Role Of AMH In Infertility , Advantage of AMH , Fecundity / Infertility & AMH , Infertility and AMH ,Prediction of pregnancy chances in couples presenting with infertility , AMH in IVF
Anti-Müllerian Hormone (AMH) is critical for physiologic involution of the Mullerian ducts during sexual differentiation in the male foetus.
In women,AMH is a product of the small antral follicles in the ovaries and serves to function as an autocrine and paracrine regulator of follicular maturation
Anti-Müllerian Hormone (AMH) is critical for physiologic involution of the Mullerian ducts during sexual differentiation in the male foetus.
In women,AMH is a product of the small antral follicles in the ovaries and serves to function as an autocrine and paracrine regulator of follicular maturation
Ovulation Stimulation Protocols for IUI - Dr Dhorepatil BharatiBharati Dhorepatil
What are important factors to be considered important
Ovarian reserve
Previous ovarian response
Basic hormone profile
Role of LH
Trigger
Luteal phase support
Pregnancy rate/cycle
Invited Lecture delivered by Dr Sujoy Dasgupta in the Annual Conference of ISAR (Indian Society of Assisted Reproduction) held at Kolkata in November, 2019
Ovarian reserve refers to the reproductive potential left within a woman's two ovaries based on number and quality of eggs. Diminished ovarian reserve is the loss of normal reproductive potential in the ovaries due to a lower count or quality of the remaining eggs
Ovarian reserve tests provide an indirect measure of the cohort of recruitable antral follicles present in the FSH window at the beginning of each menstrual cycle..Functional Ovarian Reserve
Since the first formal description of LPD in 1949 as a possible cause of infertility and recurrent miscarriage by Jones. Innumerable investigations have been undertaken in an effort to verify its existence or to characterize its pathophysiology, diagnosis, and treatment. The consensus of the literature is that LPD does exist and that its cause is multifactorial like abnormal folliculogenesis, inadequate LH surge,inadequate secretion of progesterone by the corpus luteum, aberrant end-organ response by the endometrium.
Ovulation Induction - Simplified - Dr Dhorepatil BharatiBharati Dhorepatil
What are factors to be considered
Ovarian reserve
Previous ovarian response
Basic hormone profile
Role of FSH & LH
Trigger
Luteal phase support
Pregnancy rate/cycle
Uterus Transplantation Utx (obstetric and gynecology) D.A.B.M
Is the surgical procedure whereby a healthy uterus is transplanted into an organism of which the uterus is absent or diseased.
As part of normal mammalian sexual reproduction, a diseased or absent uterus does not allow normal embryonic implantation, effectively rendering the female infertile.
This phenomenon is known as Absolute Uterine Factor Infertility (AUFI).
Uterine transplant is a potential treatment for this form of infertility.
Uterus is a dynamic, complex organ. It is hugely blood-flow dependent.
More than 116,000 Number of men, women and children on the national transplant waiting list as of August 2017.
33,611 transplants were performed in 2016.
20 people die each day waiting for a transplant.
every 10 minutes another person is added to the waiting list.
Does A Low AMH Level Indicate InfertilityFertile Heart
AMH levels and their link to fertility issues are a heated debate among fertility specialists. Some agree that they are connected while others remain skeptical. Here is some insight into what they are.
Ovulation Stimulation Protocols for IUI - Dr Dhorepatil BharatiBharati Dhorepatil
What are important factors to be considered important
Ovarian reserve
Previous ovarian response
Basic hormone profile
Role of LH
Trigger
Luteal phase support
Pregnancy rate/cycle
Invited Lecture delivered by Dr Sujoy Dasgupta in the Annual Conference of ISAR (Indian Society of Assisted Reproduction) held at Kolkata in November, 2019
Ovarian reserve refers to the reproductive potential left within a woman's two ovaries based on number and quality of eggs. Diminished ovarian reserve is the loss of normal reproductive potential in the ovaries due to a lower count or quality of the remaining eggs
Ovarian reserve tests provide an indirect measure of the cohort of recruitable antral follicles present in the FSH window at the beginning of each menstrual cycle..Functional Ovarian Reserve
Since the first formal description of LPD in 1949 as a possible cause of infertility and recurrent miscarriage by Jones. Innumerable investigations have been undertaken in an effort to verify its existence or to characterize its pathophysiology, diagnosis, and treatment. The consensus of the literature is that LPD does exist and that its cause is multifactorial like abnormal folliculogenesis, inadequate LH surge,inadequate secretion of progesterone by the corpus luteum, aberrant end-organ response by the endometrium.
