So, during each menstrual cycle in a woman's ovaries. She leaves the ovary and begins to move along fallopian tube towards the uterine cavity. If at this time she meets a sperm, fertilization occurs and then, if favorable, pregnancy occurs. If such a meeting does not occur, the egg dies. Oddly enough, even knowing general scheme pregnancy, many men and women have absolutely no idea when sex will be without consequences.
Get it done in 48 hours
You will be surprised, but the egg remains capable of fertilization for only two days from the moment it leaves the ovary. If you do not meet sperm during this period, there can be no talk of any pregnancy. Simply put, a woman is able to conceive within a very short period of time. These same " dangerous days”, as they are commonly called, is ovulation or the middle of the menstrual cycle. Sexual contact during the release of the egg and the next two days is the most dangerous in terms of possibility. A logical question arises: why then should contraception be used at every sexual contact? It's simple. Despite the fact that the lifespan of an egg is very short, the situation is influenced by many indirect factors, which are not always taken into account.
Before and after
Firstly, not every woman has a regular menstrual cycle and works like a clock. Hormonal levels may change due to moving to another region, illness or severe stress, and all this automatically shifts the menstrual cycle up or down. So it turns out that even with regular cycle and the predicted date of ovulation, you can miscalculate and not fall into the safe period.
Another factor that should definitely be taken into account is the ability of sperm to maintain their viability inside a woman’s body for several days after sexual intercourse. That is, you can have sex on completely safe days, and the male reproductive cells will simply wait for the egg to be released in place. That is why gynecologists recommend most careful protection 4-5 days before the expected start of ovulation and another 3-4 days after - just in case. After all, it also happens that you expect the middle of the cycle on some days, but it comes a little later.
But about a week after ovulation, the safest days for conception begin. The egg, whenever it leaves the ovary, has already died, so there is simply nothing for the sperm to fertilize. Before the onset of menstruation, during it and 2-3 days after, you can have sex without fear.
Every woman dreams of becoming a mother. Particularly responsible couples are examined before conceiving a child. The most important thing to do is check your hormonal background. To do this, you should take a hormone test. These include anti-Mullerian hormone (AMH). But what to do when the test results indicate low AMH? Is it possible to get pregnant in such a situation? This article will help you find answers to these questions.
AMG norm
An AMH test helps determine how many eggs are capable of becoming a baby. It shows how many follicles have matured in a woman's ovaries.
Before drawing conclusions about whether your AMH is low or normal, you need to familiarize yourself with the normal values. This hormone begins to increase from the onset of puberty. Therefore, in women of reproductive age, this indicator reaches its maximum level and ranges from 1 to 2.5 ng/ml.
For a more accurate assessment of the hormone content, the test should be taken on the 5th day of the menstrual cycle. Deviations from the norm may be caused various diseases. If they are eliminated, then it may be possible.
In the case of IVF, a slight increase in the hormone will only play into the woman’s hands. After all, this increases the likelihood successful resolution procedures.
Reasons for decreased AMH
An increase in AMH levels can trigger one of the following conditions:
- normogonadotropic anovulatory infertility;
- abnormalities in the functioning of luteinizing hormone (LH) receptors;
- tumor processes in the ovaries;
- the presence of polycystic formations in the ovaries.
Low AMH is observed when:
- decrease (usually associated with aging of the body);
- menopause (not a pathology, since sooner or later it occurs in the life of every woman);
- overweight (obesity during childbearing age, that is, at 20-30 years);
- ovarian dysfunction.
Possibility of pregnancy with reduced AMH
The presence of a reduced concentration of the hormone in a woman’s body almost always indicates the presence of some kind of pathology. Disturbances in the reproductive system can be of a different nature: from ordinary excess weight to tumor formations.
Regardless of the reasons that caused the decrease in hormone levels in the body, pregnancy with low AMH becomes problematic. Because the content of this hormone cannot be increased artificially. It is possible to correct the cause of deviations from the norm, but an increase in the number of eggs is unlikely. It is possible to influence their quality and maturity.
