PCOS PCOS and Anti-Müllerian Hormone By Nicole Galan, RN facebook twitter linkedin Nicole Galan, RN, is a registered nurse and the author of "The Everything Fertility Book." Learn about our editorial process Nicole Galan, RN Medically reviewed by Medically reviewed by Anita Sadaty, MD on November 06, 2019 facebook twitter linkedin instagram Anita Sadaty, MD, is a board-certified obstetrician-gynecologist at North Shore University Hospital and founder of Redefining Health Medical. Learn about our Medical Review Board Anita Sadaty, MD Updated on January 10, 2020 Print Anti-Müllerian hormone (AMH), also known as Müllerian inhibiting substance, is a type of hormone secreted by an ovarian follicle as it matures. AMH levels are an important diagnostic measure as they are directly associated with the number of antral follicles found on the ovary each month. Hero Images / Getty Images Antral follicles, also referred to resting follicles, are those in the latter stage of development. Each has the potential to release an egg when fully mature. Doctors may evaluate AMH levels for several reasons. Among them, the actual number of follicles—referred to as the ovarian reserve—can give doctors an idea as to how successful in vitro fertilization (IVF) may be. The higher the antral follicle count, the higher the AMH levels. The association has a high predictive value in this instance. AMH and Its Effects in PCOS On the other hand, these very same measures can be a problem in women with polycystic ovary syndrome (PCOS). Women with PCOS will often have a high number of antral follicles and, as a result, an equally high level of AMH in their blood. The problem with this is that too much AMH can actually stop ovulation from occurring. In a normal ovary, AMH works by preventing the premature development of a follicle and, in turn, the release of an immature egg during ovulation. When AMH levels are too high, they can inadvertently put on the brakes on this process, halting the maturation of an egg midstream. In the same way that AMH can help predict the likelihood of a successful IVF procedure, it can help diagnose PCOS in women who may not have obvious signs of the syndrome. What an AMH Test Can Tell Us AMH levels can be measured with a simple blood test. The blood can be drawn on any day of the menstrual cycle and, thereafter, sent to the lab for analysis. When returned, the results can tell us if the AMH is high, low, or normal. AMH Levels High levels are above 5.0 ng/ml.Borderline high is between 3.5 ng/ml to 5.0 ng/ml.Normal is between 0.7ng/ml to 3.5ng/ml.Borderline low is between 0.3 ng/ml to 0.7 ng/ml.Low levels are below 0.3 ng/ml. A high level alone cannot diagnose PCOS since AMH levels typically decrease with age. As such, doctors will compare a woman’s age with the AMH results and use those to help make a diagnosis. When AMH Is Important in Diagnosing PCOS AMH can be extremely useful in diagnosing PCOS, especially in women over 35. Normally speaking, to confirm a PCOS diagnosis, a woman would need to meet two of three diagnostic criteria: Delayed ovulationPolycystic ovaries on an ultrasound examLab results indicating an increase in certain hormones associated with PCOS symptoms (including hirsutism, acne, hair loss, etc.) The problem with this is that polycystic ovaries on ultrasound are rare in women with PCOS after the age of 35. As such, if the other symptoms are vague, a PCO diagnosis may be missed or considered inconclusive. By picking up an elevated AMH, doctors can sometimes support a diagnosis with reasonable confidence. While the test is not considered a substitute for a polycystic ovary ultrasound, it has diagnostic value in association with the other tests. Moreover, in women known to have PCOS, elevated AMH levels correspond to an increased severity of symptoms, making its use all the more important in diagnosing and monitoring PCOS-related illnesses. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Dumont, A.; Robin, G.; Catteau-Jonard, S. et al. Role of Anti-Müllerian Hormone in pathophysiology, diagnosis, and treatment of polycystic ovary syndrome: A review. Reprod Biol Endocrinol. 2015; 13(1):137. doi: 10.1186/s12958-015-0134-9