Ovulation Induction - Simplified - Dr Dhorepatil BharatiBharati Dhorepatil
What are factors to be considered
Ovarian reserve
Previous ovarian response
Basic hormone profile
Role of FSH & LH
Trigger
Luteal phase support
Pregnancy rate/cycle
Uterus Transplantation Utx (obstetric and gynecology) D.A.B.M
Is the surgical procedure whereby a healthy uterus is transplanted into an organism of which the uterus is absent or diseased.
As part of normal mammalian sexual reproduction, a diseased or absent uterus does not allow normal embryonic implantation, effectively rendering the female infertile.
This phenomenon is known as Absolute Uterine Factor Infertility (AUFI).
Uterine transplant is a potential treatment for this form of infertility.
Uterus is a dynamic, complex organ. It is hugely blood-flow dependent.
More than 116,000 Number of men, women and children on the national transplant waiting list as of August 2017.
33,611 transplants were performed in 2016.
20 people die each day waiting for a transplant.
every 10 minutes another person is added to the waiting list.
Does A Low AMH Level Indicate InfertilityFertile Heart
AMH levels and their link to fertility issues are a heated debate among fertility specialists. Some agree that they are connected while others remain skeptical. Here is some insight into what they are.
Ovarian reserve testing is important before planning IVF cycle, ovulation induction, family planning reasons, before and after chemotherapy and radiotherapy. Ovarian reserve testing such as AMH may help also in diagnosis of granulosa cell tumors and amenorrhea.
Ovarian Reserve Testing in Infertility Dr. Jyoti Agarwal Dr. Sharda JainLifecare Centre
The Best Gametes
Give The Best Result
OVARIAN RESERVE
Plan fertility preservation
Fertility outcome
Response to ovarian stimulation
Predict pregnancy rate
Monitor fertility decline
Fertility after chemotherapy and cancer treatment
PCOD,How are they different ??Difficulties & Solutions made Easy , Dr. Sharda...Lifecare Centre
Tremendous advances and extensive human studies have uncovered the complexity and management of PCOD
Global prevalence -2.2% to 26% Roughly 1 in 15 women worldwide, (Lancet, 2007)
Anti-Mullerian Hormone (AMH) -Novel Biomarker & its ApplicationsDr. Rajesh Bendre
Serum anti-Mullerian hormone (AMH) is a unique biomarker that has a critical role in folliculogenesis as well as steroidogenesis within ovaries. Secretion from preantral and early antral follicles renders AMH as the earliest marker to show ovarian reserve decline.
Anti Mullerian hormone -(AMH) -All Facts You Should Know | A Crucial Hormone ...martinshaji
Anti Mullerian hormone is one of the major hormone stimulating growth , ovarian cycle , and also helpful in pregnancy , hence it is necessary to know of AMH ...............and AMH test
a brief study
please comment
thank you ....
