In preparation for pregnancy, a comprehensive study of the hormonal status of a woman is carried out. It becomes especially relevant in case of infertility. In this case, the patients are assigned a study of anti-Müllerian hormone (AMH). The delivery of this analysis is included in the mandatory list. What is the anti-Müllerian hormone responsible for? Anti-Müllerian hormone and IVF are inextricably linked. The production of this substance occurs in the granulosa layer of the ovaries, the follicles in it.
The more tiny follicles there are in a woman's body, the higher the AMH index. The AMH level is a reliable indicator of ovarian reserve and allows you to assess the possibility. If the hormone level is high, IVF can take place with your own eggs.
If the AMH level approaches 0, then it is pointless to stimulate the ovaries. is carried out after considering the use of the donor egg. It should be noted that the level of AMH in women practically does not change during the fertile period.
It is difficult to overestimate the importance of anti-Müllerian hormone for IVF. Do I need to take it? Necessarily! If the severity of AMH is investigated in a timely manner, IVF will be carried out with maximum efficiency. There is no other way to know if the ovaries may react to upcoming stimulation.
Indications for taking anti-Müllerian hormone with IVF
Preparation for IVF in infertility to identify ovarian reserve.
Ineffectiveness of the performed stimulation.
The rate of anti-Müllerian hormone in women for IVF
With any indicators of AMG, it is possible to carry out additional reproductive measures. The differences will be in whose egg will be used for fertilization. To resolve the issue of the need to stimulate your own reserve or use donor material, you need to know that the rate of anti-Müllerian hormone for IVF is set for each laboratory, depending on the reagents used. Average values of normal parameters are 1-12 ng / ml. Such blood test results indicate a good ovarian reserve and active ovarian function. Indicators of less than 1 ng / ml signal a decrease in the supply of follicles or depletion of the gonads.
How to take AMG correctly
An anti-Müllerian hormone test before IVF is mandatory. The tactics of the protocol will depend on it. Therefore, it must be taken in compliance with clear rules:
- Blood must be donated in the morning at 8-9-10-11 hours.
- Before the study, it is necessary to observe the fasting regime for 8-12 hours. During this time, you can drink water.
Now assisted reproductive technologies are closely related to the everyday life of our society. Couples who cannot have children without the help of assisted reproductive technologies would have no chance of a happy life filled with children's laughter. To use ART methods in a married couple, it is necessary to undergo a full comprehensive clinical and laboratory examination, including also some methods of functional diagnostics.
One of these tests is a blood test for AMH content. This abbreviation stands for anti-Müllerian hormone. What it is and how AMG affects eco-friendly health insurance now we will analyze.
Anti-Müllerian hormone is a steroid that is produced by the granulosa cells of the ovary. It is synthesized from the birth of a girl until the onset of menopause. This indicator indicates the level of the ovarian reserve of the female body. That is, how many more follicles the female ovary contains. That is, in simple terms. How many chances a woman still has to get pregnant or not. And depending on this, the doctor must choose the optimal method of conception.
If the indicator is low, then the chances of finding the desired offspring from a woman, respectively, are less.
What other conclusions can be drawn from the results of the level of anti-Müllerian hormone?
The state of the reserve of follicles in the ovaries. If a woman of reproductive age has very low levels of anti-Müllerian hormone, then we can conclude that we are facing a woman with premature ovarian depletion.
The functional ability of the ovaries, the ability and readiness of the female body for the maturation of follicles and the maturation of eggs in them.
Fertility rate of a woman
The degree of response of a woman's ovaries to a hormonal effect on the ovaries in order to achieve the phenomenon of superovulation. This indicator is very important when conducting an in vitro fertilization protocol.
Allows you to calculate the risk of a woman developing hyperstimulation syndrome - a pathological condition in which ovarian hyperfunction is observed in response to therapy, which manifests itself in a massive transfusion of the liquid part of blood into the interstitial space and all the resulting consequences for the woman's body, and if fertilization occurred during a natural onset pregnancy. Or implantation after embryo transfer, then on an unborn child.
