AMH in ART and beyond
AMH or the anti-Mullerian hormone is a 140 kDa disulfide-linked homodimer glycoprotein and a member of the transforming growth factor B. Now this specific expression pattern of AMH in growing non-selective follicles has prompted scientists to investigate whether serum AMH levels are indicated for the size of the growing follicle pool and the direct measurement of the primordial follicle pool is impossible. So, however, the number of primordial follicles is indirectly reflected by the number of growing follicles.
It is not only produced by small growing follicles, but it has an inhibition effect on the initial follicle recruitment. It also inhibits FSH-dependent growth and selection of pre-antral and small antral follicles. So, this is step one and there also has an effect on the pre-antral and small follicle growth. In PCOS, what is seen that a very elevated AMH level, and it has been seen that it is associated with abnormalities of early folliculogenesis within the complex PCOS pathogenesis which makes claim why AMH has the potential to be used as a biomarker for the diagnosis of PCOS. Ovarian aging can be defined as a period in which there is a measurable decline in the level of circulating AMH but also a rise of FSH and estradiol. AMH usually increases up to the age of 24 years and afterward it decreases until menopause. Now in some studies, it has been seen that the AMH levels in the blood drop yearly by approximately 0.3 mcg/L. Clinical studies now support expanded clinical application of serum AMH testing like in the prediction of menopause or the monitoring of ovarian effects of the medications and surgical procedures or evaluating the risk of a variety of disorders like PCOS, POI, POF but what is most important is caution. Caution is required while interpreting a single AMH measurement because biological fluctuation, surgical procedures, and medication, for example, contraceptives and lab methodology can frequently lead to dramatic changes in AMH results within individuals. So some steps are recommended to account for variability in AMH results.
A few questions that need some answers include:
- How to assay AMH?
- How is it done?
- How BMI affect AMH?
- Can AMHactually accurately predict menopause?
For detailed answers to these and other questions you might have on the AMH in ART and beyond, enroll for live lectures by Dr. Sweta Gupta (MBBS, MD MRCOG, DFSRH, MSc ( Reproduction & Development, Bristol, UK ), Fellowship in Reproductive medicine & ART) click here https://docmode.org/amh-in-art-and-beyond-dr-sweta-gupta/