Measurement of the Anti- Müllerian Hormone (AMH) in Endocrinology: A Mini-Rev...Crimsonpublishers-IGRWH
In this mini-review the use of the measurement of anti-Müllerian hormone (AMH) as an indicator of the ovarian reserve(OR) is discussed, showing different views in commercial and regular IVF clinics. The automated second generation AMH assay is discussed and the problems with this assay are analyzed. The role of AMH measurements in pediatric endocrinology is reviewed, showing AMH measurement are of proven value in this area. The debate of AMH levels in PCOS is discussed as wellas its value in premature ovarian failure and oncology. It is concluded, that now the greatest challenge is collecting new age-specific reference values for a standardized AMH assay
Optimal protocols for Ovulation induction (Assisted Reproductive technologies)Anu Test Tube Baby Centre
Presentation given in Tirupati, India in 2018 on Ovulation Induction for assisted reproductive technologies. Dealing with infertility using Intra uterine insemination (IUI) and In vitro fertilization (IVF)
Update on LETROZOLE Current Guidelines for Ovulation Induction Dr. Sharda Jain Lifecare Centre
Update on LETROZOLE Current Guidelines for Ovulation Induction
LET NOT FORGET
WHY
??
LETROZOLE was withdrawn from
Indian market (2012)
“SAFETY ISSUES”
“Could Be Teratogenic In Human”?
The Newer Concepts In Endometriosis Management : Dr Sharda JainLifecare Centre
The Newer Concepts In
Endometriosis Management
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DIAGNOSTIC DELEMMA
DEBILITATING DISEASE QOL
PROGRESSIVE DISEASE
RECURRENCE IS BIG PROBLEM
NO FINAL VERDICT ON CAUSE
NO PERMANENT CURE
The exact prevalence of endometriosis is unknown, but estimates 10% in the general female population in India but up to 50% in infertile women
The Newer Concepts forReduced Surgery to preserve fertility in Endometrios...Lifecare Centre
The Newer Concepts forReduced Surgery to preserve fertility in Endometriosis
ENDOMETRIOSIS IS ENIGMA
DIAGNOSTIC DILEMMA
DEBILITATING DISEASE QOL
PROGRESSIVE DISEASE
RECURRENCE IS BIG PROBLEM
NO FINAL VERDICT ON CAUSE
NO PERMANENT CURE
The exact prevalence of endometriosis is unknown, but estimates 10% in the general female population in India but up to 50% in infertile women
Anemia Free India Gynaecologist to focuss on *12gm Haemoglobin at Delivery I...Lifecare Centre
Important Highlights
Prophylactic Iron and Folic Acid Supplementation in all six target age groups.
Intensified year-round Behaviour Change Communication (BCC) Campaign for:(a) improving compliance to IFA and deworming, (b) enhancing appropriate infant and young child feeding practices, (c) encouraging increase in intake of iron-rich food through diet and/or fortified foods (d) ensuring delayed cord clamping .
Testing and treatment of anaemia, using digital methods and point of care treatment, with special focus on pregnant women and school-going adolescents.
Addressing non-nutritional causes of anaemia
in endemic pockets with special focus on malaria, hemoglobinopathies and fluorosis
Strategies for Improving Success Rates in ART PARTLifecare Centre
Strategies for Improving Success Rates in ART
Part - 2
Strategies for Improving Success Rates in ART
Tailoring Controlled Ovarian Stimulation
Strategies for Luteal Phase in ART cycles
Endometrial Receptivity Array
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How to improve success rates in ART?
The big debate कार्य में आनंद
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Strategies for Improving Success Rates in ART Second Part
Innovations & Breakthroughs in IVF Part Three
OPEN DEBATE
SOCIALEGG FREEZING : Dr Poorva Bhargav and Dr Sharda JainLifecare Centre
SOCIALEGG FREEZING : Dr Poorva Bhargav and Dr Sharda Jain
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It is the process of saving or protecting eggs, or reproductive tissues so that a person can use them to have biological children in future
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
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- ETHICAL CHALLENGES IN LIFE SCIENCES
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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NVBDCP.pptx Nation vector borne disease control programSapna Thakur
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
3. 3
AMH is a glycoprotein
Originally known as Mullerian Inhibiting
Substance(MIS)
Appears in females at puberty
Produced by granulosa cells of pre-antral and small
antral follicles of 4-6 mm
AMH is not expressed in atretic follicles and theca cells.