The indicator of the level of AMH allows you to presumably calculate the timing of the onset of menopause.
What are the indications for passing this analysis? To begin with, a woman with problems of conception needs to contact an obstetrician-gynecologist, who, depending on the clinical picture, anamnesis data, will make appointments. Among the indications are:
- Long-term, and most importantly - unsuccessful, attempts by a married couple to get pregnant without using any type of contraception
- Infertility of unknown etiology;
- A history of unsuccessful attempts to use the in vitro fertilization technique;
- An increase in the level of follicle-stimulating hormone;
- Pathological conditions of the ovaries such as polycystic ovary syndrome, ovarian neoplasms;
- Premature puberty, premature ovarian failure syndrome are also indications for the delivery of such a hormone;
When is this examination necessary?
It is better to take the test on the 3-5th day of the ovarian-menstrual cycle, although the level of this hormone is not subject to significant changes, depending on the phase of the cycle. before the examination, you should not load your body with any physical or emotional stress in a few days. The level of the hormone can respond to a decrease in the number of follicles due to surgical interventions, depending on the age of the patient: the higher it is, the lower the level of anti-Müllerian hormone.
It is also not worth examining at the time of an acute course or exacerbation of chronic diseases, since the result may be distorted.
Normal indicators of the AMH level are numbers from 1.1 to 2.5 in the female sex.
But, sometimes, there are situations in which the results obtained greatly upset women. This can be either a decreased or an increased level of anti-Müllerian hormone.
What are the reasons for the decrease in the level of this indicator:
- Menopausal changes in a woman's body. The ovarian tissue reserve is depleted, follicles do not mature in the organs, and, accordingly, the production of a sufficient amount of anti-Müllerian hormone does not occur.
- Decreased ovarian reserves - the oocyte reserve is reduced, and sometimes completely absent.
- The presence of congenital pathologies in the development of the reproductive system, namely, congenital malformations of the ovaries.
- Postoperative conditions associated with surgical interventions on the ovaries, resulting in a decrease in the volume of ovarian tissue. Such consequences include wedge-shaped resection of the ovary, removal of ovarian neoplasms with involvement of the ovarian tissue in the pathological process, and, accordingly, its removal.
- Various disorders of puberty, namely premature puberty.
- Dysfunction of the hypothalamic structures, pituitary gland and, as a consequence, ovarian dysfunction.
Causes
The reasons for the decrease in the level of this hormone:
- Various mutations of AMH receptors;
- The development of such a pathological condition as polycystic ovary syndrome;
- Infertility due to the presence of anovulation;
- Dysfunction of luteinizing receptors, as well as follicle-stimulating hormone;
- If a married couple was never able to conceive a child, despite medical and in some cases surgical treatment, then 75% of such families turn to reproductive medicine clinics for help.
However, sometimes there are obstacles for the use of assisted reproductive technologies. The first reason for the inaccessibility of the technique for carrying out extracorporeal fertilization lies in its price segment. Not every family has enough financial resources to pay for the basic IVF protocol, not to mention the additional possible waste in the form of pre-implantation diagnostics. The state tried to solve this problem by launching the Federal Program for In Vitro Fertilization Protocol at the expense of the Mandatory Medical Insurance Fund (MHI). By submitting an application to the site, each married couple has the opportunity to receive a free IVF protocol.
But, unfortunately, not only financial issues stand in the way of gaining the desired happiness. The criterion for the possibility or refusal to carry out an in vitro fertilization procedure can be many indicators that deviate from the norm. And one of them is the level of anti-Müllerian hormone.
AMG norm for IVF according to compulsory medical insurance
An essential role is played by the level of AMG for IVF under compulsory medical insurance.
That is, whether a married couple will be able to take advantage of the IVF procedure under compulsory medical insurance, with a low AMH, a woman has the right to refuse. What is the reason for this? The crux of this problem is that when a woman has a low anti-Müllerian hormone, the ovarian response to stimulation in the IVF protocol program may be unsatisfactory.
