AMH is one of the most helpful tests of doctors dealing with infertility treatment recently.
FEATURES OF AMH TEST
It changes with the age of the woman. It decreases with age. It provides guidance on starting treatment and medications.
The change between menstrual periods is very small. It changes very little when viewed from month to month. It does not give different results every month like some other hormones. A single measurement may be sufficient.
It can be measured every day of the menstrual period. Most hormones can be tested on a certain day of menstruation, you need to wait for that day. However, AMH can be checked any day.
It is the only indicator of the ovarian follicular structure.
It is closely proportional to the number of eggs on ultrasound.
It is useful in predicting a bad or excessive response to in vitro fertilization treatment.
WHAT IS AMH AND WHERE IS IT SECRETED?
AMH (anti-AMH) mullerian hormone), this glycoprotein, which begins to be secreted from the granulosa cells of the ovaries in the 8th month of the mother's womb, before the birth of girls, continues to be secreted until menopause. It decreases immeasurably 3-4 days after the removal of the female ovaries (oophorectomy). So it is a very good indicator.
WHAT IS AMH USED IN TREATMENT?
RELIABLE INDICATOR OF OVARIAN RESERVE (HOW MANY EGGS DO YOU HAVE LEFT? )
The highest number of eggs in the ovary was measured in girls while they were still in the womb, and millions of eggs were detected. Although this number decreases at birth, when a girl is born, she has 300 - 400 thousand eggs.
By wasting these eggs every month, all of them are exhausted until menopause. The important thing is to be able to measure how many eggs are left at any point in life. This is called determining ovarian reserve. AMH is one of the best indicators of this reserve.
WHY DOES IT INCREASE IN THE POLYCYSTIC OVARY (PCO)?
In women with polycystic ovary, AMH may increase very much. The biggest reason for this is the increase in the number of eggs and especially granulosa cells in the ovary. Thus, much more AMH is secreted. In some studies, granulosa cells were found to be 75 times more in women with PCO. r, which will cause a large increase in AMH and will guide us regarding the course of the treatment.
IN PREDICTION OF OHSS (OVARIAN HYPERSTIMULATION SYNDROME)
OHSS in in vitro fertilization treatment Overstimulation of the ovary causes both treatment failure and overstimulation of the ovary, leading to life-threatening consequences.
However, in treatments based on AMH results, the embryo transfer rate and pregnancy rate per cycle increase, while the risk of OHSS, drug costs, and expenses increase. , fertilization failure decreases.
DO WE HAVE A CHANCE TO LOWER AMH IN PATIENTS WITH OHSS RISK?
Laparoscopic ovarian transplantation is required for patients with high AMH levels and risk of ovarian overstimulation. Drilling (LOD) is performed and significant decreases can be achieved. In this operation, very small stimulation is applied to the ovary, causing some cells there to secrete less AMH. This causes the treatment to be more successful.
WHAT SHOULD THE AMH VALUE BE?
Although the AMH value varies in various studies, if it is below 0.99, it is very weak 3.04 (± 2.06) indicates normal and 5.6 (± 2.85) indicates that it is high.
What we do not want here is for patients to make some decisions about themselves by looking only at their values. What we are trying to explain here is that it is important to always evaluate laboratory results together with factors such as the patient's age, psychological state, examination findings, environmental factors, personal characteristics and other diseases. Sometimes our patients evaluate the laboratory results themselves based on hearsay, and the results lead to psychological disorders that even we have difficulty correcting.
For this reason, it is much healthier to have the laboratory results evaluated by doctors who are experts in this field, in order not to miss important results.
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