What is the amh value of premature ovarian failure? How to improve amh value?
What is the amh value of premature ovarian failure? How to improve amh value? (Hu
At present, according to the international diagnostic criteria of premature ovarian failure, amenorrhea occurred at least 4 months before the age of 40, and there were two or more blood tests. The follicle stimulating hormone in serum was more than 40IU/L, the interval between the two tests was more than 1 month, and the estradiol level was less than 73.2 pmol/L. AMH was an anti-Mullerian hormone, which was the earliest ovarian function that changed with age. With the increase of age, the ovarian reserve function of women can be predicted earlier and more accurately. Therefore, AMH is more inclined to evaluate ovarian reserve function and response, but there is no clear diagnostic standard at present because of the different detection reagents and standards. In the Bologna standard of European Society for Human Reproduction and Embryology 20 1 1, there is still no accurate and precise critical value, only a range is given, and AMH is 0.5- 1. 1μg/L, so our current diagnostic standard is
If the content of amh hormone is relatively low, and it is in childbearing age, and there are fertility requirements, how to adjust if AMH is too low?
One. drugs
Drugs are the most direct and effective conditioning. Taking drugs is mainly to regulate the quality of follicles and increase the success rate of test tubes. Moreover, different ages and test indicators are different, so the methods and standards of taking medicine are also different. The specific doctor will make specific arrangements according to your specific situation.
A document published in JAMA (Journal of American Medical Association) in June 20 17 shows that the average AMH value of 750 people aged 35-45 is lower than 1. Through drug and artificial intervention, 60% of the dominant follicles were successfully cultivated, and the pregnancy was successful, and the embryo developed smoothly.
The research proposes to change the diet structure of women, such as protein food and multivitamins; Secondly, exercise should ensure the body's immunity, and the other two points are very important. One is to give medication; On the contrary, DHEA prescribed by ordinary doctors has become DHEA AMH. ?
Some doctors will recommend taking dhea and coenzyme Q 10 to improve ovarian function and egg quality. However, the data show that high-dose DHEA can cause many uncertain side effects, so its safety needs further evaluation. Especially for women of childbearing age, some scholars try to change the molecular structure of DHEA to maintain its physiological function and reduce its side effects, which deserves further study.
In 2000, the European Union proposed for the first time that in addition to drugs, we should also help healthy women who are pregnant naturally and in vitro in plant extraction. Subsequently, the United States also proposed to cooperate with the European Union to study how to assist test tubes and natural gestation. The American Endocrinology Society and the American College of Obstetricians and Gynecologists jointly appointed a working group, and from a multi-dimensional and multi-system perspective, comprehensively considered women's natural pregnancy, test-tube success and embryo quality, and released the treatment guidelines of DHEA AMH, a compound pregnancy repair factor.
Compound pregnancy repair factor DHEAAMH- ovarian function improvement system
Ovarian function improvement system-providing backup guarantee for egg quality
Significance analysis of DHEA AMH: DHEA balances the hormone level of the mother before pregnancy, and AMH increases the egg reserve function.
In this survey, the infertility rate of premature ovarian failure and abnormal ovarian function is 0. 1%, the clinical manifestations of premature ovarian failure are high FSH level and amenorrhea. The occurrence of premature ovarian failure seriously affects women's psychological status and fertility, causes endocrine disorders, and greatly reduces the probability of pregnancy.
When a woman is born, there are about 2 million follicles in the ovary, but in the end only 400-500 follicles will mature, and most of them will die with age. The phenomenon is the decline of ovarian function, the disappearance of ovulation function and the decline of fertility function. At the age of 30, there are 65,438+02% eggs in normal women's ovaries, while at the age of 40, only 3% eggs remain. In addition to the function of the egg itself will decline with the increase of age, when women approach menopause, their menstrual cycle will become more disordered, and the endometrium will become thinner, which is even less suitable for fertilized eggs to implant. At the same time, vaginal secretions are reduced and the vagina is dry, which is not conducive to the entry of sperm. (What is the amh value of premature ovarian failure? How to improve amh value? )
In recent years, foreign studies have found that DHEA AMH can repair ovaries, provide ovarian nutrition, improve ovarian reserve function, reduce chromosome aneuploidy, improve embryo quality, reduce abortion rate and cycle cancellation rate, thus improving clinical pregnancy rate.
