If after a year of normal sexual life, if you want to have a child, pregnancy has not occurred, you need a visit to the doctor, who, as a rule, will prescribe the appropriate diagnosis. The main test before IVF is to determine the level of anti-Müllerian hormone. AMH analysis is an indicator of the number of healthy eggs, mature follicles.

What is AMG

Anti-Müllerian hormone is an indicator of the ability of a woman's body to perform a reproductive function. AMH is produced in the follicles. The amount of the substance is not dependent on other hormones, the menstrual cycle. The hormonal indicator is constant, which makes it possible to calculate the number of mature eggs.

Low AMH during IVF in a woman

AMH (Mullerian inhibitory substance) is the main marker of ovarian aging. Even with an unchanged female cycle, a low level of AMH signals the onset of ovarian exhaustion. A reduced amount of AMH indicates deviations in the childbearing function, but IVF remains possible in this case as well.

When is a hormone test needed?

The AMH test allows you to determine the reserve of ovarian functioning. The indications for the study are:

1. Lack of conception for a long period.
2. IVF with a negative result.
3. Elevated FSH levels.
4. Diseases of the ovaries (granulosa cell neoplasms in the organs of the reproductive system, polycystic).
5. Delayed maturation of the body.

Low AMH levels may also be caused by antiandrogen therapy.

Research before IVF

The patient undergoes a gynecological examination, instrumental and laboratory tests. A gynecological examination is performed to visually assess the state of the organs of the reproductive system, to exclude congenital and acquired pathologies.

Smears are taken to determine the purity of the vagina by examining the microflora. Bacteriological analyzes make it possible to identify infectious venereal diseases. A smear for cytology from the cervical canal provides timely detection of malignant growth and precancerous conditions.

Preparing for the AMH test

To get the most accurate results, follow these guidelines:

• the analysis is taken on the 3rd day of the menstrual cycle;
• physical activity should be avoided for 3 days before the procedure;
• eliminate stressful situations;
• the day before taking the analysis, you can not smoke, drink alcoholic beverages;
• an hour before the test, it is forbidden to drink, take food.

Important! It is contraindicated to conduct a test to determine the level of AMH in the presence of inflammatory processes, infectious diseases.

Modern methods of pre-implantation diagnosis () make it possible to transfer only genetically complete embryos into the uterine cavity, which makes it possible to increase the efficiency of IVF.

How is the analysis for AMG performed?

Blood for the study is taken from a vein, the analysis takes 2-3 minutes to 2 days. After blood sampling, using a special serum, the level of AMH is determined.

The concentration of AMH varies greatly throughout the life of both women and men.

Hormone Decreasing Factors

The decrease in the reserve of ovarian functions is influenced by the childbearing age of the patient, which changes over time. A decrease in the functioning of the reproductive system can also be observed with a normal female cycle. The AMH index, which does not reach 1.0 ng / ml, obtained in a laboratory study, means that there are almost no chances for fertilization, not excluding the IVF method.

Normal AMH levels in women and men

Examine the resulting hormone for several days. Therapy is prescribed based on the picture obtained by studying the level of AMH. In the case when the hormone is below normal, it is concluded that the woman's reproductive system is not able to produce healthy eggs, which would be enough to perform IVF. The indicators are very dependent on age, normal values ​​​​are presented in the table.

This table shows normal (reference) AMH values ​​for men and women by age. AMH values< 1 нг/мл у женщин свидетельствуют о значительном понижении овариального резерва.

What causes AMH deficiency

The main causes of low hormone levels are:

1. Menopause. It is characterized by the termination of the female cycle. There are no ovulations, the reproductive system loses its functions.
2. Anorchism. Male pathology, in which there is a congenital underdevelopment of the organs of the reproductive system. This pathological condition is also characterized by underdevelopment of the prostate gland.
3. Low ovarian reserve. The number of eggs capable of fertilization is not produced due to the age-related characteristics of the female body.
4. Underdevelopment of the sex glands. Pathologies are possible in women and men. More often these are congenital defects of the ovaries, testicles.
5. Accelerated puberty. Accelerated development of body systems, including sexual, is a violation of the maturation of the body.
6. Pathological changes in the pituitary gland. With this deviation, changes occur in the organs of the female reproductive system, which leads to a decrease in luteinizing hormone, which ensures the functioning of the reproductive system.

Obesity is also considered one of the reasons for low levels of anti-Mullerian hormone.