Statistics indicate that for women with low AMH, the only consolation can be the procedure of artificial insemination. In addition, it often requires donor biological materials.
But there are also cases when a decrease in AMH corrects itself. This suggests that during the analysis, its content was influenced by some negative factor, which distorted the results of the study.
Therefore, in each specific case it is necessary to contact a specialist and develop a specific action plan.
AMH indicator for IVF
IN modern world for couples who want to conceive a child, but for some reason are unable to do so naturally, there is a procedure for artificial insemination. In medicine it is called in vitro fertilization (IVF). This process is quite complex and time-consuming.
Initially, you need to undergo an examination. The most revealing in in this case There will be an AMH test. Anti-Mullerian hormone will show the reproductive specialist how many of a woman’s eggs are suitable for fertilization. That is why there are limits, that is, a certain indicator of this hormone is necessary.
To carry out the artificial insemination procedure, a woman’s AMH level must be at least 0.8 ng/ml. Otherwise, the procedure will simply be impossible, because there is not the required number of eggs for fertilization. Even stimulation with low AMH will be difficult.
However, too increased rate may cause trouble. In preparation for IVF, hormonal stimulation of follicle maturation is carried out. Because of high content AMH in a woman’s body poses a risk of ovarian hyperstimulation.
Low AMH levels: is IVF possible?
Statistics indicate that IVF with low AMH is possible. But this is very difficult to implement. The hormone level does not affect whether the embryo will take root in the woman’s body. But the very fact of fertilization can. Indeed, with a low AMH level, the number of eggs is very low, and their quality may be even worse. Moreover, in this case, time is not on the side of the future parents.
In principle, the procedure for artificial insemination with low AMH is no different from the IVF procedure with normal hormone levels. But here the woman is forced to take more serious hormonal drugs. In addition, a longer period is required for the maturation of eggs.
Typically, patients are prescribed hormonal medications at double the dose. This, of course, sounds scary, but there is no reason to worry. A low hormone level will not lead to ovarian hyperstimulation or any other disease reproductive system.
Further actions of specialists depend on how the preparatory stage. If everything went well and the number of eggs that can be fertilized has increased, then doctors take a puncture of the follicles, fertilize the egg and implant the embryo into the mother’s body. If the hormone level remains low, then drug therapy subject to revision.
IVF protocols
The AMH level is crucial for the IVF procedure. Knowing this indicator, the fertility specialist chooses a more appropriate action plan and protocol.
IVF protocols for low AMH can be of two types: long and short.
Long protocols are carried out a week before the start of menstruation. Over the next three weeks, ovarian stimulation is performed to increase the number of eggs suitable for fertilization. Then a puncture is taken large quantity eggs (up to 20 pieces) and their fertilization is carried out. Three- or five-day-old embryos conceived artificially are implanted into the woman. This protocol contains possible complication- risk of ovarian hyperstimulation.
The short protocol begins on the 2-3rd day of menstruation. The egg is stimulated. For this purpose a puncture is made dominant follicles. However, even in this case, complications are possible - lack of quality eggs. In addition, the procedure is only suitable for women with good ovaries.
IVF without hormonal stimulation
With low AMH, fertilization is possible without exposing the woman to shock doses hormonal drugs. In this case, doctors monitor the woman’s natural ovulation using ultrasound. In this way, no more than 2 mature eggs are obtained per cycle, which significantly reduces the chance of pregnancy.
This method, however, is also very difficult and has its pros and cons. TO positive aspects This means that in this case you will not get twins or triplets, and you will not suffer from side effects hormone therapy. In addition, the cost of such fertilization is much lower.
The disadvantages include the high probability of missing the moment of egg maturation. Moreover, its quality will not be exactly what is necessary for a successful procedure.
Statistics
Low FSH, low AMH and other deviations from normal values are an obstacle to fertilization. Statistics show that with IVF, only 20-60% are successful. The likelihood of success depends on the woman's age, the quality of her egg and her hormonal status.
However, medicine does not stand still, and every year diagnostics and fertilization procedures are improved. Thus, from year to year it becomes easier to give birth to a child.
