Anit-Mullerian Hormone (AMH) Reagent – Jaj International

Anti-Müllerian Hormone (AMH) is a 140 kDa homodimer glycoprotein consisting of two identical subunits linked by disulphide bonds and is synthesized by the testes and ovaries. Its clinical applications are prediction of ovarian response and gonadotropin dose selection upon in vitro fertilization. In males, AMH is used to investigate sexual developmental disorders and gonadal function. AMH is commonly assayed by enzyme-linked immunosorbent assay or automated immunoassay formats that show variation between methods.

This review applies fundamental chemical pathology concepts to explain the observed analytical variation of AMH measurement. We examine the lack of standardization between AMH assays, the impact of antibody design on variable measurements, consider the analytical detection of AMH isoforms, review analytical interference in AMH measurement, and briefly assess systematic bias between AMH assays.

The improved attempt at standardizing AMH measurement by the recent approval of a WHO Reference Reagent offers promise for harmonizing immunoassay results and establishing consensus medical cut-off points for AMH in disease. Standardization, however, will need to redress the issue of poor commutability of standard reference material and further assign a standard reference procedure to quantify AMH standard reference material. The improvement of the analytical phase of AMH testing will support harmonized method development and patient care.

AMH levels accurately reflects the ovarian follicular reserve and could, therefore, be considered as an extremely sensitive marker of ovarian aging and a valuable tool in the diagnosis and the recurrence of granulosa cell tumors. Furthermore, AMH evaluation is of clinical importance in predicting the success of in vitro fertilization (IVF).

Additionally, AMH is a diagnostic marker of Polycystic Ovary Syndrome. Thus clinical usefulness of AMH evaluation in the fields of gynaecological endocrinology, menopause, gynaecological oncology and assisted reproduction makes it a fastest growing diagnostic marker.

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