What determines the results of the analysis

There are a number of factors that provoke negative results of AMG:

• age over 40;
• ovaries less than 3 cm3;
• the level of follicles in the ovary is below 10-15 pcs.

The last subparagraph is especially important, since with a small number of follicles during egg stimulation, the response will not be significant, which will lead to negative results of conception, including artificial insemination.

The clinical significance of the analysis for AMH

The number of cells ready for fertilization depends on the level of the hormone in the blood. With the help of a study on AMG, they evaluate:

1. Preservation of the follicular reserve. If the level of anti-Mullerian hormone is lowered, one can judge about premature ovarian exhaustion, which can be possible with massive ovarian sclerosis, as well as as a result of surgery on the appendages.
2. Functioning of the ovaries.
3. Potential fertility indicators, especially in young women.
4. Perspective of the result in IVF. If the AMH level is below normal, standard protocols are likely to have a weak follicular response.
5. The risk of developing hyperstimulated ovary syndrome. This especially happens often if the ACG rate is increased during IVF.

The onset and possible causes of early menopause are also assessed.

Features of IVF with FSH deviations

If, when deciphering the tests for AMH, it is found that the level of anti-Mullerian hormone is underestimated, the chances of pregnancy are very small due to the difficulty of selecting the required number of cells that are complete for fertilization.

Cell donation

The embryo obtained from the test tube is placed in the uterus. With an insufficient level of performance of the functions of the ovarian reserve, the fusion of the spermatozoon and the egg does not occur, which does not make it possible to obtain a ready-made embryo. In such cases, it is often suggested to use the donation of germ cells from young women.

Important! If you manage to get a fertilized embryo with a low level of AMH, the chance of getting pregnant remains low.

hormone therapy

IVF requires hormone therapy.

Often, in women over the age of forty, involuntary abortions are observed, as well as chromosomal abnormalities in the intrauterine child, therefore, hormone therapy should be performed before IVF to increase the number of cells capable of fertilization. Doses of drugs are doubled, but such therapy does not affect the health of a woman who is under constant medical supervision.

What is included in IVF

If the treatment was successful, proceed to IVF:

• A puncture is taken from the ovaries.
• Fertilization is performed by spermatozoa.
• The finished embryo is transplanted into the uterus.

An important part of successful IVF is monitoring the pregnancy process, as well as the development of the embryo.

IVF protocols for low AMH

There are the following ways to implement the IVF program if the AMH indicator is lowered:

1. Classic IVF co. Apply if the anti-Mullerian hormone is low in both ovaries.
2. modified cycle. Obtaining 2-4 follicles by using low doses of drugs. Used to reduce the burden on the patient's body. The cost of the protocol is also reduced. The rapid recovery of a woman after stimulation makes it possible to increase the frequency of conducted artificial insemination programs.
3. Japanese protocol. Freezing of embryos is used, followed by the isolation of the strongest and its transfer to the uterine cavity with minimal hormonal stimulation.
4. Shanghai protocol. 2 stimulations and 2 punctures are performed during the menstrual cycle. With this method, it is possible to increase the number of viable cells in less time.

Often, depending on how the clinical picture manifests itself, the methods of artificial insemination are selected alternately. When choosing any method of artificial insemination, it must be preceded by pre-implantation genetic screening.

IVF with donor eggs for low AMH

There are 2 ways of artificial insemination with donor cells:

1. In vitro fertilization with vitrified donor cells. The most accessible method. are thawed, fertilized with the husband's sperm, embryos are cultivated, which are to be transferred to the uterus.
2. Artificial insemination with fresh donor cells. This type of IVF is complex and expensive. Taking into account the wishes of the couple, a donor is individually selected to undergo stimulation. The eggs obtained from a donor during puncture are fertilized with the husband's sperm. The cultured embryos are placed in the patient's uterus.

Often, in various clinical situations, methods of artificial insemination are recommended to be alternated to obtain effective results.

Important! In women with a reduced level of AMH, when changing the tactics of using donor eggs, the effectiveness of the procedure increases by an order of magnitude.

Ovarian Tissue Depletion Predictions

In reproductive medicine, it is very important to predict the depletion of ovarian tissue. To this end, you should:

• organize a scrupulous collection of anamnesis of pathology;
• collect an anamnesis of heredity;
• conduct laboratory diagnostics with the determination of AMH, FSH, LH;
• conduct high-precision ultrasound to count the number of antral follicles;
• perform genetic analysis of premature ovarian failure.

