## **Core Concept**
Antimullerian hormone (AMH) is produced by the granulosa cells of small antral follicles in the ovaries. It serves as a marker of ovarian reserve, reflecting the number of remaining follicles. AMH levels are used clinically to assess ovarian function and fertility potential.

## **Why the Correct Answer is Right**
During the menopausal transition, the number of follicles in the ovaries decreases significantly. As AMH is produced by the granulosa cells of small antral follicles, a decrease in the number of these follicles results in lower AMH levels. Therefore, AMH levels decrease during the menopausal transition, making **D. Decreases** the correct answer.

## **Why Each Wrong Option is Incorrect**
- **Option A: Increases** - This is incorrect because AMH levels do not increase during the menopausal transition. Instead, they decrease as the ovarian reserve diminishes.
- **Option B: Remains the same** - This is incorrect because AMH levels do change during the menopausal transition; they decrease as ovarian function declines.
- **Option C: Fluctuates wildly** - This is incorrect because, while there may be some variability, AMH levels generally decrease in a more predictable manner as ovarian reserve declines.

## **Clinical Pearl / High-Yield Fact**
A key point to remember is that AMH levels are a useful indicator of ovarian reserve but do not directly predict when menopause will occur. They are more reflective of the remaining follicular pool rather than the timing of menopause.

## **Correct Answer:** . Decreases