Comparing the role of anti-Müllerian hormone as a marker of FSH action in male and female fertility

Abstract

Introduction: Originally limited to the assessment of patients with congenital disorders of sexdevelopment, anti-Müllerian hormone (AMH) measurement has more recently been extended toseveral conditions affecting the reproductive axis in males and females. FSH regulation ofgonadal function has been extensively studied, but its role on AMH production has beenexplored only recently.Areas covered: We addressed the relationship between FSH action on the gonads and theusefulness of AMH as a marker in conditions affecting the reproductive axis in both sexes.Expert opinion: Sertoli cells are the most active cell population in the prepubertal testis. SerumAMH is an excellent marker of FSH action on Sertoli cell proliferation and function in patientswith congenital hypogonadotropic hypogonadism. Low serum AMH is expected to predict lowsperm production and prompts initial FSH treatment followed by hCG or LH addition.Gonadotropin treatment may be more effective if installed to mimic the postnatal activation stageof the hypothalamic-pituitary-testicular axis. In females, AMH secretion by small antral folliclesis stimulated by FSH. Elevated AMH indicates increased follicle numbers and should beconsidered as a potential contraindication of gonadotropin treatment in infertile patients due toan increased risk of developing ovarian hyperstimulation syndrome.