What is AMH and what it means in the IVF process?

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What is AMH?

AMH is a glycoprotein from the transforming growth factor (TGF) of the beta superfamily, and it is produced exclusively in women by granulosa cells of the pre-antral and minor antral follicles.

AMH exists in both women and men. In men, it plays an important role in the development of the male reproductive organs by preventing, during the embryonic phase, the development of Miller channels that produce the female reproductive organs.

In men, this hormone is created from birth and throughout life by secreting it in the testes, while in women, AMH plays an important role in ovarian follicul genesis and ovarian follicular cell production after puberty, and because of this role it is called the “keeper” of the ovarian reserve.

What is the AMH level for?

With the age of the woman the number of follicles/the follicular reserve decreases, and thus the level of AMH decreases. This is especially important because as pregnancy in the modern age is delayed, women are getting older and AMH levels are getting lower, hence fertility is diminishing and is the cause of a great deal of sterility in women.

AMH is a reliable marker for the reproductive potential of the ovary. The advantages of this marker over many others are that its value throughout the cycle is constant and its values ​​are not conditioned by body weight, lifestyle, diet, use of alcohol, narcotics and other substances.

Generally, women with low AMH levels have fewer oocyte reserves and therefore less chance of pregnancy. In practice, during VTO procedures, it happens that patients with low AMH values ​​show excellent stimulation response and vice versa that patients with high values ​​show poor response to stimulation, thus ending the VTO practically before it began.

It is important to know that the levels of this hormone decrease significantly, especially at age after 35. However, this decrease may occur earlier, but it is caused by other factors, and that’s when we talk about ovarian failure.

Because there are small boundaries between different categories and blood retrieval may show slightly different values, there is a table of criteria generally used:

Interpretation of resultsAMH blood level (ng / ml)
High values (often PCOS)>4,0
Normal values>1,5-4,0
Low normal values>1,0-1,5
Low values>0,5-1,0
Extremely low values<0,5

 

If you have low AMH, what is recommended is IVF programs with donated eggs , Combined IVF program with your own and donated eggs and IVF with Cytoplasmic transfer.

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