What is the role of anti-Müllerian hormone testing in infertility workups?

• A. AMH estimates ovarian reserve and helps predict response to stimulation; not a direct measure of fertility but guides dosing and prognosis
• B. AMH directly determines fertility and pregnancy chances
• C. AMH is only useful after menopause
• D. AMH has no role in infertility workups

Answer: (A)

Anti-Müllerian hormone testing is used because AMH levels reflect the pool of recruitable follicles in the ovaries, i.e., ovarian reserve. In infertility workups, this helps estimate how the ovaries might respond to stimulation. A higher AMH suggests a larger ovarian reserve and a better likelihood of yielding a reasonable number of eggs with stimulation, guiding gonadotropin dosing and helping to form a realistic prognosis. A lower AMH indicates diminished reserve and a potential for poorer stimulation response, which can influence treatment planning and expectations.

Importantly, AMH is not a direct measure of fertility or pregnancy chances. It doesn’t tell you whether a person will conceive or carry a pregnancy, because fertility depends on many factors beyond the size of the remaining follicle pool, including egg quality, tubal function, uterine receptivity, and male factors. AMH is relatively stable across the menstrual cycle and remains useful in various contexts, such as planning for fertility preservation in cancer patients or assessing ovarian reserve over time. Be aware that assay differences and conditions like PCOS can affect AMH interpretation, so it’s one piece of the broader infertility assessment.