1. AFC: Direct scan of ovarian "inventory"
1. Definition: The number of antral follicles with a diameter of 2-10mm in bilateral ovaries is counted by vaginal ultrasound to reflect the basic ovarian reserve.
2. Detection timing: Days 2-5 of the menstrual cycle (ovariac resting period), when the count is the most accurate.
3. Clinical significance
·Normal range: 5-12.
·5: Indicating that ovarian reserve is seriously insufficient and the probability of pregnancy is significantly reduced.
·20: Be wary of polycystic ovary syndrome (PCOS), where follicular development and maturation are blocked.
2. AMH: A stable indicator of the ovarian "biological clock"
1. Definition: It is secreted by granulosa cells of preantral follicles, is not affected by the menstrual cycle, and can be detected at any time.
2. Age correlation (normal range for different ages)
age AMH normal value (ng/mL) 25 years old 2.0 - 4.0 35 years old 1.0 - 2.5 40 years old 0.5 - 1.5 Below range: Ovarian reserves decline, and egg quantity and quality decline simultaneously Abnormal increase: Screening formetabolic diseases such as PCOS is needed.
3. FSH: "Early warning sign" of ovarian decline
1. Definition: The basic level of follicle stimulating hormone secreted by the pituitary gland reflects the ability of the ovary to respond. The higher the value, the more difficult the ovary is to work.
2. Testing timing: Blood was drawn on an empty stomach on days 2-5 of menstruation (basic state).
3. Hierarchical interpretation
|
FSH value (IU/L) |
significance |
|
<10 |
normal ovarian function |
|
10-15 |
The ovaries began to"strain" and the inventory decreased |
|
>20 |
Significant decline in ovarian functionincreases the risk of amenorrhea within 1 year |
|
≥40 |
Diagnosis of premature ovarian failure (with low estrogen) |
·Pregnancy may still be possible when FH>10, but needs to be evaluated in conjunction with AMH and AFC.
·Stress, staying up late or medication can cause a temporary increase in FSH, which requires re-examination to confirm.
4. Combination of three indicators: the core basis for predicting the success rate of test tube
According to clinical data in reproductive medicine, there are significant differences in tube outcomes between different indicator combinations
|
index combination |
Average number of eggs retrieved |
high quality embryo rate |
clinical pregnancy rate |
|
AMH≥1.5 + FSH≤10 |
12-15 pieces |
65%-70% |
60%-65% |
|
AMH 0.8-1.5 + FSH 10-15 |
6-10 pieces |
50%-55% |
40%-45% |
|
AMH≤0.7 + FSH≥15 |
3-5 pieces |
30%-35% |
20%-25% |
5. Personalized intervention strategies: from evaluation to optimization
·Low reserve population (AFC↓/AMH↓/FSH↑)
Preconditioning activates ovaries (such as growth hormone and androgen supplementation)+ microstimulation to promote ovulation + optimization of embryo laboratory technology (such as time difference imaging system) to improve egg utilization.
·PCOS population (AFC↑/AMH↑)
Endocrine metabolism regulation (metformin, insulin resistance intervention)+ antagonist regimen to prevent premature ovulation + in vitro maturation culture (IVM) technology to improve egg maturity.
6. Overall view of fertility assessment: more than three aspects
1. Uterine receptivity: Those who have had cesarean section need to check for scar diverticulum; patients with a history of abortion are advised to eliminate adhesions through hysteroscopy.
2. Metabolism and endocrine
Thyroid function (TSH> 2.5 doubles the risk of abortion)
Glucose metabolism (infertility rate exceeds 50% with a history of diabetes for more than 7 years)
BMI management (ideal 20-22
3. Male factors: Sperm concentration (≥ 8 million/ml), forward mobility (≥40%), and normal morphology rate (≥4%) are the bottom line for successful fertilization.
Dynamic evaluation, scientific decision-making
Fertility is not a static indicator. For women over the age of 35, it is recommended to review AMH and sex hormones every 6 months; in the event of repeated transplant failures, in-depth investigation of endometrial receptivity, immune factors and sperm DNA fragmentation rate (DFI) is needed. The three core indicators are like the "fertility map". Only by combining comprehensive assessment and precise intervention can we find the most suitable soil for each seed of life on the road to assisted reproduction.
For more on fertility preparation, second/third-generation IVF, and overseas, U.S., Thailand, Malaysia, America or Cambodia IVF, scan the QR code on the right or call lelaiwa's hotline+852 6145 8043!
