Developmental Signals - Anti-Mullerian Hormone

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Male embryo showing the degenerating paramesonephric duct (Mullerian duct)

Anti-Mullerian Hormone (AMH; Anti-Müllerian Hormone; Mullerian Inhibiting Substance, MIS; Mullerian Inhibiting Factor, MIF) is a secreted glycoprotein factor (transforming growth factor-beta, TGF-beta superfamily) that regulates gonadal and genital tract development. In the male embryo, the Sertoli cell secrete AMH and inhibit paramesonephric (Mullerian) duct development. In postnatal males, AMH increases during the first month, reaching peak level at 6 months of age, and then slowly declines during childhood falling to low levels in puberty.

In reproductive age women, AMH is produced in the ovary by the granulosa cell surrounding preantral and small antral follicles and serum levels may reflect the remaining follicle cohort and decrease with age.

Links: AMH | Male | uterus | ovary | testis | endocrine

Factor Links: AMH | hCG | BMP | sonic hedgehog | bHLH | HOX | FGF | FOX | Hippo | LIM | Nanog | NGF | Nodal | Notch | PAX | retinoic acid | SIX | Slit2/Robo1 | SOX | TBX | TGF-beta | VEGF | WNT | Category:Molecular

Some Recent Findings

  • Salivary and serum androgens with anti-Müllerian hormone measurement for the diagnosis of polycystic ovary syndrome[1] To determine the predictive value of a raised androgen level with an elevated anti-Müllerian hormone (AMH) for the diagnosis or exclusion of polycystic ovary syndrome (PCOS), a prospective cross-sectional study of 170 women (105 with PCOS type A and 65 normal) was undertaken. AMH was combined with one of, total serum testosterone (T); calculated free androgen index; salivary testosterone (salT); serum androstenedione (A); salivary androstenedione (salA).... Therefore, the combination of an AMH with a cut off of 35 pmol/l combined with a raised T and/or a FAI will confirm PCOS whilst a normal AMH with a normal T and/or FAI will exclude PCOS, thus addressing diagnostic uncertainty."
  • Review - In-vitro regulation of primordial follicle activation[2] "In vivo, primordial follicles gradually exit the resting pool, whereas when primordial follicles are placed into culture, global activation of these follicles occurs. Therefore, the addition of a factor(s) that can regulate primordial follicle activation in vitro may be beneficial to the development of culture systems for ovarian tissue from cancer patients. Several factors have been observed to inhibit follicle activation, including anti-Müllerian hormone, stromal-derived factor 1 and members of the c-Jun-N-terminal kinase pathway."
More recent papers  
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Search term: Anti-Mullerian Hormone

<pubmed limit=5>Anti-Mullerian Hormone</pubmed>


  • Paramesonephric duct (red left, Müllerian duct) degenerates under the influence of Anti-Müllerian hormone (AMH) secreted by sertoli cells (differentiated by SRY expression).

  • Mesonephric duct (purple, Wolffian duct) differentiates under the influence of testosterone secreted by Leydig cells. Within the testes these mesonephric tubules grow towards the medullary sex cords and will form the rete teste. The mesonephric duct extending out of the gonad forms the ductus deferens.

  • Medullary sex cords (orange) form testis cords.
Links: Testis Development Movie


  • cytogenetic location - 19p13.3
  • human gene has 5 exons
Links: HGNC | OMIM - AMH


  • Secreted protein
  • 560 amino acid polypeptide
  • C-terminal domain homology with human transforming growth factor-beta and the beta chain of porcine inhibin

Links: UniProt


AMH can inhibit the autophosphorylation of the Epidermal Growth Factor Receptor (EGFR) in vitro even though it does not compete with EGF for receptor binding sites.

Genital Development


Persistent Müllerian Duct Syndrome

File:Persistent Mullerian duct syndrome
Uterine remnant present in male during surgery[3]

About 85% of all Persistent Müllerian Duct Syndrome (PMDS) cases are due to gene mutations in anti-Müllerian hormone (AMH) or the receptor (AMHR2) with autosomal recessive transmission. Often incidentally diagnosed during surgical repair of inguinal hernia or cryptorchidism.[3]

Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) has been suggested to involve an over-expression of AMH in the PCOS granulosa cells.[4]


  1. Sathyapalan T, Al-Qaissi A, Kilpatrick ES, Dargham SR, Keevil B & Atkin SL. (2018). Salivary and serum androgens with anti-Müllerian hormone measurement for the diagnosis of polycystic ovary syndrome. Sci Rep , 8, 3795. PMID: 29491484 DOI.
  2. Bertoldo MJ, Walters KA, Ledger WL, Gilchrist RB, Mermillod P & Locatelli Y. (2018). In-vitro regulation of primordial follicle activation: challenges for fertility preservation strategies. Reprod. Biomed. Online , , . PMID: 29503209 DOI.
  3. 3.0 3.1 Elias-Assad G, Elias M, Kanety H, Pressman A & Tenenbaum-Rakover Y. (2016). Persistent Müllerian Duct Syndrome Caused by a Novel Mutation of an Anti-MüIlerian Hormone Receptor Gene: Case Presentation and Literature Review. Pediatr Endocrinol Rev , 13, 731-40. PMID: 27464416
  4. Stracquadanio M, Ciotta L & Palumbo MA. (2018). Relationship between serum anti-Mullerian hormone and intrafollicular AMH levels in PCOS women. Gynecol. Endocrinol. , 34, 223-228. PMID: 28944702 DOI.


Roly ZY, Backhouse B, Cutting A, Tan TY, Sinclair AH, Ayers KL, Major AT & Smith CA. (2018). The cell biology and molecular genetics of Müllerian duct development. Wiley Interdiscip Rev Dev Biol , , . PMID: 29350886 DOI.

Shahrokhi SZ, Kazerouni F & Ghaffari F. (2018). Anti-Müllerian Hormone: genetic and environmental effects. Clin. Chim. Acta , 476, 123-129. PMID: 29175649 DOI.

Mossa F, Jimenez-Krassel F, Scheetz D, Weber-Nielsen M, Evans ACO & Ireland JJ. (2017). Anti-Müllerian Hormone (AMH) and fertility management in agricultural species. Reproduction , 154, R1-R11. PMID: 28356501 DOI.

Elias-Assad G, Elias M, Kanety H, Pressman A & Tenenbaum-Rakover Y. (2016). Persistent Müllerian Duct Syndrome Caused by a Novel Mutation of an Anti-MüIlerian Hormone Receptor Gene: Case Presentation and Literature Review. Pediatr Endocrinol Rev , 13, 731-40. PMID: 27464416

McLennan IS & Pankhurst MW. (2015). Anti-Müllerian hormone is a gonadal cytokine with two circulating forms and cryptic actions. J. Endocrinol. , 226, R45-57. PMID: 26163524 DOI.

Josso N, di Clemente N & Gouédard L. (2001). Anti-Müllerian hormone and its receptors. Mol. Cell. Endocrinol. , 179, 25-32. PMID: 11420127


Kissell KA, Danaher MR, Schisterman EF, Wactawski-Wende J, Ahrens KA, Schliep K, Perkins NJ, Sjaarda L, Weck J & Mumford SL. (2014). Biological variability in serum anti-Müllerian hormone throughout the menstrual cycle in ovulatory and sporadic anovulatory cycles in eumenorrheic women. Hum. Reprod. , 29, 1764-72. PMID: 24925522 DOI.

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Cite this page: Hill, M.A. (2021, December 7) Embryology Developmental Signals - Anti-Mullerian Hormone. Retrieved from

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