Low AMH and IVF by compulsory health insurance are possible, but on condition that the anti-Müllerian hormone levels are not lower than 0.8 ng / ml. this is the extreme level of this indicator, the AMG norm for IVF according to compulsory medical insurance. At the same time, the index of follicle-stimulating hormone should be no higher than 15 international units. If the indicators of these hormones do not fit into the specified framework, then a married couple may be denied IVF, including low AMH, IVF according to CHI with a low level of hormones, it is still possible.
With a low level of AMG and IVF according to the compulsory medical insurance, the reproductive physician must make a very important decision. On which the success of the protocol will depend and it lies in the correct, balanced choice of the ovulation stimulation scheme. The so-called "soft protocols" are applied using smaller doses of gonadotropin-releasing hormones.
If, nevertheless, a married couple was denied in carrying out the protocol on compulsory medical insurance or eggs were not received after stimulation, then there is the possibility of using ART methods in the form of using a donor egg. The essence of this method consists in fertilizing the donor's egg with the sperm of the spouse, comparing the donor and recipient cycle, cultivating the embryos and replanting them into the uterus of the recipient woman. A woman carries a child, gives birth to him and is the biological mother. Sometimes, only this technique allows the family to receive the greatest gift in life - to give birth to a long-awaited child.
There is always a way out!
Displays the number of mature eggs.
If the indicators of this hormone are abnormal, then this significantly reduces the chances of a successful result of the in vitro fertilization procedure.
The appointment of anti-Müllerian hormone in the body
Anti-Müllerian hormone (AMH) is an active substance produced by the female body during the period of functioning of the reproductive system.
The protein molecule is produced by specialized ovarian cells until the onset of menopause. It is a hormone that affects growth factor.
AMH begins to be released during puberty, which is medically called puberty. This process ends in girls with the appearance of the first menstrual flow.
This hormone is an indicator of ovarian reserve. This is the number of eggs ready for fertilization in the follicles.
AMH acts as a marker of ovarian dysfunction. This condition occurs when it is impossible to produce hormones and germ cells. Usually, hormonal failure becomes the cause of this pathology.
With the help of an AMH test, you can find out the ovarian response (the number of mature eggs that can develop into healthy embryos). This study is usually performed during in vitro fertilization.
Anti-Müllerian hormone functions:
- Regulation of follicle output in a calm state.
- Influence on the rate of decrease in the primary reserve.
Today, this hormone is used to diagnose infertility, the causes of which have not been clarified by doctors.
Research on the amount of this biological substance in the female body is done with unsuccessful attempts at in vitro fertilization.
Based on the results of AMG, one can understand the reasons for the increase in follicle-stimulating hormone.
Today, the analysis for this substance is used to diagnose granule cell carcinoma of the female reproductive glands. This tumor most often develops in women after 40 years.
Normal AMH levels
Indicators from 2.1 to 7.3 ng / ml (nanograms per milliliter) are considered the norm. This concentration indicates that a woman is of reproductive age, that is, she can become pregnant on her own.
Low levels of the hormone indicate ovarian depletion. This pathology indicates the premature development of menopause.
With an increased level of AMH, the number of small antral follicles increases.
This condition is caused by polycystic ovary disease. With such a disease, the hypothalamic regulation of the work of the female reproductive glands is disrupted.
For IVF, AMG should be taken on the 3rd - 5th day of the menstrual cycle.
Before the study, it is prohibited:
- Smoke.
- Drink alcohol.
- Get nervous.
- Exercise.
- Take hormonal medications.
The analysis involves taking blood from a vein. AMH is determined using a special serum.
The results are deciphered by an endocrinologist. The AGM norm for IVF is not less than 0.8 ng / ml.
Deviations from the norm with IVF
Indicators of anti-Müllerian hormone play an important role in in vitro fertilization.
After all, they help to find out the number of finished eggs and make a prediction about future conception.
