ANTI-MULLERIAN HORMONE AND FERTILITY

ANTI-MULLERIAN HORMONE AND FERTILITY

Initially Anti-Mullerian hormone was only considered in its involvement in the sexual differentiation and Mullerian regression in the males, but now it serves as a bio-marker for the ovarian reserve. It expresses itself in the small antral follicles. It can predict the condition of the patients with assisted reproductive therapy and it is also important in the patients with the polycystic ovary. The following points elaborates the role of AMH in the fertility

Anti-Mullerian hormone and its effect on fertility and infertility.

·         Anti – Mullerian hormone is a protein in its composition and is encoded by the help of the AMH gene.

·         It is produced by the granulose cells which are present in the ovarian cells.

·         It has a molecular weight of 140 KDa.

·         AMH which is also known as Mullerian-inhibiting substance is a member of the super family named as transforming growth factor-beta(TGF-β). This family includes bone morphogenic proteins, activins, inhibins and growth differentiation factors.  Almost every component is involved in the functions related to reproduction in both the males and females.

·         It doesn’t have any role in the female development, however its production plays a role in the autocrine and paracrine in the maturation of oocyte and follicle development.

·         It is a predictor of the ovarian reserve as it shows the continued growth of the small follicles and thus explaining the size of the resting follicle pool in the woman’s body.

·         So, it plays a role as a marker to find out the decline of ovarian pool related to the age of the women, thus predicting the future reproductive span in the women.

·         It is because of the fact that with the increase in the age of the females, the size of their pool of follicle decreases, so the blood AMH level also decreases. Women who have small follicles like those having polysystic ovaries have a high rate of the AMH level and women who are close to their menopause have low level of AMH.

·         Research shows that AMH is a much better marker for the Ovarian reserve as compared to the other hormones like Follicle Stimulating Hormone, however the only problem is the cost as this test is available in only few laboratories.  

·         Thus the levels of AMH can help us to predict about the chances of fertility in a woman by assessing her ovarian reserve and greater the AMH greater the chances of fertilization and conception in the women.

Current medical treatments for fertility:

Infertility is defined as a complex disorder caused by the medical, psycosocial and other aspects in which a person can't conceive the baby. With proper medical care this problem can be solved. Following are some of the current medical treatments for fertility:

A number of medications and surgical procedures are here to solve this problem, however it can pose some problems like becoming pregnant with twins or even multiples, a risk of the enlarged ovaries in the females. There are several drugs which are administered for abnormal FSH and LH hormone production. These are as follows:

Clomiphene citrate:

The route of administration of this drug is oral and it is used to stimulate ovulation in the women who have ovulation disorders. This drug causes the pituitary gland to release increased amounts of FSH and LH, thus resulting in the stimulation of the follicle in the ovary containing egg. Clomiphene is also used in the improvement of the fertility in the women and is used to treat the infertility of unexplained origin.

Gonadotropins:

Gonadotropins stimulate the ovary directly. It is sometimes used in combination with Intrauterine Insemination, it is a procedure in which sperm is injected with the catheter into the uterus to have increased chances of conception. Some examples of gonadotropins are as follows:

1.      Human menopausal gonadotropin: It contains Both the FSH and LH, thus play a role in the stimulation of the ovaries for the ovulation process.

2.      Follicle stimulating hormone: This hormone helps to produce mature form of the egg follicles.

3.      Human chorionic gonadotropin: It helps ovary to release the egg.

Metformin:

Metformin is used in women who have insulin resistance and thus helps in the restoration of the ovulation.

Laparoscopy:

Women in which the cause of infertility is tubal or pelvic diseases have to undergo the procedure of laparoscopy. Laparoscopy can help to reconstruct the reproductive organ thus helping the process conception.

Hysteroscopy:

Hysteroscopy can be used to remove the polyps and fibroid tumors in the uterus, dividing scar tissues and resulting in the opening of the blocked tubes.

Intrauterine insemination:

This is a procedure which involves the injection of the sperm via a catheter into the uterus at the time of ovulation. This procedure can be done with the aid of previously mentioned medications.

In vitro fertilization:

In this procedure eggs are fertilized in a culture and are then placed in the uterus. Women then take gonadotropin to aid the process of stimulation of the egg development. When the eggs get matured they are then collected using a needle guide with the help of vaginal ultrasound probe. The sperms are then washed and collected in a culture dish. After some days embryos are then returned to the uterus with the help of a catheter.

Egg donation:

It is another procedure used in the women who do not have normally functioning ovaries.

Natural ways to treat infertility:

There are many ways to boost fertility by addressing the infertility-Naturally. Some of these ways are as follows:

Avoiding toxins:

Avoiding toxins in daily life can increase the chances of fertility. It has been observed that there are many toxins who can affect the fertility. Some examples of these toxins from our daily life are as follows:

1.      VCH chemical which is used in rubber tires, plastics, and tires can affect the fertility.

2.      Toxins released from cigarette, cigars, tar, and fumes from the road.

3.      Phthalates, which are present in plastic bags, IV bags, cling wrap, Medical supplies can cause miscarriage and testicular toxicity.

4.      Ovulation can also be disturbed or even stopped by ovotoxicants.

5.      Pesticides found in vegetables and fruits.

6.      Fumes from the paint.

7.      Chemicals used in dry cleaning of the clothes.

8.      Formaldehyde which is found in deodorants, aerosols etc.

Healthy and fertility diet:

 There are various foods which can boost the process of fertility. A fertility diet is most of the times organic in nature and full of proteins. Right nutrients and right combination can assure a healthy baby. Some of the food which helps the process of fertility are as follows:

1.      Organic meat in small quantities, fish like sardine etc.

2.      Home cooked organic legumes.

3.      Vegetables and fruits of all seasons.

4.      Nuts, whole grains, seeds etc.

5.      Use butter and cheese for cooking purpose.

6.      Olive oil and other nut oil are also very important.

Avoid the animal derived hormones like estrogen:

Milk is mostly consumed for our calcium requirements, but we never think that besides calcium what else are we consuming. There are a number of hormones in milk and other dairy products. So they should be used cautiously during the time of conception. Some of these hormones are:

1.      Somatostatin

2.      Melatonin

3.      Growth hormone

4.      Leutinizing hormone

5.      Insulin

6.      Corticosteroids

7.      Thyroid stimulating hormone

8.      Prolactin

9.      Estrogen and many more.

Avoiding coffee, alcohol and smoking:

Coffee is one of the most favorite beverage across the globe, however one must know that it reduces the chances of fertility to a greater extent, researchers have come to know that a cup of coffee on a daily basis can pose a great damage to the fertility and if conceived than it can cause damage to the fetus. Similarly, alcohol also plays the same role in fertility. Cigarette smoking is a major threat to the people who want to conceive a child. Sperms of cigarette smokers get abnormal and the rate of motility of sperm also decreases by smoking. So these three things must be strictly avoided.

To have a check up for sexually transmitted diseases:

Couples must go for a regular check up sexually transmitted diseases as some of the STDs are asymptomatic, like in the case of Chlamydia infection which can cause a great damage to the fertility as it can affect both the sperms and ovaries.

Avoiding fats:

Avoiding fats during conception  process can increase  the chance of having a baby.