[Clinical use for anti-mullerian hormone in gynecology]

Anti-mullerian hormone (AMH) is a glycoprotein produced by granulosa cells of primary, pre-antral and small antral ovarian follicles and its clinical applicability has been recently demonstrated by several studies. Prediction of the response to ovarian stimulation for in vitro fertilization corresponds to the most frequent utilization of AMH in clinical practice, being routinely assessed in many services to identify subgroups of women susceptible to a poor response or to Ovarian Hyperstimulation Syndrome. There are great perspectives that AMH may be applicable to the individual determination of risk for iatrogenic gonadal injury in women with neoplasms who will be submitted to chemotherapy. It is also probable that AMH assessment will be included in protocols for the investigation of amenorrhea and oligomenorrhea, since AMH levels are increased in Polycystic Ovary Syndrome, reduced in premature ovarian failure and normal in other conditions such as hyperprolactinemia and hypogonadotropic hypogonadism. It is possible that AMH will be utilized in the future for the prediction of age at menopause and of reproductive prognosis, providing solid bases for pre-conceptive and contraceptive counseling.