High FSH and low AMH
Quite often, along with low AMH levels, high level FSH. FSH is follicle-stimulating hormone, which is responsible for the production of follicles in the ovaries. This situation is quite a serious obstacle to the IVF procedure.
Undoubtedly, statistics claim that almost all IVF attempts end in pregnancy. But high FSH levels can prevent this from happening. In this case, it is recommended to perform the fertilization procedure using donor material.
And yet there is a chance to use your egg for this, but it is very small. This is only possible if FSH levels are slightly elevated. But if FSH is very high, it’s not worth wasting precious time. A woman may never ovulate, which indicates the advisability of using a donor egg.
Anti-Mullerian hormone is a biologically active substance that regulates the process of growth and division of tissues, and in female body affects the number of follicles in the ovary.
When the AMH level decreases, spontaneous pregnancy becomes unlikely.
In particular, with significant deviations in the functional reserve of the ovaries, the likelihood of successful in vitro fertilization decreases.
A decrease in hormone concentrations is a reflection of what is gradually being depleted own resources.
When planning pregnancy and previous unsuccessful attempts, studying the concentrations of this hormone is one of the most necessary.
Also, the specialist, after receiving the results of the study, needs to determine the cause of the decrease and eliminate it as soon as possible.
Depending on the patient’s current physiological indicators and the reason for the decrease in AMH, the specialist will determine whether it is possible to become pregnant with low anti-Mullerian hormone in a particular case:
- Basically, pregnancy with low AMH is not denied in cases where hormonal levels have not reached critically low levels. In this option, independent pregnancy with low AMH is possible, but the likelihood of its occurrence in the natural cycle decreases. After undergoing individually selected hormonal correction and ovarian stimulation, the chances of pregnancy increase.
- Also, the likelihood of getting pregnant with low AMH is determined through an auxiliary study - analysis. When FSH values do not go beyond 10-15 IU, pregnancy can occur.
- When AMH is low and FSH is high, the chances of conceiving are low, as modern reproductive technologies within conservative treatment cannot guarantee a high percentage of successful pregnancy. The way out of the situation is the IVF procedure.
For reference!
An increase in FSH concentrations is evidence that a woman’s reproductive system is working hard, and the functions of the ovaries begin to fade as menopause approaches.
Why does the hormone decrease?
The need for an AMH test may arise in situations where pregnancy does not occur for a long time, and visible reasons at initial examination the doctor did not find it.
After receiving the results of the hormone test, the doctor needs to determine the root cause that provoked hormonal disorder.
The reasons for the drop in AMH may be different, but the main factors provoking such negative women's health phenomenon are as follows:
- ovarian failure;
- early menopause;
- decrease in ovarian reserve;
- critically high body weight (grade 2+ obesity);
- early development genitals.
With low anti-Mullerian hormone, you can get pregnant, but spontaneous conception is extremely rare, since AMH is only an indicator indicating the number of physiologically capable eggs.
It is possible to stimulate this indicator with medication, but it all depends on the response of the ovaries to stimulation, since the number of viable eggs does not increase and, in fact, the ovarian reserve remains unchanged. It is possible to qualitatively increase AMH only after eliminating the causes that led to a decrease in healthy eggs.
How to increase AMH
At the current stage of development medical science There are no recognized effective methods for increasing the ovarian reserve and the number of eggs. It is possible to temporarily slow down the process of reducing AMH if you want to get pregnant through hormone replacement therapy.
Treatment involves the use of pharmacological agents that suspend the functioning of the ovaries for the required period, thus making it possible to achieve stabilization of the indicators.
This technique is used in relation to patients who have been found to have problems with a decrease in the reserve and a decrease in anti-Mullerian hormone in the absence of pregnancy and the presence of her desire in the future.
The key condition for such therapy is its timely start.
For reference!
Medical research has concluded that it is possible to increase the AMH value with the use of vitamin D3 and dehydroepiandrosterone. This method is used for values up to 0.5 ng/ml.
Elevated anti-Mullerian hormone when planning pregnancy
With a slight decrease in anti-Mullerian hormone, pregnancy can occur - the probability of conception increases in relation to the value reduced rate.