If a woman is found to be at significant risk, she should use her reproductive potential without delay. The doctor should inform the patient that with a low level of AMH, it is more difficult for her to become a mother every day. This applies not only to spontaneous pregnancy, but also with the help of IVF.

Conclusion

A correct assessment of the research results can only be performed by a doctor, since for the prognosis during IVF, a comprehensive examination must be done. A normal AMH level is not the most important condition influencing the choice of therapy tactics.

The ability to get pregnant in a certain period of time determines. For conception, its amount must be within the normal range. In the body of a woman from birth to the onset of menopause, AMH is produced by the ovaries.. This substance is special because the brain does not control its secretion.

Until adolescence, the concentration of the hormone in the body of girls is constant. The increase in the amount of the substance occurs with the onset of puberty and reaches a maximum by 20-30 years. This period for girls is favorable for conception and childbirth, if the concentration of AMH in the blood is normal. After 40 years, the amount of active substance gradually decreases. With menopause, its concentration is minimal or it is not detected at all.

Norm, table by age

The norm of AMH in women is determined by a wide range of indicators, since the numerical value of the ovarian reserve is individual. The amount of the substance is not affected by the phase of the menstrual cycle, lifestyle and other external factors. In the table, the AMH norms are presented depending on the age of the woman:

Indications for analysis

From a physiological point of view, the rate of anti-Müllerian hormone in women is an indicator of immature (resting) follicles. Each month, one of them matures, releasing a mature egg for conception.. Mature AMH follicles are not released into the blood.

It is reasonable to speak of a violation of reproductive function if a woman of childbearing age for a long time under favorable conditions has difficulty conceiving a child. Deviation from the normal values ​​of anti-Müllerian hormone in women may be associated with an insufficient number of mature eggs (decrease in ovarian reserve), developmental pathologies, and diseases of the reproductive system.

An anti-Mullerian hormone test is prescribed in the following cases:

• unexpressed causes of infertility;
• unsuccessful IVF attempts;
• early menopause;
• carrying out antiandrogen therapy;
• diagnosis of malignant ovarian tumors.

Analysis

On which day of the cycle to take anti-Mullerian hormone depends on the disease for which the analysis is prescribed. As a rule, his handed over on the 3rd day of the cycle, since the level of other hormones (for example, FSH (follicle-stimulating)), the concentration of which is determined by the phase of the uterine cycle, is examined in parallel.

This rule is carried out during a normal cycle, with artificial stimulation of the ovaries for IVF, with diseases that cause a violation of the cycle. In some cases, the study may be scheduled for the 4th or 5th day.

To donate AMG hormone, you must follow several rules that contribute to obtaining reliable results:

• venous blood is given in the morning on an empty stomach;
• three days before the study, it is necessary to exclude physical activity, stressful situations;
• the analysis is not performed in the presence of acute diseases or after recent ones;
• do not smoke one hour before blood sampling,
• on the eve you can not drink alcoholic beverages, fried, fatty;
• your doctor may give you additional advice to prepare for blood sampling.

A direct blood test involves several stages:

1. Analysis of FSH and AMH.
2. Determination of the number of eggs ready for fertilization.
3. Calculation of the volume of the ovaries.

The results of a laboratory blood test are issued after 2-3 days, in some cases it can take up to 7 days. The interpretation of the results is carried out by the attending physician.

Significantly increases the chances of conceiving a child, the normal content of anti-Müllerian hormone in the blood of a woman. The concentration of this substance depends on the number of immature follicles, as it is secreted directly by them.

This is an indicator of mature eggs that can be used for fertilization.. Women should remember that their number is decreasing every month, and for planning pregnancy, it will not be superfluous to study the hormonal background, including determining the level of AMH. For this purpose, a laboratory study of venous blood is carried out.

One of the indicators of possible infertility is the level of anti-Müllerian hormone in a woman's body. Based on this indicator, reproductive specialists decide whether to resort to the IVF procedure and whether to use a donor egg. What is this hormone, is it possible to increase its level, and in general, why is it “anti-Mullerian”?

• Why the hormone is "anti-mullerian"
• The function of anti-Müllerian hormone in the body of a woman
• Why Reproductionists Pay So Much Attention to Anti-Müllerian Hormone
• AMH: normal, low and high
• How to prepare for the test on AMG

Who was "against Muller"?