Low AMH
According to reviews, IVF with low AMH is less likely to end in successful fertilization. The reason for this is the smaller number of eggs that produce the sex glands.
The result of IVF with a low AMH depends primarily on the qualifications of the reproductologist and on the response of the female body to stimulation.
It is necessary for the maturation of several follicles with eggs, which are then taken through a puncture for further artificial fertilization.
Successful IVF with low AMH is only possible if the parameters are normal. If the follicle-stimulating hormone is overestimated, then it will not occur.
The FSH norm for IVF is 1.37-9.90 mU / l. Fertilization in the event of a deviation from the norm will not occur due to the impossibility of collecting the required number of mature eggs.
The chances of IVF with low AMH are considered minimal. Doctors focus on the fact that in case of deviations, conception occurs in 20% of cases, but in 85% of cases the pregnancy fails due to detachment of the ovum from the endometrium of the uterus.
There are also known cases when, due to the low level of anti-Müllerian hormone, children were born with chromosomal abnormalities (Down syndrome, Patau, Edwards and others). Most often, children with pathologies are born from mothers whose age is over 35 years old.
If the AMH indicator is below 0.8 ng / ml, then the woman is prescribed a special hormone-based therapy by the reproductive specialist, which increases the number of mature eggs.
To increase AMG for IVF, drugs are used based on menopausal gonadotropin: Menogon, Pergonal, Manopur. Also drugs "Puregon" and "Gonal" are used.
To suppress the production of estrogen, the following agents are used: "Clostilbegit", "Serofen" and "Clomid".
If a woman has problems with the amount of human chorionic gonadotropin, then drugs are prescribed: "Prophase", "Ovitrel", "Horagol" and "Pregnil".
With such indicators, treatment is first prescribed, and then only IVF is done.
Conclusion
For IVF, AMG in women must be normal. If the level of this hormone is low, then doctors will not be able to collect eggs, so the chances of fertilization are automatically reduced. With reduced results, therapy is prescribed.
Many women, after being diagnosed with infertility, even with a low AMH, managed to become pregnant, but reproductologists note that these cases are not regularities.
The ability to fertilize directly depends on the age of the expectant mother, the strength of her body and susceptibility to hormonal drugs. NS
approved drugs to increase the protein molecule can provoke ovarian hyperstimulation syndrome.
It is very dangerous for women and can have the following consequences:
- Development of ascites.
- Premature ovarian failure.
- Rupture of the sex glands.
- Thickening of the blood.
- Ovarian torsion.
- Accumulation of fluid in the abdominal cavity.
Video: Anti-Müllerian Hormone (AMG)
In 2018, there were changes in the legislation, and the IVF procedure became available at the expense of the general health insurance (MHI) funds. Unfortunately, according to the norms, not all women who are unable to conceive a child naturally can exercise this right. The patient must meet a number of criteria, including the level of anti-Müllerian hormone (AMH), which is responsible for the likelihood of a positive outcome of artificial insemination.
You can perform an in vitro fertilization procedure for your own money with almost any test results. The doctor can warn, but he cannot refuse to carry out conception in this way. In the event that a woman wants to exercise the right to consider her situation to receive a quota, she must be ready to refuse, due to the unpromising nature of this procedure.
What should be the norm of the anti-Müller index in women
Anti-Müllerian hormone (AMH), also sometimes called Müller's inhibitory substance... This hormone is checked in patients to clarify the likelihood of their pregnancy: the higher it is, the more likely a woman is to become pregnant. For 2018, this figure must be at least 1.0 to obtain an IVF quota.
It is issued only to those women who have a sufficient level of the hormone, which means that they have a high chance of conception. Such measures are aimed at preserving budgetary funds by excluding from the queue for the quota of patients whose artificial insemination, most likely, will not end positively.
AMG helps diagnose reproductive health problems in women
It is necessary to clarify that in some regions the value of the minimum possible level of AMG for IVF may differ from the general one in the country. Information about the situation in your region should be clarified at the reproductive center of your city or at the local antenatal clinic.