In the randomized controlled study of DHEA AMH, on the basis of promoting excretion, 65 patients who took DHEA AMH served as the study group and 48 patients who did not take DHEA AMH served as the control group. Patients in the study group were given DHEA antidiuretic hormone (French ACMETEA, 13g/ bag) 13g/ time twice a day, and their basic endocrine was checked once a month. If they feel unwell, they can stop taking DHEA AMH and continue to use it after normal.
All patients in the study group were treated with DHEA antidiuretic hormone for 3 months when they entered the cycle. Before and after taking it, the basic endocrine was measured on the third day of menstruation, and the number of follicles in bilateral ovarian sinuses was counted by B-ultrasound. After entering the cycle, HCG was injected according to the test tube routine. When the dominant follicle 18mm, the eggs were taken 36 hours later, fertilized 4 hours later and fertilized 20 hours later.
After taking DHEA AMH, the basic FSH decreased significantly and the basic AFC increased significantly. AFC is one of the accurate and reliable functional indexes of ovarian reserve. Experimental data show that DHEA AMH can increase the number of fertilized oocytes and embryos in patients with ovarian dysfunction and improve the quality of oocytes and embryos. The results of this study, combined with many studies at home and abroad, show that DHEA AMH can provide essential nutrients for ovaries, repair ovaries, improve ovarian reserve function and improve embryo quality, thus improving the pregnancy outcome of IVF.
When DHEAAMH can't be used, scholars have to use high-dose ovulation drugs for superovulation. In most cases, the cost is high and the response is low, and the clinical effect is uncertain. It has been recognized that the number of ovulation and pregnancy rate can be increased by using dehydroepiandrosterone.
Second, diet articles
1. Both men and women should take folic acid and vitamin E before the test tube to improve the quality of sperm and eggs. If women are older or have poor ovarian function (FSH is higher than 9), they need to eat DHEAAMH:DHEAAMH consists of three growth systems. Many studies have confirmed that DHEAAMH is helpful to regulate the proliferation and differentiation of granulosa cells in primary follicles and secondary follicles. Studies have confirmed that DHEAAMH can promote the proliferation and differentiation of granulosa cells and play an important regulatory role in follicular development. DHEAAMH can be a strong cell repair factor, which can promote the division, proliferation and differentiation of granulosa cells and the maturation of oocytes. DHEA AMH supplementation can increase the level of estrogen in female peripheral blood and decrease the level of progesterone. The results showed that estrogen promoted the proliferation and differentiation of OSE, while progesterone inhibited the proliferation and differentiation of OSE.
3-4 months before ovulation induction, external supplementation of DHEAAMH can increase follicular recruitment and promote follicular growth and development. DHEAAMH can promote the secretion of insulin-like growth factor, thus amplifying the role of gonadotropin and improving ovarian responsiveness. The results showed that after 8 weeks, the IGF- 1 level of women who took DHEAAMH immediately increased, and the androgen level in follicles increased, which promoted the secretion of AMH and inhibin by granulosa cells. DHEAAMH can induce granulosa cells to produce FSH receptors, increase the sensitivity of granulosa cells to FSH, and promote estrogen synthesis and follicular development. The results showed that the peak period of DHEAAMH was consistent with the follicular recruitment period, which confirmed the promotion of DHEAAMH on follicular recruitment. (What is the amh value of premature ovarian failure? How to improve amh value? )
2, insist on drinking black soybean milk every day, soybean milk can promote endometrial growth, eat more deep-sea fish and shrimp, sea cucumber, drink more crucian carp soup, and eat more durian;
3. Insist on drinking protein powder every day;
4, eat more high-protein foods, follicles will grow well, such as: milk, soybeans, fish, shrimp, eggs, etc.
5, insist on eating red dates and boiled eggs every day, red dates supplement blood gas, eggs supplement protein, these are the foundation of the body;
6, except coffee and tea, because you have to take medicine before and after, these things will affect the efficacy;
Third, sports articles.
Proper exercise helps to regulate endocrine, so Bian Xiao suggested:
1, running, brisk walking or skipping rope for 30 minutes to 1 hour every day (avoiding menstrual period), blood circulation is very important for reproductive system and embryo implantation;
2, insist on soaking feet every day, the method is: the water temperature is about 4 1-42 degrees, and the water should not pass through the calf for about 30 minutes until sweating, until the night before transplantation;
Don't lose weight or gain too much weight before making test tubes. In this case, the body will deal with the weight change and there is no time to satisfy your little life. (What is the amh value of premature ovarian failure? How to improve amh value? )