The anti-Müllerian hormone got its unusual name in honor of the German naturalist Johann Müller, who lived in the 19th century. It was this scientist who discovered that human embryos up to the 6th week have the same development of the genital organs - this is the so-called "Mullerian duct", from which the vagina, uterus and fallopian tubes are then formed in women. In future men, at the 9th week of embryonic development, a special hormone begins to be released, which “starts” the development of the Mullerian duct in a different way - it transforms it into the epididymis. Since its action is directed "against" the female path of development of the Müllerian duct, the hormone was called anti-Müllerian (AMH - anti-Müllerian hormone).

The function of anti-Müllerian hormone in the body of a woman

Normally, AMH begins to be produced even before birth, during the 32-36th week of pregnancy. However, up to puberty, its amount is insignificant. The concentration of AMH rises sharply during puberty, and reaches a maximum between 20 and 30 years of a woman. Further, the secretion of the hormone decreases, but remains stable until the onset of menopause. Why does the content change so much?

” Anti-Mullerian hormone in women is produced directly in the follicles - granulosa cells, one of the layers surrounding the egg. However, not all follicles produce AMH, but only those that are ready for immediate growth and, in the future, for ovulation.

In general, the number of eggs in a woman's body is determined at the time of their laying, at 11-12 weeks of intrauterine development. However, the reverse process of the death of primary follicles, which is called atresia, immediately begins. So by the time of birth, the number of eggs in the body of a newborn girl decreases several times, to 1.5 million, and at the time of the first menstruation, there are no more than 300 thousand of them at all.

All this huge number of follicles is in a "sleeping" state and will never be used - these are the so-called primordial follicles, about 50 microns in size (they can only be detected during microscopic examination of tissues). No more than 500 of them can mature in a woman's lifetime.

This process is “started” by the action of follicle-stimulating hormone (FLH), which begins to be produced in the brain (in the pituitary gland) during puberty. Of course, not all follicles mature at once - about 25 follicles are simultaneously in the preantral and antral phases of development. Their size is already from 150 to 500 microns, and they can be easily detected (and counted) during an ultrasound examination.

” One (sometimes two or three) follicles reach the stage of ovulation at the same time, and it is the anti-Mullerian hormone that “slows down” them on the way. On the one hand, it promotes the growth and development of the preantral follicle, on the other hand, it partially inhibits the action of FSH, preventing all 25 follicles from “starting” at the same time.

When the size of the follicle reaches approximately 8 mm (the stage of a large antral follicle), another anti-Müllerian hormone, called inhibin B, begins to be produced instead of it. It gives the pituitary gland feedback - "that's it, no more FSH is produced, the required number of follicles ready for ovulation has already been reached."

Why Reproductionists Pay So Much Attention to Anti-Müllerian Hormone

As you probably understand, anti-Mullerian hormone is produced directly by maturing follicles. Its amount does not depend on the phase of the menstrual cycle. Its concentration does not directly affect the processes of conception and pregnancy (since it ceases to be produced in a mature egg).

” Since the anti-Mullerian hormone is produced in follicles ready for growth and development, its amount allows you to quite accurately determine the so-called "ovarian reserve" - ​​how many potential follicles are ready for ovulation in general, which means how high the probability of conception is.

Of course, the number of antral follicles can also be estimated using ultrasound, but such a study is subjective, and its results inevitably depend both on the quality of the equipment used and on the skill of the specialist. The analysis of AMG is impartial and completely accurate, which is why it is used in preparation for the IVF procedure.

AMH: normal, low and high

As you have noticed, the concentration of AMH in a woman's body rises at the time of puberty, reaches a maximum at the peak of fertility from 20 to 30 years, and gradually decreases to zero at menopause.

Average normal levels of anti-Müllerian hormone at different ages

However, the average figures are typical for women who do not experience problems with conception. Therefore, reproductologists have their own scale, focused on the lower limits of the hormone concentration.

An AMH value above 1.0 ng / ml indicates a fairly high probability of pregnancy in a natural way.

The AMH index is higher than 0.2 ng / ml - pregnancy may occur as a result of IVF.

The causes that caused a decrease in AMH levels do not necessarily indicate potential infertility. For example, if one ovary or part of it is surgically removed from a woman, then the level of AMH can be reduced, but this does not prevent the natural onset of pregnancy.

” Naturally, the question arises - is it possible to somehow increase the level of AMH in order to increase the chances of conception? No, you can’t: anti-Mullerian hormone is produced by an active follicle (and not vice versa: AMH does not stimulate the primordial follicle). So a low AMH level is just an indicator of reproductive problems.

