Fertility and a woman’s age
The most important factor influencing a woman’s fertility is her age. Over the years the changes occurring in a woman’s body reduce her changes for fertilisation. The number of follicles decreases gradually, those which remain are aging, the percentage of aneuploidies (abnormalities of chromosomes number) is growing resulting in lower chances of fertilisation and the risk of pregnancy loss.
OVARIAN RESERVE EVALUATION
– key element of the infertility diagnosis
A woman’s reproductive potential is determined on the basis of evaluating her ovarian reserve. Every woman has the definite number of primary follicles which are partially used in every cycle. The ovarian reserve depends on the number of primary follicles remaining in the ovary. Only these follicles can transform into a mature ovum.
Evaluation of ovarian reserve aims at:
- detecting young patients with diminished ovarian reserve – accelerated treatment
- detecting middle-aged patients who still have valuable ova – deciding on further clinical proceedings
- eliminating patients who have no chances for pregnancy (costs of treatment, onerousness of treatment)
AMH (Anti-Müllerian Hormone)
AMH (Anti-Müllerian Hormone) is a hormone produced both in women and men. In women AMH is produced in ovarian follicles by the cells surrounding the ova ready to grow. The AMH level does not depend on the female menstrual cycle so it can be tested on any day of the cycle. Its level decreases with increasing female age, therefore it is a very good marker of the decrease in fertility, including the premature ovarian failure. In patients PCOS (Polycystic Ovary Syndrome) the AMH level is significantly higher.
INHIBIN B serves the evaluation of ovarian reserve. Inhibin B is produced by granulosa cells in small antral follicles. The substance is secreted primarily in the follicular phase of the menstrual cycle. It level in the early follicular phase reflects the number and quality of ovarian follicles. There is a positive correlation between the Inhibin B levels and the number of antral follicles assessed in ultrasound examination performed in the first days of menstrual cycle.
Another important test is AFC (Antral Follicle Counts). In this case additional information relating to ovarian reserve is obtained in ultrasound examination which allows the assessment of endometrium and ovarian structure, number of antral follicles (follicles about 2-6 mm in diameter) and the follicle growth in patients with ovulation disorders or qualified to treatment using assisted reproduction techniques.
LABORATORY TESTS – FEMALE INFERTILITY DIAGNOSIS
Laboratory tests, when performed and interpreted properly, are the important diagnostic tool. The INVICTA Basic Diagnostic Panel for women consists of the set of 12 laboratory tests.