AMH; Müllerian inhibiting factor; MIF; Müllerian-inhibiting hormone; MIH; Müllerian-inhibiting substance; MIS
About eight weeks after conception the human foetus has two sets of ducts, one of which can develop into the male reproductive tract and the other into the female reproductive tract. If the foetus is genetically male (XY chromosomes) then the embryonic testes will produce anti-Müllerian hormone. This causes the Müllerian (female) ducts to shut down and the male (Woolfian) ducts to survive – hence the term anti-Müllerian hormone. The Woolfian ducts are then free to develop into different parts of the testes: the epididymus, the vas deferens and the seminal vesicles. In a female foetus (XX chromosomes) the Woolfian ducts shut down and the Müllerian ducts develop into the fallopian tubes, uterus (womb), cervix and the upper part of the vagina. Anti-Müllerian hormone may also have a role in regulating sex steroid production in puberty and in the adult ovaries and testes. In the ovaries, anti-Müllerian hormone is important in the early stages of development of the follicles. These are eggs surrounded by one or more layers of cells.
It is not currently known how the production of anti-Müllerian hormone is controlled.
When the male foetus does not produce enough anti-Müllerian hormone, the Müllerian ducts do not shut down and this leads to persistent Müllerian duct syndrome. Patients with this syndrome will have a male appearance but they usually have undescended testes (cryptchordism) and low or absent sperm count due to abnormal development of the Woolfian duct. This leads to malformation of the vas deferens and epididymus. This condition is rare.
Measuring levels of anti-Müllerian hormone provides a way of estimating ovarian reserve in women, in other words, how responsive the ovaries are to stimulation by the pituitary gland (see article on follicle stimulating hormone). Consequently, anti-Müllerian hormone levels are routinely used to predict how well a woman is likely to respond to in vitro fertilisation (IVF) fertility treatment, and what doses of hormones should be used during IVF.
In women anti-Müllerian hormone levels peak around puberty and remain relatively constant until after the menopause, when no follicles remain, and levels of anti-Müllerian hormone become low. Some studies suggest that levels of anti-Müllerian hormone may be lower than normal in women who undergo premature ovarian failure. However, anti-Müllerian hormone results need to be interpreted with caution since many other factors can affect an individual’s fertility.
High levels of anti-Müllerian hormone may be associated with polycystic ovary syndrome. However, measuring anti-Müllerian hormone can be misleading and does not give a definitive diagnosis of either premature ovarian failure or polycystic ovary syndrome. It is important that any test to measure anti-Müllerian hormone levels is carried out by a qualified medical professional.
Last reviewed: Apr 2015