But elevated concentrations of anti-Mullerian hormone are not positive, since they may indicate various pathologies reproductive system, often – tumor processes, congenital defects and disorders of LH receptors.
When biologically active substance A woman rarely has difficulty conceiving and, if IVF is necessary, there is a high chance of successful completion of the procedure.
The main danger of elevated AMH values lies in hyperstimulation - the formation of big number follicles, and the glands enlarge.
When the procedure is not performed, which increases the duration of the protocol.
How to lower AMH
The need to reduce the values of anti-Mullerian hormone is formed when the digital values of the indicator reach 7 or more units. This often happens with PCOS, when ovulation does not occur.
It is possible to stabilize and bring the AMH value to a physiologically correct level solely by restoring ovulation.
To achieve this, they use conservative methods, And surgical route solving the problem.
After completing a course of therapy and strictly following medical instructions, ovulatory ability is restored within 1 month.
The significance of AMH results and its role in IVF
AMH indicators reflect the state of ovarian reserve. A woman who is healthy has approximately 300 thousand. eggs, and with each subsequent year their number decreases.
Ovarian resource is a designation of the number of follicles present in them and provides the opportunity to predict ovarian stimulation during the IVF procedure.
With a sufficient RR index, a woman, even with critically low levels of anti-Mullerian hormone, has a chance of becoming pregnant when turning to artificial insemination methods.
IVF for low levels of anti-Mullerian hormone
To successfully complete IVF, it is required that the values of the biologically active substance be at a minimum level of 0.8 ng/ml.
With lower substance indices, the onset of pregnancy is in doubt even during the IVF process, since the number of mature eggs ready for fertilization is extremely small.
Nevertheless, low index Anti-Mullerian hormone does not affect the engraftment of the implanted embryo.
Critically low values of the biologically active substance indicate the presence of significant difficulties, however, pregnancy is possible.
If AMH concentrations are insufficient, the procedure is performed in the same way as for normal indicators substances. The indicator influences the choice best option IVF protocol.
The stages of its implementation are identical at any concentration of AMH. With an underestimated value biologically active compound Long protocol and standard protocol are used.
The long protocol is used for weak ovarian response, when 3-7 follicles mature.
It is first necessary to undergo long-term – up to 45 days – and powerful hormone therapy, the purpose of which is to stimulate intensive production of eggs and accelerate the process of ripening of eggs.
The standard protocol is used for a moderate response - when 10 follicles or more mature. If stimulation is successful, the reproductologist performs the following manipulations:
- ovarian puncture;
- fertilization of the egg;
- Egg division is monitored for 3-5 days;
- The eggs are implanted in the uterine cavity.
If the procedure is successfully completed, the patient is transferred from the reproductologist's register to the obstetrician-gynecologist.
The use of stimulation at critically low AMH has no effect and can lead to rapid depletion of OR. Difficulties occur in the stimulation phase due to the small number of eggs and in the fertilization phase - due to their insufficient quality, division and formation of the embryo does not occur.
When the ovarian response is poor - no more than 3 follicles, further procedures are recommended to be performed according to the cryoprotocol.
The eggs or embryos are frozen so that they can be used again without going through the stimulation stage again. There are also options for IVF with a donor egg.
How to take AMG
Executed at the beginning ovulatory cycle, approximately 3-5 days. The material for the study is deoxygenated blood.
After collection, it is centrifuged and then the hormone concentrations are determined in the apparatus and in the resulting sample.
The cost of such a study is quite high - 1100-2800 rubles, depending on the region and the chosen medical institution.
Often, to accurately determine an indicator, it is necessary to conduct a study in several stages - in total, the duration of the procedure is 2-5 days.
When should you get tested?
An analysis to determine the values of anti-Mullerian hormone is necessary for the following indications:
- infertility of unknown etiology;
- suspicion of tumor processes of the granulosa cell type in the ovary;
- later sexual development;
- suspected or diagnosed PCOS;
- undergoing antiandrogen therapy and assessing its effectiveness;
- preparatory stage of the IVF procedure.