AMH
4. BASIS OF AMH
Anti-Mullerian hormone (AMH)
plasma levels reflect the continuous
non-cyclic growth of small follicles,
thereby mirroring the size of the
resting primordial follicle pool and
thus acting as useful marker of
ovarain reserve.
5. FACT ABOUTAMH
After an initial increase until
early adulthood, AMH
concentrations slowly
decrease with increasing age
until becoming undetectable 5
years before menopause.
6. ADVANATAGE OF
AMH
It helps in forecasting of
reproductive lifespan, ovarian
response to stimulation ovarian
dysfunction and gonadotoxic
cancer treatment of ovarian
surgery.
9. 9
AMH is produced by the small growing (primary and preantral) follicles in the
postnatal ovary and has two sites of action. It inhibits initial
follicle recruitment (1) and inhibits FSH-dependent growth and selection of
preantral and small antral follicles (2).
Model of AMH action in the ovary.
10. 10
The intrafollicular concentrations of AMH in
normal human antral follicles show a gradual
reduction as the diameter of the follicle
increases, and a sharp decline is observed
around 8mm
Physiological function- prevent excessive follicle
recruitment. Acts as a Gatekeeper
11. Not cycle dependant-can be measured
any day
Less cycle to cycle variation than FSH.
Not altered after down regulation with
GNRH agonist.
Pregnancy
AMH – factors that Increase
Polycystic ovaries
AMH - unaffected
12. AMH
This renders AMH easy to measure at any
time as opposed to other currently
available markers of ovarian aging, such
as inhibin B, estradiol (E2) and FSH, which
are all menstrual cycle dependent and
constitute relatively late markers of the
ongoing process of primordial follicle
pool depletion.
13. - Overweight
- Ethnicity
- Vitamin D status
- Polymorphisms of AMH and its receptor
- Smoking and Alcohol intake
- Genetic variants across the genome.
Factors influencing AMH
concentrations are
14. 14
High (often PCOS) Over 3.5 ng/ml
Normal Over 1.4 ng/ml
Low Normal Range 0.7 – 1.3 ng/ml
Low 0.3 - 0.6 ng/ml
Very Low Less than 0.3 ng/ml
AMH BLOOD LEVEL
16. 16
High (often PCOS) Over 3.5 ng/ml
Normal Over 1.4 ng/ml
Low Normal Range 0.7 – 1.3 ng/ml
Low 0.3 - 0.6 ng/ml
Very Low Less than 0.3 ng/ml
AMH BLOOD LEVEL
17. AMH of less than 1.36 ng/ml has a
sensitivity of 75.5% and specificity of
74.8% in prediction of poor response.
AMH > 3.5 ng/ml has a sensitivity of 88%
and
67% specificity in prediction of
hyperstimulation
AMH BLOOD LEVEL
18. AMH of less than 1.36 ng/ml has a
sensitivity of 75.5% and specificity of
74.8% in prediction of poor response.
AMH > 3.5 ng/ml has a sensitivity of 88%
and
67% specificity in prediction of
hyperstimulation
AMH BLOOD LEVEL
20. Infertility and AMH
BENEFITS OF ORT IN SUBFERTILE COUPLE
ORT guides in prognosticating outcome in
individual cases by
Pre-treatment counselling
Choice of infertility treatment
Avoidance of ovarian hyperstimulation
21. Fecundity / Infertility
& AMH
AMH helps to predict fecunity and accurate ovarian
reserve.
Increasing age means a decreasing AMH level
Lower AMH levels at any given time
irrespective of age predicts a poor response
to ART.
High AMH levels – candidates prone for OHSS.
22. Prediction of pregnancy chances
in couples presenting with
infertility
Ovarian reserve testing may
allow for a better
assessment of the fertility
potential of a given
woman.
23. AMH in IVF
AMH is the best currently
available measure of ovarian
reserve hence guides in
individualizing dosing for ovarian
stimulation thereby improving
the efficiency and safety of IVF.
