Anti–Mullerian Hormone & Ovarian Reserve, Unidad De Reproducción Centro Gutenberg

Introducing Unidad De Reproducción Centro Gutenberg. 

Located in Malaga, Spain, Unidad De Reproducción Centro Gutenberg has been successfully providing multiple options for IVF Treatment for 34 years. Unidad De Reproducción Centro Gutenberg specializes in performing Gynecology, Urology & Andrology, Infertility Screening & Treatment, Procedures & Manipulations, Laboratory Tests & Genetic Screening, MESA & TESE, Ovulation Induction (OI) cycles, IUI (Intrauterine Insemination) cycles, IVF, ICSI & PICSI cycles, Oocyte & Sperm Donation, Egg & Sperm Cryopreservation and Storage, Embryo Vitrification & Storage, ROPA cycles for the lesbian couples, and much more. 

When we talk about female fertility there is a very important term that all women should be aware of during their routine gynecological check–up: this term is the ovarian reserve. We use this terminology to quantify the number of eggs a woman has at a certain time in her life. The Anti–Mullerian Hormone, which you’ve probably heard of, is very closely related to the concept of ovarian reserve.

When trying to get pregnant, the concept of the ovarian reserve must be clearly understood. That’s why we want to give you more information today, and explain to you why we measure the Anti–Mullerian Hormone and its purpose in Assisted Reproduction.

When and how are a woman’s eggs produced?

During the early stages of development of a female embryo, the cells which will later form the ovaries will divide several times, thus resulting in oocytes or eggs. During the 20th week of development of a female embryo this cell division will come to a halt, and the total number of oocytes formed up until that point (week 20 of intrauterine life), will be what we know as the ovarian reserve.

Right away, these oocytes will enter into a process of cell maturation and apoptosis (cell death). This means that beginning at week 20 of development, the ovarian reserve starts to decline irreversibly and will continue declining once the female is born. Once the ovarian reserve has been depleted, ovulation will no longer take place and the menstrual cycle will disappear. In other words: menopause will arrive.

In conclusion, a woman is born with a fixed number of eggs in her ovaries and, from before the moment she is born, the decline in her ovarian reserve is irreversible.

How do we measure ovarian reserve?

As we just explained, ovarian reserve is a dynamic parameter that diminishes throughout a woman’s life. Thus, age is the main conditioning factor. When measuring ovarian reserve, we can use two methods: 

• Antral Follicle Count. The egg, while it develops or matures, goes through different stages. During these stages, the egg is defined as a primordial follicle, primary follicle, secondary or pre–antral follicle, tertiary or antral follicle, and a pre–ovulatory or Graafian follicle. The Antral Follicle Count performed via an ultrasound scan is a good indicator of ovarian reserve status.
• Anti–Mullerian Hormone blood test. The menstrual and ovulatory cycle is controlled by endocrine system hormones. That’s why studying and testing the Anti–Mullerian hormone can help us learn more about the status of a woman’s ovarian reserve. This hormone is produced by pre‑antral and antral follicles in the ovaries and indicates the “level” of a female’s ovarian reserve.

When and how is the Anti–Mullerian Hormone measured?

When analyzing the Anti–Mullerian Hormone, we must keep in mind that the level does not fluctuate throughout the phases of the menstrual cycle. Thus, this analysis can be performed at any time during the cycle.

When it comes to measuring the hormone, the process is very simple. The only thing needed is to have a blood sample drawn, and you don’t even need to be fasting.

What are the Anti–Mullerian Hormone reference values?

Firstly, it’s important to keep in mind that this hormone, in addition to indicating the ovarian reserve level, is a measurement that can predict how well the ovaries will respond to stimulation in an Assisted Reproduction Treatment. 

Optimal Anti–Mullerian Hormone values range from 0.7 to 3.5 ng/ml, and are ideally around 1.0 ng/ml in women interested in undergoing In Vitro Fertilization Treatment. The results of the Antral Follicle Count (determined via ultrasound), must also be evaluated alongside the results of the Anti–Mullerian Hormone blood test.

As a result, when we evaluate a woman’s ovarian reserve, we can discover that her level is high, normal, or diminished depending on factors such as age, ultrasound results, and hormone markers. A high ovarian reserve indicates a high risk of experiencing ovarian hyper–stimulation during hormone stimulation or IVF Treatment. This would mean that the patient would be at high risk for suffering from a complication called an ovarian hyper–stimulation syndrome. 

On the other hand, a diminished ovarian reserve is defined as a lower number of eggs than expected for the woman’s age. This is associated with decreased chances of achieving a pregnancy, even with Assisted Reproduction Techniques. A diminished ovarian reserve doesn’t cause symptoms but is occasionally related to menstrual cycle issues, though in the majority of cases the cause is unknown. We do know that endometriosis, surgery on the ovaries, certain immune disorders, chemotherapy, and radiation therapy may lead to a premature decline in ovarian reserve.

Due to everything explained here, considering motherhood at an earlier age is necessary. In this regard, we advise consulting with a specialist if you’ve been trying to get pregnant for a while but have not yet been able to conceive. Likewise, we recommend you consider Egg Freezing if you wish to postpone motherhood. 

At URE Centro Gutenberg we have all of the physical and professional resources needed to evaluate the status of a female’s ovarian reserve. We can help you get an idea about your Fertility so that you can make the best decision regarding your reproductive years. Contact us!

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