AMG promotes tissue growth during embryonic development and, by its value, a specialist is able to fairly accurately predict the number of eggs that will be capable of fertilization. The concentration of anti-Müllerian hormone depends on the number of dormant follicles, and from them you can determine the reproductive potential.
Its norm for patients of reproductive age can be from 1.0 to 2.5 ng / ml, which indicates a woman's ovarian reserve. It happens that the AMG value can reach up to 15 nanograms per milliliter; with such indicators, IVF at the expense of the compulsory medical insurance will also be refused.
In cases where the AMH level is above 0.6669 ng / ml, but below 1.0, a woman has a small chance of fertilizing her own egg and she can go to a private clinic, where doctors will select the necessary IVF protocol for her.
Features of the procedure with a low hormone level
In patients whose AMH level does not reach the minimum norm, too little follicular growth is assumed, as well as an insufficient response to stimulation. Also, according to the results of studies, it has been proven that if the level of anti-Müllerian shows little hormone, it can lead to various pathologies of the development of the embryo.
Anti-Müllerian hormone values
Women wishing to undergo IVF under the compulsory medical insurance need to be prepared for the fact that until the AMG level is equal to 1 or higher, the commission will refuse them to receive a quota. In the event that the level of the Mueller inhibitory substance is zero or fluctuates around this mark, stimulating the ovaries is meaningless. I must say that during the fertile period, the value of AMH remains practically unchanged.
IVF protocol
With a low AMH level, the following IVF protocols can be used:
- Japanese protocol- stimulation takes place at a minimum and intermittently, in each cycle, specialists try to get 1-2 eggs capable of fertilization. All obtained embryos are cryopreserved and transplanted in the following cycles;
- eco in the natural cycle- ovulation is not stimulated, or it is prescribed in the minimum amount. Over the course of several cycles, specialists try to obtain at least one egg.
Patients with low ovarian reserve can be prescribed hCG and LH drugs, estrogens, androgens, L-arginine, herbal medicine, as well as improving microcirculation and even hirudotherapy. All these procedures and drugs are not included in the compulsory medical insurance, but after their use, a positive trend is observed, and the chances of a successful IVF outcome increase.
The patient's AMH level will affect the reagents that will stimulate ovulation.
In vitro fertilization without hormonal therapy
Patients whose levels of Mueller's inhibitory substance are less than normal will have a suitable IVF protocol in their natural cycle. This is done in cases where hormonal drugs are contraindicated for a woman who is not able to conceive naturally, or in a situation where more than one follicle is not expected to grow as a result of stimulation.
IVF without hormonal therapy is carried out mainly for patients older than reproductive age, that is, up to 30 years, as well as for women with a low ovarian cycle. An embryo obtained from a single quality fertilized egg can be cryopreserved or transferred in a fresh cycle. There is also the practice of transferring embryos accumulated in natural cycles into the uterine cavity.
The patient undertakes all examinations, additional appointments of a specialist, as well as the delivery of tests. IVF according to the compulsory medical insurance includes only: the initial appointment of a reproductologist, stimulation of ovulation.
Low AMH and high FSH
In addition to the sufficient value of AMG, when taking tests for IVF, it will be necessary to find out what level of follicle-stimulating hormone of the pituitary gland (or FSH). The production of FSH stimulates the growth of follicles and eggs. If AMH is lowered, as a rule, FSH rises, which adversely affects conception: the quality of the eggs is not enough for fertilization.
Estimated AMH content in men and women, depending on age
In this situation, the IVF procedure is impossible, or you need to use a donor egg. Unfortunately, in 2018, the use of donor material is not included in the compulsory medical insurance, and the patient will have to pay all expenses on her own. FSH levels of more than 10 nanograms per milliliter are considered high.
