Wednesday, March 25, 2009

AMH Test Showing Antral Follicles in the Ovaries

What is AMH ?
AMH stands for Anti-Mullerian Hormone. Since AMH is produced directly by the ovarian follicles, AMH levels correlate with the number of antral follicles in the ovaries . It has been documented that women with lower AMH have lower antral follicular counts and produce a lower number of oocytes compared with women with higher levels.

AMH Reference ranges

Ovarian Fertility Potential pmol/L
Optimal Fertility 28.6 pmol/L - 48.5 pmol/L
Satisfactory Fertility 15.7 pmol/L - 28.6 pmol/L
Low Fertility 2.2 pmol/L - 15.7 pmol/L

AMH levels do not vary with the menstrual cycle and can be measured independently of the day of the menstrual cycle.
AMH can be used for
1. Evaluating Fertility Potential and ovarian response in IVF – Serum AMH levels correlate with the number of early antral follicles. This makes is useful for prediciting your ovarian response in an IVF cycle. Women with low AMH levels are more likely to be poor ovarian responders.
2. Measuring Ovarian Aging – Diminished ovarian reserve, is signaled by reduced baseline serum AMH concentrations. Women with poor ovarian reserve who have entered the oopause have low levels of AMH.
The other tests to check ovarian reserve include checking your inhibin levels.
However, these are new and expensive tests, and is still not easily available. This is why the gold standard for ovarian reserve testing is still the Day 3 FSH level.

The theory is that because the level of anti-mullerian hormone found in the blood does not fluctuate throughout the month, it could be an accurate predictor of whether a woman is still fertile and how many eggs she has left in her ovaries. The manufactures claim that it is more accurate than a simple oestrogen test. If they’re right, then the test would be a predictor of who’s more likely to have success with in-vitro fertilization.
In addition to the test’s possible applications as a predictor of fertility, it may also be useful as a test for polycystic ovarian syndrome (PCOS). It is believed that women with PCOS have elevated levels of AMH in their blood, which would make the AMH test ideal for diagnosis.
How the Test is DoneCurrently, the test is not covered by most insurance and it expensive to have done. To perform the test 3mls of blood is taken on the second or third day of the woman’s period. Using the results of the test and an "Ovarian Reserve Index", the estimated number of eggs remaining in the ovaries is plotted on a graph showing the woman’s position compared with the average number for her age group. Makers of the test claim that this will predict ovarian reserves for the next two years.
ControversyThere is some controversy over what exactly this test can truly tell you, if anything. Using the test as a predictor of menopause is probably useless, but using it as an indicator of ovarian reserves may be more feasible. Whatever the use, fertility experts currently believe that the AMH test is about 70 percent accurate.


Celia said...

I just want to thank you, I have to see my RE tomorrow and want to talk to him about this. Now I won't sound like such a dope.

Beth said...

I'm glad I could share some info with you. Please let me know how your doctor apt goes.