In males, AMH is secreted by the Sertoli cells of the testes. During embryonic development in males, secretion of AMH from testicular Sertoli cells is responsible for the regression of the Mullerian duct and the normal development of the male reproductive tract.
In females, AMH plays an important role in the ovarian folliculogenesis. Follicle development in the ovaries comprises two distinct stages: initial recruitment, by which primordial follicles start to mature, and cyclic recruitment, which leads to the growth of a cohort of small antral follicles, among which the dominant follicle (destined to ovulate) is subsequently selected. FSH directs the cyclic recruitment.
Measurement of serum AMH is mainly used for assessment of ovarian reserve reflecting the number of antral and pre-antral follicles, the so-called antral follicle count (AFC), and for the prediction of response to controlled ovarian stimulation. Further clinical applications of AMH are diagnosis of disorders of sex development (DSD) in children and monitoring of granulosa cell tumours to detect residual or recurrent disease. AMH has been suggested as a surrogate biomarker for AFC in the diagnosis of polycystic ovary syndrome (PCOS) and for the prediction of time to menopause.
