Regulation of sexual development and maturation is a very complex process, in which many hormones participate. One of them is the antimulylerov hormone, or the inhibitor Muller. In the embryonic period, he is responsible for resolving the rudiments of the female genital organs in men, so that boys form the male sexual organs. In adult men, its concentration in the blood is high and remains relatively constant throughout life. In women, this hormone is produced in the ovarian follicles, which are at rest. As soon as the follicle begins to ripen, the secretion of AMG in it decreases, and then completely stops. Since the number of resting follicles decreases with age, the production of antimulylerovaya hormone in the body of a woman also decreases.
Indications for the analysis of
If AMG is a male hormone, then when and why should it be given to women? The answer to this question lies in the physiology of the ovary. The ovary consists of follicles, in each of which there is an immature ovum. Most follicles are at rest, and only once a month one of them begins to ripen. Resting follicles secrete antimulylerov a hormone, ripening - cease. Consequently, the concentration of antimulylerovoy hormone in the blood shows the number of resting follicles. This indicator is called an ovarian reserve of a woman, the possibility of conception and the speed of menopause depends on it. The analysis on AMG is prescribed in the case of:
- infertility of unknown origin( i.e., unable to establish the cause),
- inefficiency of IVF,
- of premature menopause in women,
- antiandrogen therapy,
- of medications affecting ovarian function,
- of malignant ovarian malignancy,
- delayed puberty in girls and boys,
- of establishing a child's sex in doubtful cases,
- determining the presence of testicular tissue.
In women, antimulylerovsky hormone is an indicator of a high ovarian reserve, in adolescence its concentration is high enough, although lower than in boys of the same age, it decreases with time and after the menopause AMG in a woman's blood is not determined. The analysis for antimulylerovskiy hormone allows to find out the cause of infertility, to diagnose the tumor.
How to take the
test The antimuyler hormone content assay is usually administered on the third day of the cycle, along with analyzes for other hormones( eg, FSH).This rule also applies to the saved menstrual cycle, and with the artificial stimulation of ovulation with IVF, and in diseases that disrupt the menstrual cycle. In some cases, the analysis can be shifted to the fourth - fifth day of the cycle. The question of which day to donate blood for analysis, is decided depending on the disease, in connection with which he is appointed. Three days before the study( ie, with the onset of menstruation), a woman needs to refrain from heavy physical exertion and stress, if she has any acute illness, then you can not take the analysis. An hour before the test, you can not smoke, this can distort the results of the study. The attending physician can give additional instructions on how to properly prepare for the analysis on AMG.In case of increased or decreased concentration of AMG, you need to contact the endocrinologist for treatment.
Interpretation of results
The concentration of antimulylerovogo hormone for women - 1.0 - 2.5 ng / ml. This concentration is observed in the blood of a healthy young woman with a high ovarian reserve, which is able to conceive and bear the child. In the pre-menopausal period, the concentration of AMH can be reduced because of age-related causes, even if it is right to prepare for the analysis. This is not considered a pathology.
The increased concentration of AMG shows the presence of ovarian tumors( both benign and malignant), anovulatory infertility( absence of ovulation with normal follicle-stimulating hormone concentration), congenital ovarian pathologies, delayed puberty, and polycystic ovary. It can also be a consequence of anti-androgen therapy - taking drugs that reduce the concentration of male hormones in women with their excess. In such cases, therapy of the underlying disease( removal of cysts and tumors), therapy with drugs containing female sex hormones( for this purpose, hormonal contraceptives are usually prescribed).In the case of antiandrogen therapy, female sex hormones are prescribed after the course of treatment. But in general, an elevated level of AMH, if it is not caused by an ovarian tumor, indicates a relatively reproducible problem with reproductive health.
A low level of AMH is an indicator of decreased ovarian reserve. It is observed:
- in premature sexual development,
- with a decrease in FSH level,
- for ovarian fibrosis,
- after ovarian removal and ovariotoxic therapy,
- after severe poisoning.
Normally its decrease is observed in menopause, and with obesity can be diagnosed and in the pre-menopausal period. To increase the concentration of AMG, there is an American drug DHEA.In our country, it is considered a dietary supplement, but it is nevertheless better if the doctor appoints it. Also, with a low level of AMG, vitamin D3 is prescribed. According to some reports, the level of antimulylerovaya hormone in the blood in summer is higher than in winter, and in people who are much in the sun - higher than people who rarely leave the room - this is due to sunburn and synthesis of vitamin D3.This fact is one of the reasons that ECO is more successful in summer than in other seasons.
AMG in men
As already mentioned, antimulylerov hormone - one of the first male sex hormones that appear in the body of an unborn boy. AMG causes the regression of the Mullerian ducts - the rudiments of the female genital organs, from where it got its name, and gives the opportunity to develop male genital organs. We can say that at the embryonic stage it is AMG that makes a man a man. After birth, the concentration of antimulylerovskogo hormone in the blood in men remains high - in the norm to 5.98 ng / ml. But men can also see its decrease or increase.
Low concentration of AMG in men speaks of congenital abnormalities of the testicles, their underdevelopment( anarchism) or abnormal location( anarchism), testicular tissue poisoning, testicular fibrosis, impaired male sex hormone production. In adolescent boys, a reduced level of antimueller hormone indicates a delay in puberty. Normally, the level of AMH can decrease with age, with obesity and early sexual development, this happens more quickly.
A high level of AMH in men can be observed in testicular tumors, cryptorchidism, and some congenital anomalies in the structure of the testicles.
Correction of AMG in men does not make sense without treatment of the underlying disease. As a rule, when the main problem is eliminated, the level of AMG comes back to normal, but sometimes there is a need for hormonal therapy. Man can take the analysis any day.
