eating while pregnant

  • Subscribe to our RSS feed.
  • Twitter
  • StumbleUpon
  • Reddit
  • Facebook
  • Digg

mardi 7 juillet 2009

What is AMH?

Posted on 11:42 by Unknown
Clearly the issue of ovarian reserve strikes many doctors and patients as "clear as mud!" Remember from our past discussions that ovarian reserve relates to the number of eggs that a patient has and the reproductive potential of those eggs. Ovarian reserve is not truly a test of egg quality as a woman's age is the final arbitrator of egg quality. As I am currently unable to make any patient younger, although I could retire if I could, we need to keep the difference between egg quantity (ovarian reserve) and egg quality (age) segregated in our mind.

So in trying to determine how a woman might respond to fertility drugs we use a variety of tests to predict her response. Day 3 FSH and estradiol, antral follicle count on sonogram and the clomid challenge test (CCCT) have been the methods used most recently. However, for the past 2 years we have also been measuring anti-mullerian hormone (AMH). This protein is made in the cells that line the follicles (the fluid filled cysts that contain a woman's eggs - 1 egg per follicle). The more follicles, the higher the AMH and the better the response to fertility drugs which resue the extra eggs that were doomed to run out of gas during the menstrual cycle.

Apparently AMH is getting some attention in periodicals outside of the medical literature as you can see in this link to the Wall Street Journal. We still rely on Day 3 FSH, estradiol and sonogram to get a complete sense of how a patient will respond to fertility drugs, BUT the AMH has proven helpful in many patients as we try to pick a stimulation protocol.

However, in doing Natural Cycle IVF, all tests of ovarian reserve may fail to predict success since by its very nature...natural cycle IVF is unstimulated. So if a patient is doing Natural Cycle IVF, whether or not they would respond to fertility shots is a moot point! What has been amazing to us is the ability of patients with high FSH, low antral follicle counts and low AMH to generate a beautiful embryo in Natural Cycle IVF. What matters is pregnancy and delivery but we have many patients whose ovarian reserve testing is poor and yet they have had success with Natural Cycle IVF. "It only takes one good embryo" as many patients are fond of saying!

So should you have an AMH level done. Yes, as long as you are working with a doctor who can interpret the results for you given the "big" picture and not lose sight of the forest for the trees.

Good luck

DrG
Envoyer par e-mailBlogThis!Partager sur XPartager sur Facebook
Posted in | No comments
Article plus récent Article plus ancien Accueil

0 commentaires:

Enregistrer un commentaire

Inscription à : Publier les commentaires (Atom)

Popular Posts

  • HSG vs HSC vs H2O sono...What is the difference?
    Medical terminology can really give patients fits and no where is this more apparent than in the distinctions between hysterosalpingogram (H...
  • Natural Cycle IVF. Part 3: It Works
    Although I anticipated posting this final part concerning NC-IVF two weeks ago, it took me longer than I had anticipated to pull all the dat...
  • Let It Snow, Let It Snow, Let It Snow
    Here I sit on a Wednesday afternoon watching DC clear out in anticipation of a "major snow event." In the mid-Atlantic this means ...
  • And the winner is....Aauuuuugggghhh.....
    Well, since the NHL season just ended 5 minutes ago with a crushing defeat for my hometown Boston Bruins I guess that winter is now official...
  • Question 41. I read on the Internet that two inseminations are better than one. Is this true?
    The internet is quite an amazing place. You get anything you need at 2 am and research obscure medical disorders to your heart's content...
  • Avoiding "cookie-cutter" Medicine
    Medicine has been called an art and to some extent this is clearly true. Although statistics, protocols and algorithms exist to guide therap...
  • Improving Implantation: The goal of SEET using PGS
    The Holy Grail of IVF is having an IVF pregnancy rate that approaches 100% with a low rate of pregnancy loss...Now, I know that some clinics...
  • Question 20. How expensive are infertility treatments?
    Children are not cheap. Unfortunately, those patients with infertility are having to invest in a bit more than dinner and a movie in order ...
  • Question 55. My husband and I were told by one RE that we needed ICSI, but another RE says that we don’t. What should we do?
    So if you have read the survey results you are aware that most readers like the clinical vignettes that I post to illustrate points of inter...
  • What is Assisted Hatching?
    Older brothers can certainly torment younger ones a great deal. My brother Steven is a typical middle child. As my eldest brother (and my pr...

Blog Archive

  • ►  2014 (10)
    • ►  juillet (1)
    • ►  juin (1)
    • ►  mai (1)
    • ►  avril (1)
    • ►  mars (1)
    • ►  février (2)
    • ►  janvier (3)
  • ►  2013 (14)
    • ►  décembre (1)
    • ►  novembre (1)
    • ►  octobre (1)
    • ►  septembre (1)
    • ►  août (1)
    • ►  juillet (1)
    • ►  juin (1)
    • ►  mai (1)
    • ►  avril (1)
    • ►  mars (2)
    • ►  février (1)
    • ►  janvier (2)
  • ►  2012 (30)
    • ►  décembre (2)
    • ►  novembre (1)
    • ►  octobre (3)
    • ►  septembre (1)
    • ►  août (2)
    • ►  juillet (2)
    • ►  juin (3)
    • ►  mai (2)
    • ►  avril (2)
    • ►  mars (3)
    • ►  février (6)
    • ►  janvier (3)
  • ►  2011 (28)
    • ►  décembre (2)
    • ►  novembre (3)
    • ►  octobre (1)
    • ►  septembre (2)
    • ►  juillet (3)
    • ►  juin (2)
    • ►  mai (2)
    • ►  avril (3)
    • ►  mars (5)
    • ►  février (3)
    • ►  janvier (2)
  • ►  2010 (52)
    • ►  décembre (2)
    • ►  novembre (6)
    • ►  octobre (5)
    • ►  septembre (4)
    • ►  août (1)
    • ►  juillet (4)
    • ►  juin (3)
    • ►  mai (4)
    • ►  avril (9)
    • ►  mars (13)
    • ►  janvier (1)
  • ▼  2009 (22)
    • ►  novembre (1)
    • ►  octobre (2)
    • ►  septembre (2)
    • ►  août (2)
    • ▼  juillet (4)
      • It only takes one!
      • What is AMH?
      • Gestational Carrier IVF
      • Can my endometrium be too thick?
    • ►  mai (2)
    • ►  avril (1)
    • ►  mars (3)
    • ►  février (2)
    • ►  janvier (3)
  • ►  2008 (27)
    • ►  décembre (2)
    • ►  novembre (1)
    • ►  octobre (3)
    • ►  septembre (6)
    • ►  juillet (1)
    • ►  juin (2)
    • ►  mai (3)
    • ►  avril (2)
    • ►  mars (1)
    • ►  février (2)
    • ►  janvier (4)
  • ►  2007 (66)
    • ►  décembre (1)
    • ►  novembre (5)
    • ►  octobre (6)
    • ►  septembre (7)
    • ►  août (11)
    • ►  juillet (13)
    • ►  juin (22)
    • ►  mai (1)
Fourni par Blogger.

Qui êtes-vous ?

Unknown
Afficher mon profil complet