Anti-Muellerian hormone (AMH) is a glycoprotein hormone structurally related to inhibin and activin from the transforming growth factor beta superfamily, whose key roles are in growth differentiation and folliculogenesis. AMH is activated by SOX9 in the Sertoli cells of the male fetus. Its expression inhibits the development of the female reproductive tract, or muellerian ducts (paramesonephric ducts), in the male embryo, thereby arresting the development of fallopian tubes, uterus, and upper vagina. AMH expression is critical to sex differentiation at a specific time during fetal development, and appears to be tightly regulated by nuclear receptor SF-1, transcription GATA factors, sex-reversal gene DAX1, and follicle-stimulating hormone (FSH). AMH is also a product of granulosa cells of the preantral and small antral follicles in women. AMH is only present in the ovary until menopause. AMH can serve as a molecular biomarker for relative size of the ovarian reserve. AMH can also be used as a marker for ovarian dysfunction, such as in women with polycystic ovary syndrome (PCOS).
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