Perhaps you have never heard of a hormone antimühler. what it is, young ECO-mothers are well aware of, since the test for AMH is one of the obligatory tests during the procedure of artificial insemination.
It is noteworthy that the hormone antimullers itself has no effect on the ability of a woman to conceive and endure a healthy baby. However, the level of AMH in the body very accurately predicts not only the chances of natural conception, but also the success of IVF. This is a kind of “litmus test” of female fertility and women’s health.
Antimulants hormone in women is a “by-product” of the ovaries. It is produced by the cells of the egg-containing follicles, but only during its maturation.
Therefore, according to the AMG level, it is possible to judge exactly how the ovaries work and how many eggs they contain that can “ripen” for fertilization. Depending on the age of the woman, the antimühler hormone has a different level. It cannot be determined in girls before puberty, that is, before the start of the first menstrual cycle.
It is zero in women who have gone out of childbearing age due to natural causes – during menopause. Maximum values of AMG are normally fixed at the peak of female fertility – from 20 to 30 years. It has low values in those women who have difficulty with natural conception.
The lower the level of anti-Muller hormone, the less likely a woman is to become pregnant.
In medicine, there is the term “ovarian reserve” – this is the remaining number of eggs in a woman who can still ovulate and be fertilized. Why the “remaining”? Because each of us is born with an already fixed number of immature eggs contained in the so-called “primordial follicles.” The fate of future motherhood is decided on the third month of intrauterine development of the girl.
How many primordial follicles are formed during this period, so many eggs and will be in the arsenal of a woman when she comes to the childbearing age.
Before the start of the first menstrual cycle, these immature follicles are dormant. Then, normally, at intervals of about 28 days, one follicle matures (more rarely, several), giving birth to a mature, ready-to-fertilize egg.
Therefore, since the first menstruation, the number of fertilized eggs will only decrease. And what remains in the ovaries of a woman is her child-bearing “reserve”.
And this dynamic can be seen with the help of a test for anti-Muller hormone. Its level in an adult woman of childbearing age is currently the most accurate marker (that is, indicator) of a woman’s ovarian reserve.
In terms of AMG, it is possible to predict the time of menopause with very high accuracy, that is, the moment when a woman will no longer have eggs.
When performing artificial insemination procedures, the AMH test is used to assess the probability of pregnancy after ovarian stimulation. The level of anti-Mullerian hormone in this case will indicate whether such stimulation was successful, whether it will be possible to obtain a number of viable eggs that are sufficient for IVF, and even the probability of pregnancy in these conditions.
Diagnostic value is not only a reduced level of AMH. If the analysis shows that the hormone has increased antimullers, this may indicate certain ovarian dysfunctions.
For example, AMH is increased by 2-3 times in case of polycystic ovary syndrome, as well as in primary ovarian failure – a condition in which a woman has several eggs in one menstrual cycle, which leads to premature depletion of the ovarian reserve. Substantially elevated AMH may be a symptom of ovarian granulose cell tumors.
With a significant increase in the anti-Mullerian hormone in IVF patients during ovarian stimulation, doctors talk about an excessive response to ovarian stimulation (superovulation), when too many eggs begin to mature at the same time. In this case, the treatment of infertility is corrected before IVF.
In the diagnosis of ovarian reserve in women of reproductive age, it is considered to be the norm for fluctuations in the AMH level in the range from 0.2 to 11 ng / ml (according to other data, from 0.5 to 12.6 ng / ml). Data may vary in different laboratories. It should be borne in mind that experts should deal with the interpretation of the results of the test for antimullers hormone.
Referral to the analysis of AMH, as a rule, gives the endocrinologist. For analysis of antimullers, the hormone gives blood from a vein on an empty stomach.
An analysis of antimühler hormone for 3-5 days of the cycle. This is due to the fact that often patients are simultaneously prescribed a test for follicle-stimulating hormone (FSH) for a comprehensive assessment of ovarian function.
Otherwise, the day of the cycle does not play a special role.
In the middle of the 19th century, the German anatomist Johan Muller discovered that during the prenatal period, a duct develops in the embryo, which in girls precedes the uterus, fallopian tubes and upper third of the vagina. This duct was called – “Mullerov.”
It is noteworthy that at first it is in both boys and girls, but, as scientists of the 20th century have found out, later in the male embryo a substance begins to be produced, which leads to the resorption of this “female” Mullerian duct. Hence the name “antimuhler hormone.” Even later, it turned out that this substance in men is produced even after birth, in childhood, gradually fading away almost as an adult.
And in women, on the contrary, the first traces of the anti-Mullerian hormone can be seen only after the maturation of the first egg, that is, during the pubertal period.