Abstract

Anti-Müllerian hormone (AMH), also called Müllerian inhibiting substance, was shown to be
synthesized by the ovary in the 1980s. This article reviews the main findings of the past 20 years on
the regulation of the expression of AMH and its specific receptor AMHR2 by granulosa cells, the
mechanism of action of AMH, the different roles it plays in the reproductive organs, its clinical
utility, and its involvement in the principal pathological conditions affecting women. The findings in
respect of regulation tell us that AMH and AMHR2 expression is mainly regulated by bone
morphogenetic proteins, gonadotropins, and estrogens. It has now been established that AMH
regulates the different steps of folliculogenesis and that it has neuroendocrine effects. On the other
hand, the importance of serum AMH as a reliable marker of ovarian reserve and as a useful tool in
the prediction of the polycystic ovary syndrome (PCOS) and primary ovarian failure has also been
acknowledged. Last but not least, a large body of evidence points to the involvement of AMH in the
pathogenesis of PCOS.