2013, Cilt 11, Sayı 2, Sayfa(lar) 079-085 |
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Anti-Mullerian Hormone (AMH): As the Best Marker of Ovarian Reserve |
Meltem Demir |
Medicalpark Hastanesi, Biyokimya ve Klinik Biyokimya, Antalya |
Keywords: Anti-Mullerian Hormone; biomarker; assisted reproductive techniques |
Anti-Mullerian hormone (AMH), also called Mullerian inhibiting substance (MIS), belongs to the transforming growthfactor- Β (TGF- Β) superfamily. In women, AMH is produced by granulosa cells beginning from 36 weeks of gestation until menapause, with the highest expression being in small antral follicles. AMH is exclusively produced in the ovary by the granulosa cells surrounding preantral and small antral follicles. Hence, it is thought that serum AMH levels are a reflection of the size of the growing cohort of small follicles , which in turn reflects the number of residual primordial follicles, or the ovarian reserve.
Anti-Mullerian hormone seems to be the best endocrine marker for assessing the age-related decline of the ovarian pool in healthy women. The most established role for AMH measurements is prior to in vitro fertilization, because AMH can be a predictive of the ovarian response, namely poor and hyper-responses. However, recent research has also highlighted the facts of utilization of AMH in various of ovarian pathological conditions, including polycystic ovary syndrome, granulosa cell tumors and premature ovarian failure.
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