What does AMH indicate in infertility workups and how is it interpreted?

• A. AMH reflects ovarian reserve; low AMH suggests diminished ovarian reserve; high AMH often correlates with PCOS; values are assay-dependent.
• B. AMH measures luteal phase progesterone levels and indicates endometrial receptivity.
• C. AMH is a direct measure of sperm quality and motility.
• D. AMH assesses tubal patency and uterine cavity integrity.

Answer: (A)

AMH is a marker of how many eggs a woman potentially has left, reflecting the ovarian reserve. It’s produced by granulosa cells of small growing follicles, so higher levels generally indicate a larger pool of recruitable follicles and a stronger expected response to ovarian stimulation, while lower levels suggest diminished ovarian reserve. In infertility workups, AMH helps estimate how the ovaries might respond to stimulation for IVF and aids in counseling and dosing decisions. A low AMH points to a reduced ovarian reserve and possibly fewer retrievable eggs, whereas a high AMH is commonly seen in PCOS due to many small follicles. It’s important to note that AMH values are assay-dependent; different labs and test methods can yield different reference ranges, so results should be interpreted using the specific assay’s norms and in the context of age and overall fertility assessment. AMH does not measure oocyte quality or pregnancy prospects, and it does not assess luteal phase progesterone, endometrial receptivity, sperm quality, tubal patency, or uterine cavity integrity.