In general, it can be said with regret that the reasons for the decrease in the production of anti-Müllerian hormone are not completely clear. In addition to the obvious ones (menopause, ovarian surgery, the use of hormonal drugs), there are also non-obvious cases of a decrease in AMH. One reason could be obesity.

The level of AMH may be higher than normal, and this also does not indicate reproductive health and high fertility. Thus, often the concentration of anti-Müllerian hormone is higher in women with polycystic ovary syndrome, and an ultra-high level indicates the presence of granulosa cell tumors of the ovaries.

How to prepare for the AMH test

Although the level of AMH in general does not depend on the phase of the menstrual cycle, it is usually handed over for convenience along with other hormonal tests, on days 3-5 of the cycle. Before analysis it is not recommended:

eat within 2-3 hours (you can drink clean water without restrictions);

stop taking hormonal drugs two days before the analysis (only in agreement with your doctor!);

eliminate physical and emotional overstrain for at least a day before the test;

do not smoke for 3 hours before the study.

Although the concentration of AMH is almost independent of the phase of the menstrual cycle, fluctuations are possible over a short period of time (the reasons for this have not been fully investigated).

So if the results of the analysis are unsatisfactory - do not panic, the doctor will definitely advise you to retake it and, perhaps, next time the indicators will be more optimistic.

Prepared by Anna Pervushina

The ability to conceive an egg and further maturation directly depends on the body's ability to generate indicators of sex hormones.

To determine the level of female fertility, doctors take into account the results of AMG, which shows the state of the reproductive system.

1. AMH is a hormone that is a marker of ovarian reserve.
2. To determine the level of AMH, you need to donate blood on the 3-5th day of the cycle.
3. Anti-Müllerian hormone plays an important role in the process of embryonic development, to determine the sex of the fetus.
4. With underestimated or overestimated rates, hormonal therapy is carried out, folk recipes are used.
5. When the value decreases below the permissible limit, a woman enters the menopause, and men are diagnosed with infertility.

What is AMG

AMH is an anti-Mullerian hormone that gynecologists and reproductologists consider as a marker of ovarian reserve. It is produced by cells of female follicles, from the 32nd week of embryonic development.

In men

AMH for the stronger sex also plays an important role in the process of tissue growth. In the male body, sertoli cells are involved in its generation. This hormone helps embryos that show signs of both sexes before the 8th week to develop into a male pattern.

AMG, in this case, promotes the resorption of the Müllerian ducts responsible for the development of the reproductive system according to the female type.

Among women

Until the moment of puberty, a low concentration of AMH is observed in the blood of girls.

In the future, the level of the hormone increases, and specialists, based on the results of laboratory studies of biological material, can determine how many eggs a woman has left.

For example, during menopause, the AMH index does not exceed 1000 units, and during the period of puberty, the value of anti-Müllerian hormone varies in the range of 400,000-500,000.

Blood test for AMH

To determine the level of anti-Müllerian hormone, women must donate biological material for laboratory research, in this case, blood from a vein. The analysis is carried out on certain days of the cycle (3-5), not earlier and not later.

In the event that the patient feels unwell or has suffered severe stress, she should postpone the visit to the hospital for a month.

Normal AMH values

Each woman has a different number of eggs, against which the anti-Müllerian hormone level will differ.

That is why many people manage to conceive a child without much effort after the age of 40, and for some, problems with pregnancy begin as early as 25.

For women by age

When deciphering the analyzes, specialists use the table:

Attention! During menopause, the anti-Müllerian hormone index will vary in the range of 1.1-2.6.

For men by age

For men, doctors give a referral for analysis to check the quality of sperm, control the effectiveness of therapy, determine gender, confirm the diagnosis of infertility, etc.

Normally, in an adult patient, the AMH value should vary in the range of 0.6+/-4.0 ng/ml.

Reasons for downgrading or promotion

The following factors can provoke an increase in AMH:

• bad heredity;
• pathology in the ovaries;
• undergoing radiation or chemotherapy;
• long-term use of certain types of medicines;
• infectious diseases;
• tumor processes;
• venereal sores, etc.

A decrease in the hormone can provoke such components:

• approaching menopause;
• exhausted supply of eggs;
• ovarian dysfunction;
• early puberty;
• bad heredity, etc.

