How do AMH levels vary throughout a woman’s life?
A new study from Denmark provides data from healthy women throughout life. The healthy women data is a great reference source. Turner Syndrome (TS) women demonstrate hormone levels consistent with their ovarian function.
- Healthy women AMH levels remain stable from ages 8 – 25. Hormone levels then fall until undetectable at menopause.
- Turner Syndrome patients show us the relationship of hormone level to egg count. TS women have very early menopause. Their hormone levels reflect the ovarian function present.
TS females usually have a single X chromosome (45, X). Sometimes they can have a mixture of genetically normal and abnormal cells. Sometimes they can have an abnormal X-chromosome. TS females demonstrate a spectrum of ovarian function. They vary from early premature ovarian failure (POF, most common) to delayed POF. Delayed POF allows some normal menstrual cycles and occasional pregnancies. TS females are interesting because give us a window into hormone events that occur with menopause.
AMH in 926 Healthy Females from Birth to Adulthood from Hagen CP et al. J Clin Endocrinol Metab 95: 5003–5010, 2010
Note that after birth the anti-mullerian hormone levels rise to suppress follicle growth then fall. All this activity occurs in the first 2 years of life. Healthy female levels were stable from about ages 8 – 25. The levels begin to fall after age 25 until menopause when they are undetectable.
Hagen CP et al. Serum Levels of AMH as a Marker of Ovarian Function in 926 Healthy Females from Birth to Adulthood and in 172 Turner Syndrome Patients; J Clin Endocrinol Metab 95: 5003–5010, 2010
Note in the above chart that the AMH correlates very nicely with the TS female’s ovarian function. When TS females have normal cycles, the hormone is normal. When they have menstrual cycles then quit, the levels are low. When they have POF before puberty then the levels are menopausal. This information supports anti-mullerian hormone as a marker of the number of eggs in the ovary. AMH should help families of Turner Syndrome patients predict ovarian function and reproductive potential.
Dr Opsahl AVVO Profile
Most women with Turner’s syndrome have ovarian dysgenesis; therefore, they are usually infertile, and in very rare cases have spontaneous menses followed by early menopause. Only 2% of the women have natural pregnancies, with high rates of miscarriages, stillbirths and malformed babies.
Female turner syndrome