If we want to find an ideal method to assess ovarian reserve function, AMH is by far the closest indicator. It comes from the secretion of antral follicles and small follicles, so levels are stable during the cycle and can be monitored at any time; it is a more accurate predictor of ovarian response to stimulation and number of eggs gained, useful for individualized ovulation planning; it predicts ovarian hypofunction earlier than other indicators, alerting you to address fertility issues earlier. Wow, it’s a great tool for ovarian function assessment. Zhang Qin, Department of Obstetrics and Gynecology, Dongfeng Xiangfan Hospital The fertility of women is closely related to their ovarian function, and nothing is more familiar to those undergoing IVF treatment than the assessment of ovarian function, and nothing is more worrying than ovarian hypofunction. In the medical field, age, hormone tests such as basal follicle stimulating hormone (FSH) and estrogen (E2), and ultrasound to assess the number of follicles in reserve are often used as comprehensive reference indicators to assess ovarian function, but in recent years, Anti-Müllerian hormone (AMH) has been used as a new indicator to assess ovarian function. AMH is a glycoprotein hormone, which is the only hormone marker produced by granulosa cells at the primary stage from primary follicles to sinus follicles, and is the most highly expressed hormone marker in the antral follicles and small sinus follicles (i.e., the reserve follicles). In adult women, AMH only originates from the ovaries and can be used as an indicator of ovarian function, to evaluate ovarian reserve function and predict the effect of ovulation promotion. Second, the significance of AMH testing1AMH to assess ovarian reserve function The main indicators commonly used to assess ovarian reserve are: age, basal FSH, E2 level, inhibin B, basal sinus follicle count (AFC), ovarian volume, and ovarian stromal blood flow, but the ability to assess ovarian reserve is not very satisfactory. In contrast, AMH levels showed a significant positive correlation with the number of early sinus follicles, which was more correlated than sinus follicle count, inhibin B and FSH, and thus more reflective of ovarian reserve function. It has been found that serum AMH levels maintain a relatively static level from 18 to 29 years of age and start to decline rapidly after 30 years of age, with serum concentrations at approximately 2 ng/ml at 37 years of age, while FSH concentrations do not change significantly from 29 to 37 years of age. Thus, AMH is relatively the earliest in a series of events of declining ovarian reserve.2 AMH predicts IVF treatment outcome AMH testing is equally significant in predicting IVF treatment outcome. How to accurately predict the ovarian response to ovulation-promoting drugs in order to obtain a moderate number of eggs of high quality and to reduce complications is the key to the success of the assisted conception technique. Currently, age and basal FSH levels are the main predictors routinely used at home and abroad, but these indicators are not completely accurate in predicting ovarian responsiveness and IVF outcomes, as people of the same age, basal FSH level and height and weight may have completely different egg counts and success rates. In a study on the correlation between AMH and in vitro fertilization (IVF), blood AMH was found to be a more accurate predictor of ovulation cycle cancellation rates and egg production than FSH and E2 on day 2 of menstruation, and AMH levels can predict ovarian responsiveness and identify women at risk for ovarian hyperstimulation syndrome. For example, high levels of AMH indicate risk of ovarian hyperstimulation and low doses of gonadotropins should be used, while low levels of AMH indicate low ovarian response and higher doses of ovulation stimulating drugs should be used. It is generally accepted that when AMH is less than 0.5 to 1.1 ng/ml it indicates diminished ovarian reserve function. AMH can help us to choose the appropriate individualized treatment to enhance the effectiveness and safety of in vitro fertilization and improve the success rate of IVF. Most scholars believe that AMH can only predict the number of eggs gained, but it does not correlate with the final pregnancy outcome, and cannot accurately predict IVF outcome. AMH is secreted by the granulosa cells of antral follicles and small sinus follicles <4mm in diameter, so AMH is not affected by the menstrual cycle or medications, and is stable at any time. It generates accurate and reliable stable results to assess ovarian reserve capacity. The reference values of AMH: 0.24-11.78 ng/ml for 20-40 years old, 0.00-1.22 ng/ml for 41-50 years old, generally greater than 4 ng/ml is considered normal. a decrease in AMH means that the ovaries are aging, which means that female fertility is declining. However, AMH cannot predict the future decline of ovarian function. It is recommended that if you have a tendency to have a low AMH test, it is best to plan for fertility early to avoid delaying the best time to have children!