AMH in Diagnosis
AMH may also have a role in the diagnosis of ovarian dysfunction. Its relationship with some of the common causes of oligo/amenorrhoea has been discussed above, but its clearest potential is in the diagnosis of polycystic ovarian syndrome (PCOS). Women with PCOS often have very markedly increased AMH concentrations. This may appeal to endocrinologists more than the assessment of ultrasound findings, although the two are functionally related as high AMH production reflects the increased numbers of small growing follicles. The high intra-ovarian AMH concentrations may also contribute to a reduced responsiveness to FSH. Measurement of AMH may be of value in the differential diagnosis of oligomenorrhea, and it is likely that it will be part of future revisions of the criteria for the diagnosis of PCOS.
As a granulosa cell product, AMH is also of value in the diagnosis and monitoring of granulosa cell tumours, and the finding of a very high concentration should lead to consideration of this diagnosis. The production of AMH by the testicular Sertoli cell underlies its emerging value in the differential diagnosis of disorders of sexual development.