Importance of Antimüllerian Hormone

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-Definition:

Antimullerian hormone is a dimeric glycoprotein that inhibits the development of Müllerian ducts in the male embryo. This compound is produced by immature Sertoli cells in the male embryo and postnatal granulosa cells and after puberty and throughout their reproductive stage in women.

-Utility of its measurement:

Its determination constitutes a reliable method to measure the ovarian reserve, that is, the quantity of available follicles, a determination that is very common in reproductive medicine, when secreted by the ovary to circulation, its levels can be determined in blood. of the antimülleriana hormone increases the success of in vitro fertilization, (IVF).
This hormone, is detected with a simple analytical and together with an ultrasound of follicular count of the ovary, allows us to predict the response that a patient will have to the stimulation.
It is also important because of the following: ovarian failure is responsible for between 20% and 25% of cases, of recurrent miscarriages in the first trimester of pregnancy according to some, with a decrease in antimulleriana hormone.Currently, the most important prognostic factor is still maternal age.
Also its evaluation can be useful for the detection of testicular tissue and its prepubertal functional status and in the search of granulosa cell tumors in adults, in men, the inappropriate embryonic activity of the hormone can lead to the Persistence of Tubes Mullerians Syndrome , where a rudimentary uterus is presented and the testicles are usually not descended.
Its blood levels reflect, therefore, the amount of available ovarian follicles (follicular reserve), which are the set of cells capable of generating an oocyte, at birth there are about 750,000 follicles, but this amount is decreasing and when the woman reaches puberty already has 300,000 of these follicles, of which only 400 will be ovulated and will have the possibility of being fertilized.
What makes the measurement of this hormone really interesting is that its values decrease progressively with age, becoming undetectable at menopause and early ovarian failure. Their blood levels increase in pathologies such as polycystic ovarian syndrome and in patients of both sexes with tumors of the specific gonadal stroma (Sertoli, granulosa).
In patients who undergo assisted reproduction techniques, their success is conditioned, among other factors, by the age of the patient. It is known that infertility without apparent cause increases as the woman’s age does (> 35 years). A cause attributable to this association is the reduction of the ovarian reserve.

– LABORATORY VALUES:

Women:

Prepubertal: 3-4 ng / ml
post puberty:
High More than 3 ng / ml
Normal More than 1 ng / ml
Under normal range 0.7 to 0.9 ng / ml
Low 0.3 to 0.6 ng / ml
Very low Less than 0.3 ng / ml
Undetectable in menopause

Men:

Neonate 32-40 ng / ml
Under 9 years old: 47 ng / ml
Adults 4-5 ng / ml
It is a hormone that tells us about the quantity and quality of the ovules at a certain time in a woman’s life. The antimülleriana hormone is as much in men as in women, but with different functions.
Its main action consists of sexual differentiation in the embryonic state. In male embryos it is expressed early and its function is to inhibit the Müllerian duct. That is, the embryonic structure that will form the uterus and the tubes. In the female embryos it is expressed later, when the uterus and the tubes are already formed.
In adult women it is expressed in the ovarian follicles. It controls the production of primary follicles and inhibits the excessive production of follicles during the menstrual cycle. As in normal puberty, it decreases in men with precocious puberty dependent or independent of gonadotropins.
The recovery of circulating hormone at prepubertal values is a good indication of the effectiveness of the treatment in reducing the intratesticular concentration of testosterone, it also inhibits the action of the aromatase enzyme

-Conclusions:

In women, this hormone is an ideal endocrine marker of their ovarian reserve, reflecting not only the number of ovarian follicles, but also the oocyte quality, since it is produced only by healthy follicles that will give rise to a quality oocyte. In men the same hormone is a good marker for Sertoli cells (cells of the seminiferous tubules that provide support for spermatogenesis) and allows us to evaluate testicular function.

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