The survey shows that the average incidence of infertility in China in recent years is 12.5% to 15%, and there is a pair of infertility in every 8 couples. Among them, ovulation dysfunction is the most common in women of the appropriate age. More and more hospitals have included serum anti-Mullerian hormone (AMH) test in routine clinical examinations.
But many women don’t understand this check. They often ask for a report. AMH is the level of ovarian premature aging. I am not able to give birth… I am not prone to appearing. Ovarian hyperstimulation syndrome…Is there is polycystic ovary syndrome…
This time, we come together to know serum anti-Mullerian hormone (AMH)
Anti-Muller hormones are produced in the testes of all mammals, which can cause the Mullerian tube to degenerate, hence the name Mueller tube inhibitor. The greater the number of small sinus follicles in the ovary, the higher the concentration of AMH; conversely, when the follicles are gradually consumed with age and various factors, the AMH concentration will also decrease. When the menopause is approached, AMH gradually becomes zero. As a marker for predicting ovarian reserve.
Check AMH, what exactly is it?
1 Assess ovarian reserve: Ovarian reserve includes the quality and quantity of primordial follicles. As we age, women’s reproductive capacity gradually declines. Once the primordial follicles are exhausted, the follicles cannot be recruited, leading to menopause.
After a woman is born, almost no AMH is detected in the serum; serum AMH concentration begins to rise slowly in the weeks after birth, and serum concentration reaches a peak in late adolescence. The entire reproductive age persists, but with age and follicle consumption, the concentration gradually decreases and cannot be detected after menopause. The gradual decrease in serum AMH is significantly associated with a decrease in the number of antral follicles.
A large number of studies have shown that AMH is a reliable indicator of early ovarian function impairment, and the decline of AMH occurs before other indicators change. Therefore, AMH is an indicator of a better predictor of menopausal transition than traditional ovarian reserve markers.
2 Assessing premature ovarian failure: Early ovarian dysfunction does not have menstrual irregularities, which can persist for 3-10 years. Studies have shown that serum AMH concentrations can distinguish between early (ie menstrual cycle rules, increased follicular FSH concentration) and transitional ovarian dysfunction (irregular menstruation, increased follicular FSH concentration). AMH provides an accurate assessment of young follicles that are secreted by young gonadotropins, especially those with elevated FSH but who do not meet the diagnostic criteria for clinical premature ovarian failure.
3 Polycystic ovary syndrome (PCOS):PCOS is the most common reproductive endocrine disorder in the population, but the current diagnostic threshold is unilateral ovarian ≥12 follicles There is doubt. This is mainly due to the improvement of imaging technology to identify more follicles, and thus human factors cause an increase in the probability of polycystic ovary morphology in the general population, especially young women.
PCOS patients’ serum AMH levels increased significantly with the increase of follicular fluid AMH concentration and inhibited follicular growth. The increase in AMH has nothing to do with ovulation, mainly caused by increased follicles in small sinus. Therefore, in patients with PCOS, serum AMH levels are negatively correlated with ovarian reserve function and ovulation induction, that is, the higher the AMH level, the worse the ovarian reserve function and ovulation induction effect.
4 Predicting ovarian response in assisted reproductive technology: AMH levels predict ovarian response and identify women at risk for ovarian hyperstimulation syndrome, based on AMH values The amount of ovulation-promoting drugs.
The study found that the higher the AMH level in the serum and follicular fluid of patients receiving IVF/ICSI, the higher the fertilization rate, and AMH can be an indicator for predicting fertilization rate.
5 Predicting the age at which menopause occurs: AMH levels are closely related to the age of menopause, and AMH levels gradually decrease with age. Serum AMH levels gradually decrease in the first 5 years of menopause, and the age of menopause can be predicted.
6 Assist in the diagnosis of gender dysplasia: AMH can help diagnose whether there are developmental disorders such as gonadal dysplasia, precocious puberty, and cryptorchidism. If serum AMH levels are low or undetectable, there is a high probability of no testicular tissue. Serum AMH levels were significantly lower in patients with cryptorchidism than in single testicular patients.
So what is the normal AMH reference value? What does it mean to be below or above the reference value?
2～7ng/ml, normal value
0.7～2ng/ml, suggesting ovarian hyporesponsiveness
<0.086ng/ml, Tips for menopause
>7ng/ml, suggesting polycystic ovary syndrome, ovarian hyperstimulation syndrome, ovarian granulosa cell tumor
AMH is not only significant but also detects relative sex hormones More convenient and stable.
AMH is often used to assess ovarian function. Modern urban women have ovarian function due to poor lifestyle and stress. Not all, what should I do?
1 Hormone replacement therapy (HRT): The current classic treatment at home and abroad is hormone replacement therapy. It is generally believed to improve the development of secondary sexual characteristics in adolescent patients with ovarian insufficiency and to alleviate menopausal symptoms caused by estrogen deficiency; on the other hand, it can reduce long-term complications such as osteoporosis and cardiovascular disease. Wait. Includes estrogen therapy alone and sequential therapy with estrogen and progesterone.
2 Egg donation: Although ovarian insufficiency can cause intermittent ovulation, only 5% to 10% can spontaneously ovulate and successfully conceive, so infertility is plagued by ovarian function One of the important problems of patients with incompleteness. Studies have shown that ovulation induction therapy can not significantly improve the patient’s fertility, and in recent years, research egg donor transplantation is the most effective treatment for patients with ovarian insufficiency. However, the current incidence of pregnancy complications in ovarian donors and ethical issues remain unresolved.
3 cryopreservation technology: cryopreservation technology is one of the important methods for preserving fertility in patients with incomplete occlusion. Generally, cryopreservation of egg, embryo or ovarian tissue, and then timely thawing In vitro fertilization or in vivo transplantation after rewarming.
4 Ovarian Transplantation: Ovarian transplantation has become one of the methods for the treatment of ovarian insufficiency with the development of ovarian tissue cryopreservation, immunosuppression, microsurgery and transplantation.
5 Psychotherapy: There is a close relationship between psychological factors and infertility caused by ovarian insufficiency, which both promote and restrict each other. Patients with ovarian insufficiency are prone to mental health hazards such as anxiety, depression, insomnia, and decreased sexual life satisfaction. These psychological crises affect the fertility and treatment of patients with ovarian insufficiency. Therefore, it is important to maintain an optimistic attitude towards life and improve the quality of life.
There is no particularly good treatment for ovarian insufficiency. The most important thing is to maintain a good living condition, regular physical examination, early detection, early diagnosis and early treatment.
 Gao Yingying. Anti-Mullerian hormone determination guides individualized diagnosis and treatment of female infertility[J].International Journal of Endocrinology and Metabolism , 2015, 35(6): 423.
Chen Ling, Xiang Shuangwei. Regulation and predictive effect of anti-Mullerian hormone on ovarian persuasion[J].Medical Recapitulate, 2013, 8:1400-1402.
 Guo Yeqing, Yao Sui. Current status and progress of treatment of ovarian insufficiency[J].Chinese Journal of Clinicians(Electronic Edition),2015, (6):072- . 975
author: Doctor_leven, graduated from the Master endocrine Dalian Medical University, er interest to the medical science of
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