in the testes.

·       For a female baby with (XX) genes, small amount of AMH are produced. This frees up space for the growth of female reproductive organs. A lack of testosterone will cause the Wollfian duct to disappear and the Mullerian duct to grow into the female reproductive system if a fetus has XX (female) chromosomes.

AMH plays a critical part in the development of a baby’s sex organs while he or she is still in the womb. Babies already have genes to become either a male (XY) or a female (XX). If there is not enough AMH to prevent the development of female organs, organs of both sexes may form, and this would results in an intersex being where a baby’s genitals cannot be identified as male or female.

IN FEMALES

AMH levels can be used to:

·       determine fertility in women,

·       diagnose menstrual disorders in females,

·       monitor the health of women with certain types of ovarian cancer.

IN MALES

AMH is secreted from the testes.

·       It is used to detect abnormalities of male development.

·       It aids the development of the male sex organs in an unborn baby. Without AMH, the male baby may develop uterus, part of the vagina, and fallopian tubes.

ROLE OF AMH IN FEMALE FERTILITY

An AMH test is used often to check a woman’s ability to produce eggs that can be fertilized for pregnancy. Women ovaries can make thousands of eggs during her childbearing years, and the number reduces as she gets older. The more eggs remained in the ovaries, the higher the quantity of AMH in the bloodstream; hence AMH can determine the number of prospective eggs.

A low level of AMH is considered to be a sign of a low ovarian reserve, that is, few remaining follicles. This result would be normal for a woman who is approaching menopause. By the same token, a woman who has polycystic ovarian syndrome, AMH levels would generally be expected to be high in ovarian follicles with several tiny follicles. As a result, AMH plasma levels reflect the continuous proliferation of small follicles, and hence the size of the remaining follicle pool, making it a useful indicator of ovarian reserve.

Anti-Mullerian hormone is an endocrine marker that can be used to measure the age related reduction of the ovarian pool and, hence its ability to predict future reproductive lifespan. Although an AMH test is not a complete diagnostic solution, it can be performed at any moment during the monthly cycle, even if the woman is taking oral contraceptives ………………………………………………………………TO BE CONTINUED