Test to evaluate decreased ovarian reserve (low AMH)

This is an automatically translated article.

The article is professionally consulted by Master, Doctor Nguyen Thi Xuyen - Clinician - Reproductive Support Center - Vinmec Times City International Hospital.
The AMH test is an important step in assessing a woman's fertility now and in the future. When low AMH levels signal low ovarian reserve, more measures should be combined to improve and stimulate the ovaries appropriately.

1. Overview of Low Ovarian Reserve Tests

AMH (abbreviated as Anti - Mullerian Hormone) is a hormone secreted directly from the granulosa cells of the ovarian follicles, indicating the number of immature follicles present in a woman's ovaries. The characteristics of the AMH index - Ovarian reserve assessment index:
Reached the highest index at 25 years old and tended to decrease with age; Not fluctuating even during the menstrual cycle; As a measure of ovarian reserve, predicting a woman's fertility now and in the future. In women, the better the ovarian reserve, the better the fertility. The AMH low ovarian reserve test is an important step in assessing a woman's fertility, especially for those intending to undergo IVF.

2. The role of the AMH . test

The test to evaluate low ovarian reserve AMH offers the following values:
Monitoring ovarian aging: Helps predict the number of oocytes remaining in the ovaries, thereby predicting fertility and age of menopause Of the woman. Prognosis of female fertility: The AMH index is directly correlated with the number of follicles, so with age, AMH levels decrease with age at different rates in each woman. Therefore, the AMH test can help doctors predict pregnancy and assess the rate at which ovarian function is declining. From there, it is possible to advise on the appropriate time and method so that a woman can get pregnant naturally or choose fertility intervention. Prognosis of menopausal age: People with early menopause or ovarian failure will have an early drop in AMH levels. Predicting the onset of menopause in women and taking proactive hormone replacement therapy reduces the risk of osteoporosis and diseases associated with early menopause in women. Prediction of ovarian function decline after cancer treatment, surgery: Ovarian surgery such as electrocautery hemostasis, ablation, and dissection on the ovary can also reduce the number of follicles.

3. Who should have the AMH . test

The AMH test is considered a reliable test, helping to detect early damage to ovarian tissue during cancer treatment or after surgery. Up to now, medicine has not had any measures to restore low ovarian reserve when AMH levels are low, much reduced after surgery. However, knowing information about low ovarian reserve can still help patients have appropriate treatment options and strategies to have children.
Accordingly, women need to have AMH test when:
Polycystic ovaries; Premature ovarian failure; Primary infertility, secondary infertility; Prognosis of menopause; Menstrual disorders (menorrhoea, menorrhagia, primary amenorrhea, secondary amenorrhea...); Monitor infertility treatment.

4. Evaluation of ovarian reserve by AMH

Factors affecting the concentration of AMH include:
Age, genetics Due to location, race; Unhealthy living (drinking, smoking; using stimulants, staying up late, often stressed, stressed) Obesity; Polycystic Ovary; Endometriosis in the ovaries Take birth control pills regularly; Chemotherapy, radiation therapy; Having had reproductive surgery such as: ovary removal, ovarian tumor removal, ectopic pregnancy, endometriosis tumor, other surgery in the pelvic region... 4.1. Normal AMH index Although AMH levels do not change with the menstrual cycle, they are still affected by age or other medical, lifestyle, and stress factors.
In women who are healthy and <38 years old, normal AMH ranges from 1.25 to 4.74 ng/ml. This is considered a good condition to respond to methods of assisted reproduction, ovarian stimulation.
4.2. Low AMH Index An AMH index of 1.0-1.25 ng/ml indicates a decline in ovarian reserve, but there is still a chance of pregnancy (despite difficulty). A low AMH index: <1 ng/ml means that in most cases, pregnancy is very difficult to predict. The extremely low AMH index (<0.5ng/ml) evaluates the low ovarian reserve, the two ovaries have shrunk and cannot be found on ultrasound, the ability to conceive is difficult. In these cases, there are often indications to ask for eggs to get pregnant. 4.3. High AMH Index In the case of IVF, women with high AMH levels are more likely to respond to ovarian stimulation and have a higher number of eggs retrieved. When many eggs are aspirated, the ability to select good embryos for transfer to the uterus is higher, so the success rate of fertilization is also higher.
If the AMH is too high and too high (>10 ng/ml), which is common in women with PCOS, it can lead to an increased risk of ovarian hyperstimulation, and reduced effectiveness of insemination. IVF test tube.
In general, AMH levels that are too low or too high can put patients at a disadvantage during IVF.

5. What to do when assessing low ovarian reserve (low AMH)?

Women with low AMH scores, in addition to impaired ovarian reserve, also have a poor response to ovarian stimulation drugs. Therefore, the doctor will have to use a special treatment regimen of many drugs or high doses to stimulate the ovaries to get the desired number of follicles. In this case, the chances of conception are often lower than those with normal AMH values. However, not all cases have the same ovarian stimulation response.
AMH plays an important, but not all, role in assessing the success of an IVF case. Because this index only evaluates the ovarian reserve in a woman's body, it does not reflect the quality of the ovaries. Therefore, doctors need to combine more ultrasounds, tests and other in-depth examinations to have the most complete and accurate view of the success rate for an IVF procedure.
Customers can come to the Center for Reproductive Support - Vinmec International General Hospital. This is the leading center in Vietnam, which has developed and applied a comprehensive medical examination and treatment process, combining both gynecology and obstetrics and gynecology to provide the optimal method for each patient's case.
Advantages when customers choose Vinmec fertility center:
Equipped with modern equipment, clean air system according to international standards to ensure lab quality, single cabinet system to optimize quality embryo, improving the success rate for each cycle of artificial insemination. Implement most advanced assisted reproductive techniques in the world: ICSI (injection of sperm into the oocyte cytoplasm); support embryo escape membrane; Reproductive reserve: embryo freezing, sperm freezing, oocyte freezing to help customers take the initiative in giving birth at will, transferring embryos on day 5, minimizing pregnancy; male infertility techniques (PESA, MESA, TEFNA, TESE) Besides advanced reproductive support methods, a team of excellent doctors in the country and the world, with prestige and long-term experience in the field of infertility . Master, Doctor Nguyen Thi Xuyen graduated with a Master's degree in Obstetrics and Gynecology with in-depth research on Assisted Reproductive Medicine at Hanoi Medical University. Doctor Xuyen has participated in many researches on medical topics specializing in reproductive health and assisted reproduction.

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