Anti-Müllerian hormone and somatic ovarian function: a new perspective.
Level 5 - mechanism / opinion, no new human data
Narrative review and conceptual framework proposing mechanism-based reasoning without new human empirical data or systematic review methodology.
PubMed 42397488 · doi:10.1007/s10815-026-03964-5
What was done
This narrative review synthesized evidence from granulosa cell biology, controlled ovarian stimulation, ovarian surgery, autoimmune disease, chemotherapy exposure, and fertility studies. The authors developed a conceptual framework evaluating anti-Müllerian hormone (AMH) as a marker of the somatic follicular support network rather than total dormant primordial oocyte reserve.
What was found
The authors note that AMH is produced exclusively by granulosa cells of growing follicles, not primordial follicles, and fluctuates rapidly after somatic stressors (e.g., surgery, chemotherapy, metabolic stress) despite continuous baseline primordial attrition. Based on reviewed literature, ovarian reserve markers including AMH show poor predictive performance for natural fecundability, with cited area under the curve (AUC) values between 0.60 and 0.65.
Why it matters
Shifting the interpretation of AMH from a static counter of oocyte quantity to a dynamic indicator of granulosa cell integrity and somatic ovarian function helps explain clinical inconsistencies and refines its utility in fertility counseling.
Limits
This is a narrative review and theoretical framework without original empirical data or systematic review methodology. Specific study details, sample sizes, and quantitative pooling of primary literature are not provided in the abstract.
Cited by
- supports Anti-Müllerian hormone (AMH) is produced by the granulosa cells surrounding each ovarian follicle.