If the value of both AMH and FSH is low, then there is still a small probability of conception. The artificial insemination procedure will be carried out with minimal stimulation and in case there is a chance of obtaining several cells.
conclusions
- The reproductive potential of a woman depends on the AMH level. By its concentration, a specialist can determine the number of eggs capable of fertilization.
- For 2018, the AMG value for IVF under compulsory medical insurance should be at least 1.0 and not more than 2.5 ng / ml, although in each case the decision on the quota is made individually.
- For women with low anti-Müllerian hormone levels, the Japanese protocol and the natural cycle IVF protocol can be applied. Also, they can be prescribed various hormonal preparations and procedures aimed at improving microcirculation.
- In vitro fertilization in a natural cycle is used mainly for patients over 30 years of age, as well as for those who are contraindicated in hormones.
- If the FSH level is more than 10 ng / ml, IVF is not possible.
Now assisted reproductive technologies are closely related to the everyday life of our society. Couples who cannot have children without the help of assisted reproductive technologies would have no chance of a happy life filled with children's laughter. To use ART methods in a married couple, it is necessary to undergo a full comprehensive clinical and laboratory examination, including also some methods of functional diagnostics.
One of these tests is a blood test for AMH content. This abbreviation stands for anti-Müllerian hormone. What it is and how AMG affects eco-friendly health insurance now we will analyze.
Anti-Müllerian hormone is a steroid that is produced by the granulosa cells of the ovary. It is synthesized from the birth of a girl until the onset of menopause. This indicator indicates the level of the ovarian reserve of the female body. That is, how many more follicles the female ovary contains. That is, in simple terms. How many chances a woman still has to get pregnant or not. And depending on this, the doctor must choose the optimal method of conception.
If the indicator is low, then the chances of finding the desired offspring from a woman, respectively, are less.
What other conclusions can be drawn from the results of the level of anti-Müllerian hormone?
The state of the reserve of follicles in the ovaries. If a woman of reproductive age has very low levels of anti-Müllerian hormone, then we can conclude that we are facing a woman with premature ovarian depletion.
The functional ability of the ovaries, the ability and readiness of the female body for the maturation of follicles and the maturation of eggs in them.
Fertility rate of a woman
The degree of response of a woman's ovaries to a hormonal effect on the ovaries in order to achieve the phenomenon of superovulation. This indicator is very important when conducting an in vitro fertilization protocol.
Allows you to calculate the risk of a woman developing hyperstimulation syndrome - a pathological condition in which ovarian hyperfunction is observed in response to therapy, which manifests itself in a massive transfusion of the liquid part of blood into the interstitial space and all the resulting consequences for the woman's body, and if fertilization occurred during a natural onset pregnancy. Or implantation after embryo transfer, then on an unborn child.
The indicator of the level of AMH allows you to presumably calculate the timing of the onset of menopause.
What are the indications for passing this analysis? To begin with, a woman with problems of conception needs to contact an obstetrician-gynecologist, who, depending on the clinical picture, anamnesis data, will make appointments. Among the indications are:
- Long-term, and most importantly - unsuccessful, attempts by a married couple to get pregnant without using any type of contraception
- Infertility of unknown etiology;
- A history of unsuccessful attempts to use the in vitro fertilization technique;
- An increase in the level of follicle-stimulating hormone;
- Pathological conditions of the ovaries such as polycystic ovary syndrome, ovarian neoplasms;
- Premature puberty, premature ovarian failure syndrome are also indications for the delivery of such a hormone;
When is this examination necessary?
It is better to take the test on the 3-5th day of the ovarian-menstrual cycle, although the level of this hormone is not subject to significant changes, depending on the phase of the cycle. before the examination, you should not load your body with any physical or emotional stress in a few days. The level of the hormone can respond to a decrease in the number of follicles due to surgical interventions, depending on the age of the patient: the higher it is, the lower the level of anti-Müllerian hormone.
It is also not worth examining at the time of an acute course or exacerbation of chronic diseases, since the result may be distorted.
Normal indicators of the AMH level are numbers from 1.1 to 2.5 in the female sex.