Anti-Müllerian hormone and IVF

If a woman has an overestimated AMH, then the upcoming IVF is associated with high risks associated with hyperovulation.

With a low hormone level, ranging from 008 ng / ml to 011 ng / ml, the artificial insemination procedure can be successful. But if the AMH level is below 008, the IVF result will be negative.

Normalization methods

It is possible to normalize the amount of anti-Müllerian hormone, provided that menopause has not yet occurred. When choosing a technique, doctors take into account the following factors:

• age group;
• the presence of concomitant pathologies;
• causes of hormonal fluctuations, etc.

Attention! If the ovarian reserve has exhausted itself in the female body, then neither therapy nor alternative methods will bring the desired effect.

How to Increase Anti-Mullerian Hormone

To increase AMH, patients need to act as follows:

• drink hormone-containing preparations prescribed by a gynecologist / reproductive specialist;
• put in order the weight;
• switch to a balanced diet;
• normalize sleep;
• provide a good rest;
• give the body moderate physical activity.

Attention! In the process of carrying out therapeutic and preventive measures, folk recipes can be used. For example, to increase the anti-Mullerian hormone, it is recommended to use seafood, honey, propolis.

Deciphering the analysis

When deciphering the analysis, specialists take into account the age group of the patient, for which one or another boundary value corresponds. If deviations are identified that are amenable to medical correction, then a therapy regimen will be developed for it in a special order.

Among women

When examining women planning a pregnancy, doctors pay special attention to anti-Müllerian hormone. They believe that its optimal value should be in the range of 4.0-7.3 ng/ml.

If the lower limit is less than 2.2, then IVF will be recommended to the woman, since there is practically no chance of natural conception for her. With an AMH level of up to 0.3 ng / ml, patients are diagnosed with infertility.

AMH and pregnancy

The process of natural conception and anti-Mullerian hormone are closely related to each other. At the maximum level, the AMH indicator is at the age of 20-30 years, which is why doctors recommend not postponing conception until later.

After 30 in the female body, reproductive functions begin to gradually fade away, and when menopause occurs, pregnancy becomes impossible.

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The hormonal background of a woman is an important component in planning a pregnancy. Hormones perform a regulatory function throughout the body, helping it to function properly. They differ among themselves by type.

One of them is Anti-Mullerian hormone (or AMH for short) - a biologically active substance (protein molecule) that is produced in both the male and female bodies, but in men its concentration is much lower. The rate of the hormone depends on the age of the woman.

It is named after the German scientist Johann Müller, who identified a common canal-tube in male and female embryos - the duct from which the uterus, fallopian tubes and vagina develop in women, and the prostatic uterus and epididymis in men.

The concentration of a substance in the body indicates the ability to conceive, and a deviation from the norm may indicate a serious problem, for example, the presence of a tumor in the ovarian cavity.

Anti-Müllerian hormone (the norm is calculated by age and health status) is a substance that is produced by ovarian cells that affects the appearance of eggs in women. Anti-Müllerian hormone is produced by the body as early as 32 weeks of gestation, it is present in both male and female bodies, but in men its concentration is much lower.

In the embryonic state, a flow tube (muller) begins to form. In the male, it disappears on the 10th week, and in the female, the uterine space is formed from it. The hormone begins to play an important role in the girl's body during puberty.

After the onset of menopause, the hormone ceases to exist, this is due to the abolition of the process of formation of eggs.

If during the period of sexual development the concentration of the hormone does not reach the norm, then this is considered the first sign of infertility.

Starting from the age of 12, the concentration of the hormone gradually increases. From the age of 20-30, the hormonal background is at its peak, and after 30 years, the concentration declines, and the body is gradually preparing for the onset of menopause. During menopause, hormone production stops.

Indications for passing the analysis

The ovarian cavity is formed from follicles in which the egg ready for fertilization matures. Most of the follicles exist in a calm state, every month there is a maturation of one egg. The follicles that rest in the ovarian cavity secrete the hormone, and those that have already matured stop doing so.

Blood sampling shows how many follicles are dormant and ready to go into the ready stage. The ability to conceive and the rate of onset of menopause depend on the concentration of AMH.

There are several indications when it is worthwhile to analyze the concentration of AMH:

If a woman has an acute problem with conceiving a child, medical experts recommend taking blood samples to study the concentration of anti-Müllerian hormone within the next 30 days after the start of the menstrual cycle.

