How IVM is beneficial
IVM requires
less medication than conventional IVF and lowers the immediate cost of
treatment; however, the pregnancy rates are also lower, so it is unclear
whether IVM is more cost-effective. An IVM cycle also takes less time.
Anti-Müllerian hormone, also known as
Müllerian-inhibiting hormone, is a glycoprotein hormone structurally related to
inhibin and activin from the transforming growth factor beta superfamily, whose
key roles are in growth differentiation and folliculogenesis. Anti-mullerian
hormone or AMH is produced by granulosa cells (cells lining the egg sacs or
follicles) within the ovary. AMH can also help reproductive endocrinologists
predict a woman’s response to ovarian stimulation and to determine the best
strategy for IVF treatment.
Understanding AMH and
its role in fertility
Inside the
ovaries are follicles — pouch-like cavities that contain developing oocytes
(eggs). A woman is born with all of the eggs she will ever have, and during the
average 28-day menstrual cycle, the follicles release one mature egg into one
of two fallopian tubes for fertilization to occur.
Learning the
capacity of a woman’s follicle pool helps a fertility specialist determine
fertility potential. Since very immature, primordial ovarian follicles produce
AMH, specialists can use the results of blood work to assess egg supply.
What does AMH testing
reveal?
AMH testing
is performed as part of a complete fertility evaluation, along with FSH and
estradiol blood testing and a transvaginal ultrasound assessment of the number
of visible antral follicles.
Unlike other
hormones, AMH levels do not fluctuate during the menstrual cycle, so the blood
sample can be taken at any time of the month. A lower AMH value is found in
women with a diminished ovarian reserve and those who are close to menopause.
Women with lower AMH values will tend to have a poor response to ovarian
stimulation for IVF, and may have fewer eggs retrieved.
What testing doesn’t
reveal
While AMH
gives fertility specialists a clue as to the quantity of remaining eggs, it
cannot reveal the quality of those eggs; nor can the results definitively rule
out conception.
Who can benefit from
AMH testing?
• Women over
36 not able to conceive after 6 months of trying
• Women
under 36 who have been trying to get pregnant for about 12 months
• Patients
considering IVF or egg freezing, as low levels of AMH can indicate a
potentially poor response to ovarian stimulation
• Women who
have had chemotherapy or radiation to the pelvic region who want to know if it
has affected their future fertility
Low AMH: What can be
done?
A low AMH
value doesn’t automatically mean you will have difficulty getting pregnant. A
woman younger than 35 with a decreased egg reserve differs from an older woman
with a diminished reserve. Because of her age, a younger woman’s egg quality
may still be high.
When AMH and
other tests point to a diminished ovarian reserve, fertility professionals can
tailor treatment plans to yield promising results. Such protocols include
freezing eggs or embryos for future use, and adjusting the doses of ovarian
stimulation drugs to maximize the number of eggs harvested.
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