But, sometimes, there are situations in which the results obtained greatly upset women. This can be either a decreased or an increased level of anti-Müllerian hormone.
What are the reasons for the decrease in the level of this indicator:
- Menopausal changes in a woman's body. The ovarian tissue reserve is depleted, follicles do not mature in the organs, and, accordingly, the production of a sufficient amount of anti-Müllerian hormone does not occur.
- Decreased ovarian reserves - the oocyte reserve is reduced, and sometimes completely absent.
- The presence of congenital pathologies in the development of the reproductive system, namely, congenital malformations of the ovaries.
- Postoperative conditions associated with surgical interventions on the ovaries, resulting in a decrease in the volume of ovarian tissue. Such consequences include wedge-shaped resection of the ovary, removal of ovarian neoplasms with involvement of the ovarian tissue in the pathological process, and, accordingly, its removal.
- Various disorders of puberty, namely premature puberty.
- Dysfunction of the hypothalamic structures, pituitary gland and, as a consequence, ovarian dysfunction.
Causes
The reasons for the decrease in the level of this hormone:
- Various mutations of AMH receptors;
- The development of such a pathological condition as polycystic ovary syndrome;
- Infertility due to the presence of anovulation;
- Dysfunction of luteinizing receptors, as well as follicle-stimulating hormone;
- If a married couple was never able to conceive a child, despite medical and in some cases surgical treatment, then 75% of such families turn to reproductive medicine clinics for help.
However, sometimes there are obstacles for the use of assisted reproductive technologies. The first reason for the inaccessibility of the technique for carrying out extracorporeal fertilization lies in its price segment. Not every family has enough financial resources to pay for the basic IVF protocol, not to mention the additional possible waste in the form of pre-implantation diagnostics. The state tried to solve this problem by launching the Federal Program for In Vitro Fertilization Protocol at the expense of the Mandatory Medical Insurance Fund (MHI). By submitting an application to the site, each married couple has the opportunity to receive a free IVF protocol.
But, unfortunately, not only financial issues stand in the way of gaining the desired happiness. The criterion for the possibility or refusal to carry out an in vitro fertilization procedure can be many indicators that deviate from the norm. And one of them is the level of anti-Müllerian hormone.
AMG norm for IVF according to compulsory medical insurance
An essential role is played by the level of AMG for IVF under compulsory medical insurance.
That is, whether a married couple will be able to take advantage of the IVF procedure under compulsory medical insurance, with a low AMH, a woman has the right to refuse. What is the reason for this? The crux of this problem is that when a woman has a low anti-Müllerian hormone, the ovarian response to stimulation in the IVF protocol program may be unsatisfactory.
Low AMH and IVF by compulsory health insurance are possible, but on condition that the anti-Müllerian hormone levels are not lower than 0.8 ng / ml. this is the extreme level of this indicator, the AMG norm for IVF according to compulsory medical insurance. At the same time, the index of follicle-stimulating hormone should be no higher than 15 international units. If the indicators of these hormones do not fit into the specified framework, then a married couple may be denied IVF, including low AMH, IVF according to CHI with a low level of hormones, it is still possible.
With a low level of AMG and IVF according to the compulsory medical insurance, the reproductive physician must make a very important decision. On which the success of the protocol will depend and it lies in the correct, balanced choice of the ovulation stimulation scheme. The so-called "soft protocols" are applied using smaller doses of gonadotropin-releasing hormones.
If, nevertheless, a married couple was denied in carrying out the protocol on compulsory medical insurance or eggs were not received after stimulation, then there is the possibility of using ART methods in the form of using a donor egg. The essence of this method consists in fertilizing the donor's egg with the sperm of the spouse, comparing the donor and recipient cycle, cultivating the embryos and replanting them into the uterus of the recipient woman. A woman carries a child, gives birth to him and is the biological mother. Sometimes, only this technique allows the family to receive the greatest gift in life - to give birth to a long-awaited child.
There is always a way out!