The study should be carried out several times, and if there is a risk of infertility, it is necessary to extract fertile eggs in order to freeze them for subsequent artificial insemination.

What will the hormone level show?

The results of the AMH analysis help to identify abnormalities that occur in a woman's body. With it, you can learn in advance about the changes, before the cycle of menstruation changes.

Also, by the concentration of the hormone, you can find out the decrease in fertility. With the right research, the results can reveal the time when menopause occurs, which allows, if desired, to conceive a child.

How to take an analysis

Anti-Mullerian hormone, the norm of which in women depends on age, may indicate the development of pathology in the reproductive system. Usually, women with a normal cycle are prescribed an analysis on the 3rd cyclical day, since blood is taken together for other hormones.

On the 3rd day of the cycle, an analysis is also given for the concentration of AMH for artificial insemination and in case of a disturbed cycle. In other cases, blood sampling is required on the fifth or fourth day of the cycle.

To get reliable results, you need to follow a number of rules:

• in the morning before blood sampling, do not eat or drink anything;
• for four days, exclude physical exercises and not be nervous;
• do not donate blood for AMG if acute illnesses have recently been transferred;
• before delivery (an hour) you need to exclude smoking;
• do not eat fried and fatty foods during the day, and do not drink alcohol.

If there are any other rules that must be observed before taking the test, the medical specialist will warn and give recommendations. The results will be ready after 2-3 days, in some cases, laboratory tests may take up to a week. Only the attending physician makes a diagnosis and deciphers the indicators.

The norm of Anti-Müllerian hormone in women

Anti-Müllerian hormone, the norm in women has a wide indicative range, is not affected by the menstrual cycle. For each woman, the meaning is different, since the supply of fertile eggs is individual for everyone. The normal values ​​of the hormone in girls up to 8 - 9 years old are in the range of 1.7 - 5.3 ng / ml.

Name	Norm (ng / ml)	Elevated (ng/ml)	Reduced (ng/ml)
1. By age (years)
1.1. 20-24	1,88-7,29	≥7,30	≤1,87
1.2. 25-29	1,83-7,53	≥7,55	≤1,82
1.3. 30-34	0,95-6,70	≥6,71	≤0,94
1.4. 35-39	0,777-5,24	≥5,25	≤0,78
1.5. 40-44	0,097-2,96	≥3,00	≤0,095
1.6. 45-50	0,046-2,06	≥2,1	≤0,045

Only a medical specialist should decipher the analysis data. If the analysis was given on the personal initiative of a woman, then it is necessary to visit a doctor to get a reliable answer. Only, but can give an explanation of the ongoing changes in the female body.

Why is the hormone elevated?

There are a number of factors that can affect the level of the hormone in the blood:

Anti-Mullerian hormone, the norm of which in women depends on age, is subject to changes. Deviations up or down may indicate various pathological processes in the body. Control over changes in the hormone must be carried out not only when conception is planned, but also to detect a serious illness.

An increase in AMH can result from:

• polycystic ovaries ("blockage" of follicles in the ovarian cavity);
• tumor formation in the ovaries;
• infertility;
• late puberty;
• tuberculosis.

Based on the results of the blood test, the doctor makes a diagnosis.

Why is the hormone low?

Anti-Müllerian hormone in women varies with age. To identify pathology, you need to regularly donate blood to balance the hormonal background. Women are often afraid of deviations from the norm in a smaller direction, as this is primarily due to the inability to become pregnant.

In addition, low AMH levels indicate:

These reasons indicate that a woman with low hormone levels is more likely to be unable to conceive naturally. Trying to get pregnant with IVF in this case is minimized.

Consequences of deviation from the norm

An abnormal state of AMH concentration in a woman's body indicates its abnormal development or a pathological process occurring in the ovarian cavity. What exactly happens with the production of the hormone can be understood after taking blood for analysis.

The consequences of a deviation from the normal concentration of the hormone are directly proportional to the reasons that caused the imbalance. If maintenance therapy is not taken in time at an increased concentration of AMH, then most likely the woman will not be able to become pregnant on her own.

In advanced stages, a positive result from artificial insemination is unlikely.

Features of treatment

If there is any deviation from the norm of the content of the hormone in the body of a woman, then there is a number of features that must be observed during treatment:

What to do if the hormone is elevated?

It is necessary to treat an increased concentration of the hormone, starting from the causes of the pathological condition.