Often, the AMH value does not change throughout the entire ovulatory cycle. But, to increase the reliability of the study, it is required to complete it at the start of the cycle.
The study of AMH concentration requires the patient to follow certain rules:
- The material must be collected on an empty stomach, last appointment food should be at least 10-12 hours before the expected time of analysis.
- Stop taking hormonal and other types of medications 2 days in advance; if it is impossible to stop, provide comprehensive information about the medications you are taking. pharmacological agents, dosages and regimen for their administration to the laboratory assistant.
- In the 3 days preceding the analysis, it is necessary to abandon intense physical activity, and also, if possible, avoid stressful situations.
- The last smoke break before blood sampling is allowed 1 hour before the test, but no later.
- Alcohol-containing products should be excluded 3 days before the study
The woman receives the results of the research in her hands or they are transferred to the attending physician after 1-2 days from the date of the analysis.
The normal level of the hormone in the body of a healthy person
To obtain the most reliable information, an AMH test is required in several stages, and the result of the study is as follows:
- 0-0.8 ng/ml – critically low AMH value;
- 8-1 ng/ml – AMH is reduced;
- 1-2.5 ng/ml – physiological norm;
- 5-7 ng/ml and above – AMH is increased.
The concentration of anti-Mullerian hormone is actually not influenced by a woman’s lifestyle or eating habits.
Also, the indicator of the biologically active substance is not affected by the patient’s age, except for the period of menopause.
With any fluctuations in anti-Mullerian hormone in any direction from the norm, with a high degree of probability one can assume the presence of pathological processes in the woman’s reproductive system.
Anti-Mullerian hormone (AMH) is a marker of the health of a woman’s reproductive system. The concentration of this hormone is determined by the ovarian reserve. The AMH norm in women is 1.0-2.5 ng/ml.
Anti-Mullerian hormone assessment can predict how many eggs are present in the ovaries and whether conception is possible.
Reasons for decreased AMH
A decrease in anti-Mullerian hormone of less than 1 ng/ml occurs in the following conditions:
- Age-related decline of reproductive function. In women over 40 years of age, AMH rarely exceeds these values. In postmenopause, the concentration of the hormone in the blood is less than 0.16 ng/ml.
- Decreased ovarian reserve.
- Obesity.
In the context of studying AMH levels, it is important to consider the concept of ovarian reserve. This is an individual supply of follicles that is formed in the gonads even before birth. By the time of birth, a girl’s ovaries contain up to 7 million eggs. At the first menstruation, only 500 thousand remain.
The follicular reserve of the ovaries is not restored. Throughout a woman's life, she constantly uses up eggs. At every menstrual cycle after ovulation, their number decreases. Several eggs are released into growth at once, but only one of them becomes dominant, while the rest die. Less often, several mature eggs appear at ovulation, and then a multiple pregnancy may occur.
Normally, ovarian reserve decreases with age. A 35-year-old woman has a significantly smaller number of eggs than a 18-25-year-old girl. During menopause, the reserve is depleted and the woman’s reproductive function ends.
Anti-Mullerian hormone is synthesized in the ovaries throughout the reproductive period and is associated with follicular growth. shows the state of the ovarian reserve. A drop in AMH below 1 ng/ml indicates that the woman’s supply of eggs has decreased and the likelihood of pregnancy is low.
Causes of premature decline in ovarian reserve:
- Heredity. Early menopause and decreased egg supply are determined genetically.
- Surgical operations. Resection of the ovaries provokes a decrease in the reserve.
- Autoimmune diseases.
- Taking medications that affect the functioning of the ovaries (chemotherapy).
- Radiation irradiation of the uterine appendages.
- Bad habits. It is believed that smoking reduces ovarian reserve and leads to premature ovarian failure.
- Prolonged stress.
Is it possible to get pregnant with low anti-Mullerian hormone?
AMH production occurs in the ovaries. Pituitary hormones (LH and FSH) do not affect its synthesis. The level of anti-Mullerian hormone allows you to unambiguously determine the ovarian reserve.
