I don't want to have a baby, should I need to know my AMH?

In the past few years, I have thought that testing AMH is very important no matter if you want to be pregnant or not.
Consultation
2022-04-08
Author: Dr. Ryh-Sheng Li, MD
Translator: Ying

In the past few years, I have thought that testing AMH is very important no matter if you want to be pregnant or not.

Last month, two women with the same symptoms came to my clinic for a second opinion.

  • A 22-year-old female with irregular menstruation for a long time, no menstruation within a year, and acne. The previous doctor directly diagnosed polycystic ovary syndrome and prescribed anti-hormonal drugs (Diane-35) to regulate menstruation and Anti-acne.
  • A 40-year-old woman with irregular menstruation for a long time. She has to rely on menstrual-regulating drugs for three years for her menstruation to occur.

Irregular Menstruation 

In the view of traditional obstetrics and gynecology, older women with menstrual irregularities are menopause, and the younger ones are polycystic ovary syndrome. If you are young and have acne, you are sure to have polycystic ovary syndrome(PCOS); if you are young, acne-prone, and fat, it is also called PCOS. As if everything could be blamed on PCOS.

Indeed, 80% of girls with irregular menstruation are really PCOS, the other 15% are menopause, and 5% are pituitary dysfunction. Therefore, girls with irregular menstruation who come to consult and diagnose PCOS can get 80 points.

However, what should I do for other girls with menopause and pituitary dysfunction? If the diagnosis is different, will the treatment be the same? I don't think so. Therefore, the view and diagnosis of "irregular menstruation" really need to be changed. No longer diagnose these women PCOS with similar syndromes.

AMH

Compared with traditional hormonal tests, FSH, LH, and E2 are greatly affected by the menstrual cycle. The AMH value is not affected by the menstrual cycle. The fluctuation is not obvious and is suitable as a long-term indicator.

Compared with traditional examinations, AMH is a self-pay test, so many Obstetrics and Gynecology might think infertility centers prefer to do self-pay tests. In fact, because of the stability of AMH, it can accurately represent the ovarian function, so we choose AMH as the evaluation standard.

Will you choose a cheap but inaccurate examination, or a self-pay, not expensive and accurate examination?

How to explain AMH?

Through several years of research on AMH, a standard was unified internationally. I designed an AMH universal measuring ruler for your reference. Generally speaking, an AMH of more than 2 is normal.

However, with the accumulation of experience, I was thinking that will the 20-year-old with AMH 2 be the same as the 40-year-old with AMH 2? And so the Ovarian Age Computer was born!

In the above two cases, the AMH is less than 0.01, which means old age and menopause.

High AMH doesn't mean PCOS

With whom is going to be diagnosed PCOS needs to meet two of the three criteria, including irregular menstruation, image found by ultrasound, and symptoms of high male hormones.

Therefore, it is better to consult with a doctor for further evaluation.

Is it necessary to freeze eggs with low AMH?

The answer is not necessarily. We can maintain a healthy life, eat a healthy diet, exercise more, go to bed early and get up early, quit smoking, eat less processed food, and start taking good care of the quality of eggs in our daily life.

In addition to taking good care of eggs, to know more about yourself by following the value of AMH every six months or every three months. AMH will also fluctuate slightly, use the "egg age computer" to know your egg age range.

The benefits of freezing eggs

Egg freezing is the only tool in modern medicine that can help eggs cross the age limit.

The eggs in the ovaries are very susceptible to age, life, and environment because of evolution, and also chromosomes are very easily damaged. Because of evolution, we found that older women are prone to miscarriage and pregnancy with chromosomal abnormal babies. Thus, doing a prenatal chromosome test is important.

No matter if you are young or old, we can decide to freeze our eggs at any stage in our lifetime.

However, freezing eggs can keep the quality of your eggs at the moment. They are preserved at the moment by liquid nitrogen without change.

Now the use of vitrification technology has also greatly improved the survival rate of thawed eggs (the survival rate of thawed eggs is about 90%), so that women who want to freeze eggs no longer be afraid of losing more than half of their eggs when thawing (the survival rate of traditional slow freezing technology is about 60%).

(Whether the egg chromosomes are normal or not can only be known when the embryo is developed and through PGS test. Since there is only one set of chromosomes in the egg, once it is extracted for the test, the egg will be damaged and useless. We hope that in the future it's available to directly test egg chromosomes so that all girls can rest assured.)

The AMH test is the most accurate and intuitive test. 

Therefore, I encourage everyone to know more about your AMH and take care of your health.

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