Anti-Müllerian hormone (AMH) in the context of ovarian reserve testing — which of the following statements is CORRECT?
- A AMH fluctuates significantly across the menstrual cycle and should be measured only on day 2–3
- B AMH levels are elevated in primary ovarian insufficiency
- C AMH is produced by granulosa cells of preantral and small antral follicles and remains relatively stable throughout the cycle ✓
- D AMH above 10 ng/mL is normal for women aged 35–40 years
Correct answer: C. AMH is produced by granulosa cells of preantral and small antral follicles and remains relatively stable throughout the cycle
Explanation
AMH is secreted by granulosa cells of preantral (primary/secondary) and small antral follicles (2–8 mm), reflecting the size of the primordial follicle pool. Unlike FSH and estradiol, AMH does not undergo significant menstrual cycle variation and can be measured at any time in the cycle — this is a key practical advantage. AMH is markedly LOW in primary ovarian insufficiency and diminished ovarian reserve (elevated FSH, reduced AFC). Normal AMH at age 35–40 is approximately 1–3 ng/mL; values above 10 ng/mL suggest PCOS or excessive ovarian reserve.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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