A validated model of serum anti-Müllerian hormone from conception to menopause reflects ovarian activity throughout life

Anti-Mllerian hormone (AMH) is a product of growing ovarian follicles. Its concentration in blood may also reflect the non-growing follicle (NGF) pool (the ovarian reserve) and the rate of activation of follicle growth, and be of value in determining likely age at menopause. We have established AMH concentrations in women from age -0.3 to 59 years, using published data from normal women (n=1099), and generated a model. This was then validated using a second, independent database of similar size. The model demonstrates a rise in serum AMH to a peak at age 19.6 years, followed by a decline to the menopause, and allows the generation of normative data at all ages. During both childhood and adolescence and in adulthood, there were very close positive relationships between rate of loss of NGF pool, ie rate of initiation of follicle growth, whereas AMH showed a negative relationship to total NGF during childhood and adolescence and a positive relationship thereafter. This model indicates that AMH concentrations reflect NGF numbers and follicle growth initiation from birth to the menopause, and that there is a transition period in early adulthood when AMH starts to reflect the progressive loss of the ovarian reserve.