{'fraction_non_alphanumeric': 0.016666666666666666, 'fraction_numerical': 0.0, 'mean_word_length': 5.0874125874125875, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Evaluation of Female Fertility - AMH and Ovarian Reserve Testing.

CONTEXT
Evaluation of the infertile female requires an understanding of ovulation and biomarkers of ovarian reserve. Anti-mullerian Hormone (AMH) correlates with growing follicles in a menstrual cycle. Increasingly, AMH has been utilized as a "fertility test". This narrative review describes how to integrate the use of AMH into diagnosis and treatment.


EVIDENCE ACQUISITION
A PubMed search was conducted to find recent literature on measurements and use of serum AMH as a marker of ovarian reserve and in treatment of infertility.


EVIDENCE SYNTHESIS
Serum AMH estimates ovarian reserve, helps determine dosing in ovarian stimulation and predicts stimulation response. As such, AMH is a good marker of oocyte quantity but does not reflect oocyte health or chances for pregnancy. Screening of AMH prior to fertility treatment should be utilized to estimate expected response and not to withhold treatment. Low AMH levels may suggest a shortened reproductive window. AMH levels must be interpreted in the context of the endogenous endocrine environment where low FSH, due to hypogonadotropic hypogonadism or hormonal contraceptive usage, may lower AMH without being a true reflection of ovarian reserve. Additionally, there is an inverse correlation between BMI and AMH that does not reflect ovarian response.


CONCLUSION
AMH is a useful marker of ovarian reserve in reproductive age women. Increased screening of non-infertile women requires a thorough knowledge of situations that may impact AMH levels. In no situation does AMH reflect oocyte health or chances for conception. Age is still the strongest driver in determining success rates with fertility treatments.