A low AMH concentration indicates that the number of follicles in the ovaries is reduced. A hormone level of 0.6-1 ng/ml sharply reduces the chances of conceiving a child. Spontaneous pregnancy is possible, but ovulation does not occur in every cycle and the wait may take a long time. In this situation, an IVF procedure with drug stimulation of ovulation is indicated. When AMH decreases to less than 0.6 ng/ml, the likelihood of conception is extremely low.
About 1% of women aged 35 have early menopause. On average, their fertility declines 10 years earlier than others.
AMH deficiency at the stage of pregnancy planning requires additional diagnostics:
- FSH is a hormone that determines the maturation of follicles. The analysis is taken on the 3-5th day of the cycle. IN reproductive age its norm is 1.3-9.9 IU/ml (in the follicular phase).
- Ultrasound examination to assess possible ovulation.
AMH and FSH in combination are the main markers of ovarian reserve. An increase in FSH against the background of a decrease in AMH indicates ovarian depletion. With normal concentrations of follicle-stimulating hormone, the chances of pregnancy remain.
In medicine, there are cases of conceiving a child with low AMH - less than 0.5 ng/ml. There is no point in focusing on these situations. The probability of spontaneous pregnancy occurring during reduced level hormone is the exception rather than the rule.
IVF for AMH deficiency
The in vitro fertilization procedure is indicated if it is impossible to conceive a child naturally. IVF is carried out according to compulsory medical insurance policy and on on a paid basis. Quotas are allocated to complete the procedure free of charge, but their number is limited. In this situation, only those women who are most likely to conceive a child successfully are sent for the procedure.
According to medical statistics, women with low levels of anti-Mullerian hormone have a worse prognosis in assisted reproductive technology programs than patients of the same age with normal concentration AMG.
The IVF program is accepted under the compulsory medical insurance policy if the AMH level is at least 1 ng/ml. More low rate reduces the chances of conceiving a child:
- If the hormone concentration is insufficient, it is difficult to obtain adequate follicular growth in response to drug stimulation of ovulation. The number of eggs will not be sufficient for the procedure. Another situation is possible when the ovaries do not respond to stimulation at all.
- With reduced AMH, the risk of fetal chromosomal abnormalities increases.
If, according to the compulsory medical insurance policy, a woman is not accepted into the IVF program, she can undergo the procedure at her own expense at private clinic. In non-state medical institutions In vitro fertilization is performed when the AMH level is below 1 ng/ml.
In addition to AMH, other indicators need to be assessed. The following factors worsen the prognosis of IVF:
- FSH level is more than 15 IU/ml.
- The volume of the ovaries is up to 2 cm 3.
- Less than 5 antral follicles on the 3rd day of the cycle.
- Woman's age after 40 years.
With an unfavorable prognosis using donor eggs.
Is it possible to increase AMH?
Anti-Mullerian hormone is an indicator of the preservation of the supply of eggs in the ovaries. It will have no effect on the level of AMH in the blood. Anti-Mullerian hormone is an indicator of the number of eggs. It does not regulate the functioning of the ovaries, and its artificial increase will not affect the functioning of the reproductive organs.
In gynecology, there are no reliably working methods to increase the chances of a favorable outcome of IVF. There is no way to influence the ovarian reserve. If the supply of eggs is depleted, it cannot be restored at this stage of medical development. Medications or non-pharmacological means cannot solve this problem.
Women, planning pregnancy after 35 years, It is necessary to undergo examination and evaluate the level of anti-Mullerian hormone. If AMH is low, you should think about pre-harvesting eggs. To do this, follicles are obtained in a natural cycle and then frozen. In the future, frozen eggs can be used in an IVF program.
Oocyte freezing is practiced not only when there is an age-related decrease in the reserve of oocytes. The procedure is recommended before undergoing traumatic operations on the ovaries, or undergoing a course of radiation and chemotherapy. This tactic allows you to save eggs and conceive a child..
Müllerian inhibitory substance, or AMH, as anti-Müllerian hormone is also known, is produced in the gonads of both men and women. Hormone synthesis occurs from the first minutes of birth and highest peak reaches puberty. Then the AMH level gradually decreases and remains at the same level in men until the end of life, and in women until menopause. If the level of a substance during reproductive age falls below normal, this is a clear signal of serious problems in the body.