As a concomitant therapy aimed at lowering the concentration of the hormone, you need:

When polycystic ovaries are detected, one can resort to surgical intervention, during which the eggs will be artificially removed and the ovarian cavity will be freed. A prerequisite is a visit to a doctor (gynecologist, oncologist and endocrinologist). If no improvement is observed, a deeper re-examination is necessary.

What to do if the hormone is low

Today, medical specialists have not identified drugs that could increase the concentration of AMH and provide a woman with a sufficient number of fertile eggs.

To delay the decrease in AMH for a while, taking hormonal drugs that perform the function of blocking helps. During treatment, the ovaries stop working, which helps to maintain the ovarian reserve for a future pregnancy.

If the hormone is reduced during puberty, then it is necessary to conduct a detailed study in order to find out the cause of the deviations in time and prevent the development of serious diseases.

In some cases, it is enough to rest and build a healthy lifestyle. If the increase in the hormone does not occur, then for a woman to give birth, it is best to contact the clinic for artificial insemination.

AMG and IVF (influence on the course of the procedure)

When pregnancy is planned, testing for the concentration of anti-Müllerian hormone is mandatory. AMG and IVF are inextricably linked. Before the procedure, the specialist studies the general state of the hormonal state of the woman.

The more active follicles found in a woman, the higher the probability of successful artificial insemination. If the concentration of anti-Müllerian hormone is high, then IVF can be carried out using your own active eggs.

If the concentration of the hormone is close to zero, then there is no point in stimulating the existing eggs, because they are unable to produce offspring. In such situations, they resort to donor specimens and perform artificial insemination.

If the anti-Mullerian hormone decreases, then artificial insemination is possible, provided that the follicle-stimulating indicator is within the normal range. Under such conditions, artificial insemination is carried out in two stages, during which increased stimulation of the eggs with hormonal preparations is used.

1. Long protocol (stimulation of eggs occurs for more than 30 days, resulting in the formation of 2-4 follicles);
2. Short protocol (stimulation occurs in 14 days, resulting in the formation of 10 active follicles).

All appointments are carried out only after a complete examination of the female body, since after increased stimulation with artificial hormones, an even greater decrease in the concentration of AMH may occur due to which new health problems may form.

The entire period after successful fertilization, the woman is under the strict supervision of medical specialists. Supportive hormonal therapy is prescribed by a medical specialist so that rejection of the fetal egg does not occur.

The quality and reliability of laboratory blood tests for AMH concentrations may depend on the following factors:

• how good is the chosen laboratory;
• which of the methods was chosen for the analysis;
• how well and correctly the blood was taken;
• storage and transportation of the taken analysis;
• correct calibration;
• age of the patient (woman);
• genetic changes in the body;
• diabetes disease;
• autoimmune diseases;
• weight category of the patient;
• the use of previously hormonal medications;
• the intake of vitamin D in the body of a woman.

AMH and pregnancy

To determine the likelihood of pregnancy with abnormal AMH, medical professionals consider the possibilities under which ovarian stimulation will give positive results.

If pregnancy is planned for the period of early menopause, then stimulation and the possibility of conception should be discussed with an endocrinologist. The specialist will help you choose simulating drugs to delay menopause and activate follicles.

Pregnancy options with low AMH:

High levels of AMH indicate reproductive disorders associated with genetic problems, tumors, and polycystic disease. Conception with overestimated rates is delayed until the cause is eliminated. Do not delay treatment, as life may depend on it.

It is worth noting that a reduced AMH during pregnancy can affect the sex of the unborn baby, namely the formation of male and female genitalia at once. This occurs in the first trimester of pregnancy. In some cases, doctors prescribe maintenance therapy, which contains a small amount of hormones that regulate the condition of the pregnant woman for the successful birth of a child.

How to increase AMH folk remedies

Folk remedies, according to women and medical specialists, help restore the normal state of the hormonal background.

These include royal jelly, honey and vitamin D.

Royal jelly will help:

• improve the state of the immune system;
• strengthen the heart
• improve lymphatic flow;
• relax the uterine muscles;
• bring the pressure back to normal;
• improve thyroid function;
• improve hormone balance.

For pregnant women, this remedy is also indicated, it helps to get rid of insomnia, mood swings and arbitrary miscarriage. The period of admission varies from 1 to 3 months. The dose of royal jelly should be taken 1 hour before a meal. It has been proven that a strengthened body is capable of partial self-healing, as well as restoring the entire hormonal background in women to normal.

Article formatting: Mila Fridan

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