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Does High AMH level equal to good ovarian status?

Does high AMH level equal to good ovarian status? Why some females with high AMH are suffered by the infertile issue?



Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders in the female subfertility. The gynecologic ultrasongraphy of patients with PCOS would display bead-like follicles in the ovaries, and the luteinizing hormone (LH) level is higher without menstrual regulation in them. Generally, the regular ovulation would be controlled by the internal LH and follicle stimulating hormone (FSH) levels, but the menses in the patients with PCOS would show an irregular pattern due to their endocrine disorders. Therefore, one of the most common immediate symptoms in these patients is anovulation.

LH and FSH levels in the PCOS cases






LH and FSH levels in the normal individuals





Anti-Mullerian Hormone, AMH, is secreted by the granulosa cells of ovarian follicles, and it is commonly used as an indicator of the ovarian reserve. The AMH level would not be affected by the menstrual cycle and pregnancy status, but it would decrease with the increase of maternal age and the decline of ovarian function. However, AMH represents the ovarian reserve merely, and it could not be related with the actual quality of oocytes, which is affected by the maternal age more.




The records of AMH levels and antral follicle counts (AFC) in 304 cases with PCOS and 1896 individuals with infertility in 2014 Fertility and Sterility journal. It displayed higher AMH level and AFC in the PCOS group.



References:
Yuqian Cui, M.D., Ph.D. Ferility and Sterility. Published Online: April 17, 2014 Age-specific serum antimüllerian hormone levels in women with and without polycystic ovary syndrome



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