What happens in the body when AMH decreases
Anti-Mullerian hormone is responsible for sexual development and reproductive function representatives of both sexes, but it works completely differently in the body of a man and a woman. The level of Müllerian inhibitory substance in the blood also varies significantly.
The standard AMH level for men aged 18 years and older is 0.49-5.98 ng/ml, for women aged 18 to 34 years – 1.0-2.5 ng/ml. Then the AMH concentration in the fair sex gradually decreases and reaches zero by the age of 49. In women of reproductive age, low anti-Mullerian hormone is in the range of 0.2-1.0 ng/ml. If the number drops below 0.2, it’s time to sound the alarm and start urgent treatment.
Reduced levels of Müllerian inhibitory substance are not a cause, but an effect. If the tests show low AMH, then dangerous changes have already occurred in the body.
Among women when this hormone decreases, the functionality of the ovaries decreases, that is, the number of antral follicles decreases. These are the constituent parts of the ovaries, from which full-fledged eggs are subsequently produced, ready for fertilization. In men with low AMH in the blood, abnormal development of the genital organs begins and functional infertility develops.
What does a low AMH level mean in men and women?
If anti-Mullerian hormone is below normal during reproductive age, this is a clear sign that there is some kind of pathology. In women, AMH levels below 1 ng/ml may result from:
- early sexual development of girls;
- gonadal dysgenesis (rare chromosomal abnormality);
- hypogonadotropic hypogonadism (one of the forms of infertility);
- decreased ovarian reserve (the supply of healthy eggs at the time of analysis);
- disrupted menstrual cycle;
- the arrival of menopause.
In young girls, low concentrations of AMH often appear with ovarian dysfunction, endometriosis and granulocell tumors of the ovaries. Anorexia and severe weight loss also cause a decrease in Müllerian inhibitory substance in the blood. In late reproductive age, the opposite is true - a lack of the hormone is caused by obesity.
In young men, a low AMH level is often a sign of early puberty and so-called hormonal burnout. In older patients, the causes of hormonal imbalance may be anorchism (congenital absence of testicles), hypogonadotropic hypogonadism(functional testicular failure) and a rare pathology - persistent Müllerian duct syndrome. This is a hereditary congenital anomaly in which symptoms of false hermaphroditism appear (fully developed external genitalia and the presence of a hypoplastic uterus).
Returning the hormone to normal means curing the disease that caused the decrease in its secretion. If AMH remains at an abnormally low level for a long time, this can lead to infertility (male and female), and it will be very difficult to cure such a diagnosis.
How to increase anti-Mullerian hormone
If a low level of anti-Mullerian hormone is detected, is it possible to get pregnant? This question torments everyone. expectant mother, who receives bad test results.
In this case, urgent treatment is required for the problem that caused the decreased secretion of hormones. The therapy will increase the number of viable eggs and ensure a long-awaited pregnancy. In some cases, doctors recommend artificial ovarian stimulation to produce active eggs. Including in vitro fertilization.
AMH level within normal limits is the most important condition for conception. The only way to increase anti-Mullerian hormone in women is to cure the underlying disease. A number of modern hormonal drugs can temporarily increase the volume of the hormone in the blood, but this will not affect the number of valuable eggs, which means it will not cure infertility.
The latest research recommends using DHEA drugs to increase the volume of follicles and return AMH to normal limits. It is a multifunctional steroid hormone that stimulates androgen receptors and increases the number of antral follicles. Only a doctor can prescribe it - although DHEA-based products are dietary supplements, hormonal self-medication can only cause harm.
There is also a “home” way to increase anti-Mullerian hormone. This is taking vitamin D3, both in tablets and in the form of sunbathing. So, when analyzing for AMH in summer, its level is 15-18% higher than in winter - and this is due to vitamin D.
The reproductive health of men and women is largely determined by anti-Mullerian hormone. If the AMH level is below normal, treatment with hormonal drugs should last at least three months, and sometimes much longer.
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