AMH and PCOS

AMH levels are 2 to 3 fold higher in women with PCOS

Antimullerian  Hormone (AMH)   is a  peptide that, is produced by the ovaries.AMH  has an important  role in the embryonic life.  In the adult life it is thought that  AMH plays a role in  follicular development by modulating the role of Follicle Stimulating Hormone (FSH).

The levels of AMH are  the highest after puberty and they decline over the years   and  disappear after menopause.   You can view a chart of normal AMH levels by age here.

It is a well known fact that  Antimullerian Hormone levels are elevated in women with PCOS, Policystic Ovary Syndrome.

As you may already know PCOS is a condition ( or a number of conditions)  in which follicles and eggs do not develop normally and remain very small , hence the PCO appearance of the ovaries. . As a consequence, women with PCOS have irregular ovulation or do not ovulate at all. This is associated with absent or irregular menstrual cycles.

AMH levels  decrease with age also in women with PCOS

Serum AMH levels decreased with age both in healthy women and in women with PCOS, although they were always 2- to 3-fold higher and remained elevated until 40 years of age in PCOS subjects.

 

Why is AMH higher in women with PCOS?

It is not clear why AMH is higher in women with  PCOS  there are  various potential causes : an elevated number of small (antral) follicles, ovarian size ( larger ovaries) or ovarian blood flow.

My AMH levels are high. Does this mean I have PCOS?Can AMH  levels predict PCOS?

An elevated level of antimullearian hormone is not  sufficientto diagnose PCOS

In one study  the specificity and sensitivity for AMH  in diagnosing PCOS in symptomatic women was  79.4% and 82.8%, respectively, for a cutoff value of AMH of 4.7 ng/mL. But remember this was in  symptomatic women: women who had clinical signs of PCOS, such as irregular cycles.

In asymptomatic women  and women withouth PCOS an elevated AMH level may be correlated to larger ovaries,  or increased ovarian bloodflow.  Some doctors  describe the ovaries of these women as PCO like ovaries.

Is it bad to have an elevated AMH level?

Having an elevated Anti-mullerian hormone level simply means that  your ovaries have a good volume and many follicles , and  consequently many eggs.  Overall it is a good thing.

Is an elevated AMH level linked to insulin resistance?

Although the relation between AMH and androgen production  has been proven, the the relation between AMH and insulin resistance is not clear yet. So at the present time I would say that the answer is no.

 

Dr. Vidali specializes in the diagnosis and treatment of PCOS. If you have been diagnosed with PCOS  or an elevated AMH and you are tryingto get pregnant  your chances to conceive are excellent. Call us now for a consultation at 212317-8700

 

1: Iliodromiti S, Kelsey TW, Anderson RA, Nelson SM. Can anti-Mullerian hormone
predict the diagnosis of polycystic ovary syndrome? A systematic review and
meta-analysis of extracted data. J Clin Endocrinol Metab. 2013 Aug;98(8):3332-40.
doi: 10.1210/jc.2013-1393. Epub 2013 Jun 17. PubMed PMID: 23775353.
1: Franasiak J, Young SL, Williams CD, Pastore LM. Longitudinal anti-müllerian
hormone in women with polycystic ovary syndrome: an acupuncture randomized
clinical trial. Evid Based Complement Alternat Med. 2012;2012:973712. doi:
10.1155/2012/973712. Epub 2012 Aug 26. PubMed PMID: 22966246; PubMed Central
PMCID: PMC3433176.

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