Endocrine Abstracts

Introduction: AMH is produced by the sertoli cells in the testes and is responsible for the regression of the Mullerian structures in the male fetus. It is also produced by the granulosa cells of the ovaries in females to a lesser degree. Serum AMH measurements may be important for detecting testicular tissue and monitoring ovarian activity. The objective of this study was to establish a cross-sectional reference range for AMH in UK children.

Method: Serum AMH (pmol/l) was measured by enzyme immunoassay (Immunotech) on spare serum left over from samples collected from 281 children (m,152) for routine clinical indications. Diagnoses were noted and those with reported genital abnormalities were excluded from the reference range data.

Results: The results showed that AMH concentration in males increased and peaked during the second half of first year. Subsequently they fell gradually until the age of early puberty following which there was a more precipitous fall. The table below shows the AMH concentration (pmol/l) for males of different age ranges (years) and the AMH concentration for the total female study population.

In females, AMH remained low from birth until age of 16 with no obvious peak. In one 10 month old boy with Persistent Mullerian Duct Syndrome, AMH was undetectable. In another boy with bilateral cryptorchidism and poor testosterone response to HCG, AMH levels were low for age.

Conclusion: Our study establishes, for the first time, an age and gender related reference range for AMH infants and children in the UK and confirms the clinical utility of serum AMH measurement in evaluating disorders of sex development.