24. The dosage is more for a
lesser value and less for a
higher value to achieve a
desired ovarian response.
AMH in IVF
25. ADVANTAGE OVER OTHER
Ovarian reserve MARKERS
It is the earliest marker to change with age
It shows the least intercycle and intracycle
variability
It can be randomly measured during the cycle
It shows no modifications during GnRHa
It needs no modification in hypothalamic
amenorrhea
It is both more convenient and informative
than basal FSH
26. AMH is useful predictor
of ovarian
hyperstimulation.
AMH in IVF
27. La Marca reported the AMH level of 0.7
ng/ ml had a good sensitivity and
specificity of indentifying 75% of poor
responders.
AMH of > 3.5 ng / ml predicted hyper
response and OHSS
Patient management in
IVF
1. La Marca A. Hum Reprod 2007 ; 22:766-71
28. AMH as predictor of ovarian
response
Value of AMH (ng/ml) Ovarian response
<0.4 Extremely poor response and cycle should be
cancelled
0.4 – 1 Poor response
1 – 2 At risk of poor response and short stimulation
protocols should be used
2 – 3.5 Response adequate
3.5 – 6 Chances of hyper stimulation. Caution to be applied
> 6 High chances of severe OHSS
1. La Marca A. Hum Reprod 2007 ; 22:766-71
29. PROPOSED AMH BASED
PROTOCOLS
HIGH AMH (> 3.5 ng/ml)
a. Inform about the risk of OHSS
b. Avoid depot GnRHa
c. Low FSH dose
d. Antagonist cycle preferred
e. Agonist Trigger
f. Blastocyst transfer or Freeze all embryos and
transfer later.
30. Ovarian dysfunction
Assesing AMH concentrations
in anovulatory women may
give additional information of
follicle dynamics with ovarian
reserve.
31. PCOS
• The magnitude of AMH elevations in PCOS is
associated with the extent of disease, improved
reproductive performance in relation to weight
loss and improved ovulatory function with age.
• Hence, AMH testing may allow the early
detection of subclinical disease in siblings of
women diagnosed with PCOS.
1. Broer SL. Et . Hum Reprod. Update 2014 ; 20 (5) : 688-701 .
2. Thomoson RL et al. Hum Reprod 2009 ; 24:1976-1981.
(A)
32. Other forms of anovulation
• Women presenting with functional
hypothalamic amenorrhea were shown to have
normal AMH levels suggesting a normal size of
the cohort of early growing follicles.
• Initial AMH levels predict chances for recovery of
ovarian function following weight gain in women
with anorexia nervosa.
1. Broer SL. Et . Hum Reprod. Update 2014 ; 20 (5) : 688-701 .
2. Luisi S et al. Gynecol Endocrinol 2012 :28:34-38.
(B)
33. Management of women
with cancer & AMH
• AMH appears to facilitate establishing
which chemotherapeutic agents are
particularly toxic to the ovaries.
• They fall during chemotherapy with
some recovery 3 – 6 months thereafter.
1. Broer SL. Et al Anti – Mullerian hormone: ovarian reserve teting and its potential clincal implication.
Hum Reprod. Update 2014 ; 20 (5) : 688-71.
2. Dillon KE, et al Pretreatment antimullerian hormone levels determine rate of posttherapy ovarian
reserve recovery : acute changes in ovarian reserve during and after chemotherapy. Fertil Steril 2013 :
99: 477 – 483
34. Menopause prediction &
AMH
Prediction of at menopause by assessing
AMH at a relatively young age may
enable screening and prevention
programs with reference to
osteoporosis, breast cancer, congnition
and Alzheimer disease, cardiovascular
disease and stroke .
35. Anti mullerian hormone (AMH) alone
or best in combination with
antral follicular count (AFC)
is the
BETTER INDICATOR
of ovarian reserve
than any other hormonal or
sonographic markers available at present.
CONCLUSION
36. ADDRESS
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