About the Anti-Müllerian Hormone (AMH) Uses in the Clinical Practice - Revista Brasileira de Ginecologia e Obstetrícia
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(11):661-663
The anti-Müllerian hormone (AMH) is a glycoprotein that belongs to the transforming growth factor β (TGF-β) superfamily, and which has a key role in the male sexual development. It is produced by the Sertoli cells in the testis and induces the regression of Müllerian structures. In females, the roles of the AMH have been the focus of recent attention. In the present article, some aspects of the physiology, laboratory assessment, clinical uses and pitfalls, as well as current applications from the health perspective of women will be discussed briefly.
In humans, the AMH is encoded by the AMH gene, located on the chromosome 19p13.3, whereas the gene AMHR2, which codes for its receptor, is located on the chromosome 12. Although the physiology of the AMH in females is not completely established, a huge amount of data produced in the last few years have expanded the knowledge in this field. This hormone is secreted by the ovarian granulosa cells of the preantral and small follicles. It has been demonstrated that the AMH plays an important role in the inhibition of the initiation of the primordial follicles. Data from in vivo and in vitro studies in animals and humans demonstrated that the AMH has a key role in the maintenance of the quiescent status of those follicles. Recently, it has also been shown that this inhibition might be induced by the administration of recombinant AMH or by an overexpression of the gene that encodes the ligand, opening a broad spectrum of possibilities for the clinical use of the AMH. Another important action in the ovary is that the AMH reduces the follicle sensitivity to follicle-stimulating hormone (FSH), depending on the stage of the follicular development. According to some authors, the AMH may be one factor that dictates in which stage the follicle will begin to respond to the FSH. In terms of antral follicles, it has been suggested that the AMH has a role in the selection process together with estradiol (E2) and inhibin. Furthermore, the AMH seems to downregulate the aromatase activity in the granulosa cells of follicles before selection. All of these functions in the antral follicles suggest that the AMH may act as a follicular gatekeeper and may ensure that each small antral follicle produces the adequate amount of E2 prior to the selection. In 2016, an interesting study suggested that the AMH has a role in the gonadotropin-releasing hormone (GnRH) pulse generation control in the hypothalamus.
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The anti-Müllerian hormone (AMH) is a glycoprotein that belongs to the transforming growth factor β (TGF-β) superfamily, and which has a key role in the male sexual development. It is produced by the Sertoli cells in the testis and induces the regression of Müllerian structures. In females, the roles of the AMH have been the focus of recent attention. In the present article, some aspects of the physiology, laboratory assessment, clinical uses and pitfalls, as well as current applications from the health perspective of women will be discussed briefly.
In humans, the AMH is encoded by the AMH gene, located on the chromosome 19p13.3, whereas the gene AMHR2, which codes for its receptor, is located on the chromosome 12. Although the physiology of the AMH in females is not completely established, a huge amount of data produced in the last few years have expanded the knowledge in this field. This hormone is secreted by the ovarian granulosa cells of the preantral and small follicles. It has been demonstrated that the AMH plays an important role in the inhibition of the initiation of the primordial follicles. Data from in vivo and in vitro studies in animals and humans demonstrated that the AMH has a key role in the maintenance of the quiescent status of those follicles. Recently, it has also been shown that this inhibition might be induced by the administration of recombinant AMH or by an overexpression of the gene that encodes the ligand, opening a broad spectrum of possibilities for the clinical use of the AMH. Another important action in the ovary is that the AMH reduces the follicle sensitivity to follicle-stimulating hormone (FSH), depending on the stage of the follicular development. According to some authors, the AMH may be one factor that dictates in which stage the follicle will begin to respond to the FSH. In terms of antral follicles, it has been suggested that the AMH has a role in the selection process together with estradiol (E2) and inhibin. Furthermore, the AMH seems to downregulate the aromatase activity in the granulosa cells of follicles before selection. All of these functions in the antral follicles suggest that the AMH may act as a follicular gatekeeper and may ensure that each small antral follicle produces the adequate amount of E2 prior to the selection. In 2016, an interesting study suggested that the AMH has a role in the gonadotropin-releasing hormone (GnRH) pulse generation control in the hypothalamus.
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