High anti-Mullerian hormone - Any Ideas?

by A.M.
(United States)

Thank you for your newsletter! I have found it difficult to find useful, outside-the-box information on PCOS.

I'm not a huge researcher because I find the dramatic success and/or hopeless stories and watered down, generic information on the internet discouraging.

Your newsletter has been a helpful resource! I appreciate the sometimes hard to hear facts because they MEAN something!

I have a question for you. I was diagnosed with PCOS almost 6 years ago. I'm 5'7", 140 lbs and my cycles have been fairly regular for the past 3-4 years. According to my hormone tests, the only problem I have is a high AMH…very high...61.

I've tried a couple rounds of Clomid and one other drug that I can't remember the name of, with no effect on my follicles. Everything else "looks normal". I'm struggling to find any information about lowering it or why it is so high. I was wondering if you had any place for me to start?

Thank you!

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It's a bit of a mystery
by: PCOS Editor

Thanks for your kind comments.

(Note: AMH is short for "Anti-Mullerian hormone". It's a hormone produced in the ovaries. It is commonly elevated in PCOS. So it is sometimes used as a marker for identifying this disorder.)

That's a very high value for AMH, as shown in these charts.

Not much I can say to help you with that, especially since I know nothing about you...

-- Has an ovarian granulosa cell tumor been ruled out? Rare, but I would definitely investigate that possibility.

Mayo Clinic says: "AMH, along with related tests including inhibin A and B (INHA / Inhibin A, Tumor Marker, Serum; INHB / Inhibin B, Serum; INHAB / Inhibin A and B, Tumor Marker, Serum), estradiol (EEST / Estradiol, Serum), and CA-125 (CA25 / Cancer Antigen 125 [CA 125], Serum)", can be useful for diagnosing this possibility.

In one study, "AMH was highly sensitive (92%) and specific (81%) in detecting a macroscopic ovarian adult-type granulosa cell tumors. However, in AUC comparison analyses, the combination of the markers was superior to inhibin B alone."

-- Lab error? That is possible. Do the same test with the same lab and see if you get a similar (or very different) value.

-- Try a different lab method -- if a blood test, try urine. Or vice versa.

Background info on AMH: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4687350/

"Looks normal" means little me. Where are you on the distribution curve of normal? Low-normal, mid-range, high-normal?

You might consider a comprehensive 24-hour hormone urine test to get another perspective on things. Examples here.

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