Antimullerian hormone (AMH)
L'anti-Müllerian hormone, also called AMH, anti mullerian hormone, is a homodimeric glycoprotein produced exclusively by the somatic cells surrounding the gametes (cells of the granulosa, in the woman, and of Sertoli, in the man). His main action appears in the embryo development, during sexual differentiation.
Let's see what it is, what its functions are and why the exam is prescribed to measure the levels of anti-Müllerian hormone.
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From conception to the first minutes of life (PHOTO)
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In this article
- Anti-Müllerian hormone: what it is
- Anti-Müllerian hormone: what it is for
- Anti-Müllerian hormone: functions and biological role
- Anti-Müllerian Hormone: What If I Have Too Much or Too Little?
- Anti-Müllerian hormone: when is the test prescribed?
Anti-Müllerian hormone: what it is
About eight weeks after the conception, the human fetus has two sets of ducts, one of which can develop in the male reproductive tract and the other in the female reproductive tract.
- in MALE, the anti-Müllerian hormone results in high doses from the fetal period up to two years of age; its role is to prevent the formation of the female genital organs, by means of the regression of Müller's ducts, hence the name of the hormone in question. With growth, the levels of this hormone tend to decrease physiologically until they are practically absent.
- in FEMALES, on the other hand, the production of the anti-Müllerian hormone follows a cyclical trend: it is low at birth, increases with puberty and decreases, until it is completely exhausted with the onset of menopause. In women, the anti-Müllerian hormone is produced by the granulosa cells of the primary ovarian follicles; the value is proportional to the number of follicles that the woman can initiate to maturation: substantially, the concentration of AMH can be interpreted as a fertility index.
In women, a high or low value of this parameter can be an important indicator in determining the presence of pathological conditions, such as polycystic ovary syndrome el 'primary ovarian failure.
AMH: reference values
Men values
- Less than two years: 14-466 ng / ml
- 2-12 years: 7.4-243 ng/ml
- Adulti: 0.7-19 ng/ml
Women values
- Less than two years: <4.7 ng / ml
- 2-12 years: <8.8 ng / ml
- 13-45 years: 0.9-9.5 ng/ml
- Above 45 years: <1.0 ng / ml
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Anti-Müllerian hormone: what it is for
The anti-Müllerian hormone may also play a role in regulating the production of sex steroids in puberty and in the adult ovaries and testes. In the ovaries, anti-Müllerian hormone appears to be important in the early stages of development of the follicles, which contain and support the eggs before fertilization. The more ovarian follicles a woman has, the more anti-Müllerian hormone her ovaries can produce, and then AMH can be measured in the bloodstream to assess how many follicles a woman has left in her ovaries: hers. "ovarian reserve".
Anti-Müllerian hormone: synonyms
- The anti-Müllerian hormone is also called "anti-Müllerian hormone": its name refers to the fact that it prevents the formation of Müller's ducts in men, responsible for the formation of the uterus and fallopian tubes in female embryonic development.
- In some cases, the hormone is called Mullian Inhibition Substance (MIS).
- In the analysis reports, the anti-Müllerian hormone is often indicated simply by the abbreviation AMH.
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The scholars of Müller and Wolff coexist in the embryo:
- I Müller's scholars they are precursors of the uterus, fallopian tubes and upper part of the vagina;
- Il Wolff's scholar it allows the development of epididymis, vas deferens and seminal vesicles.
During fetal development, theanti-Müllerian hormone it is secreted only in men, in which it is responsible for the regression of Müller's ducts (therefore the dosage of AMH is high from birth to two years of age).
in femaleson the other hand, the absence of the anti-Müllerian hormone allows the development of female sexual organs: the parameter is low at birth, but progressively increases during the fertile age, only to be no longer detectable after menopause.
in female ovaries, the anti-Müllerian hormone is a regulator of folliculogenesis (i.e. the maturation of the follicles, i.e. the set of cells that serve as accompaniment and protection, while the oocyte grows in the ovaries).
In women, the anti-Müllerian hormone represents a ovarian reserve indicator and its concentration is directly correlated with the antral follicular count: in practice, it not only reflects the quantity of follicles, but also the oocyte quality.
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Read also: Fertility, how natural fertilization worksAnti-Müllerian Hormone: What If I Have Too Much or Too Little?
When the male fetus does not produce enough anti-Müllerian hormone, Mullerian ducts do not disappear and this leads to persistent Müllerian duct syndrome. Patients with this syndrome will have a masculine appearance but usually have undescended testes (cryptorchidism) and low or no sperm count due to abnormal Wollfian duct development. This can be associated with malformations of the vas deferens and epididymis. This condition is rare.
Since the ovarian follicles produce theanti-Müllerian hormone in adulthood, measuring the levels of this hormone in the blood provides a way to estimate ovarian reserve in women. Consequently, anti-Müllerian hormone levels are routinely used to predict the likelihood that a woman will respond to ovarian stimulation for the treatment of fertility area of in vitro fertilization (IVF) and what doses of hormones should be used during in vitro fertilization.
In women, anti-Müllerian hormone levels peak around puberty and remain relatively constant until after menopause, when no follicles remain and anti-Müllerian hormone levels drop. Some studies suggest that anti-Mullerian hormone levels may be lower than normal in women who experience premature ovarian failure. However, anti-Müllerian hormone results need to be interpreted with caution as many other factors can affect an individual's fertility.
High levels of anti-Müllerian hormone can be associated with the polycystic ovary syndrome. However, the measurement of anti-Müllerian hormone can be misleading and does not provide a definitive diagnosis of either premature ovarian failure or polycystic ovary syndrome. It is important that any tests to measure anti-Müllerian hormone levels are performed by a qualified physician.
Read also: Fertility and conception, from natural fertilization to assisted procreationAnti-Müllerian hormone: when is the test prescribed?
Measurement of the amount of the anti-Müllerian hormone is prescribed above all to evaluate:
- Lo state of the ovaries under development;
- La ovarian function, in case of polycystic ovary syndrome;
- La ovarian reserve, namely the number of oocytes present in a given period of the woman's life;
- The probability of a miscarriage.
The doctor may order the anti-Müllerian hormone test to determine the woman's likelihood of getting into menopause early or physiological and when you experience symptoms of polycystic ovary (PCOS).
Source for this article:
You and Your Hormones: Anti-Müllerian hormone
Read also: Natural fertilization, ovarian cycle and ovulationQuestions and answers
What does it mean if the AMH is low?
If on the AMH test the low values are low, they indicate: physiological or premature menopause; ovarian insufficiency, i.e. the significant reduction in the ovarian reserve; in humans they indicate hypogonadism and disorders of sexual development.
How to deal with a low ovarian reserve?
Values lower than 1.1 ng / ml are considered low reserve indicators. A low anti-Müllerian hormone value predicts a poor response to stimulation and, therefore, the achievement of a low number of ovules in IVF, but does not define the probability of pregnancy.
TAG:
- pregnancy hormones
- hormonal changes
- ovarian reserve examinations
