FSH is a pituitary gonadotropin hormone that influences the growth of a dominant ovarian follicle as well as the maturation of an egg cell inside it. The levels of this hormone depend directly on the follicular ovarian reserve and change in the course of a menstrual cycle, which is why you should undergo a blood test for FSH concentration on day 2-5 of the cycle.
FSH production and release are stimulated by a hypothalamic hormone whose secretion occurs sporadically, hence the release of FSH into blood is impulsive. Therefore, for an accurate assessment of the follicular reserve, it is recommended to evaluate not only FSH but also AMH levels.
AMH is a glycoprotein produced by ovarian granulosa cells that correlates with the number of preantral and antral follicles. AMH is not secreted by the cells of the dominant follicle, hence an AMH blood test can be undergone on any day of the menstrual cycle.
AMH production does not depend on pituitary gonadotropin hormones, which is why its values are more stable in comparison with FSH and can clearly reflect the status of the ovarian reserve. At present, this parameter is the most precise indicator of a normal ovarian function. A decrease in AMH levels testifies to the reduction of the ovarian reproductive function. This parameter is an accurate reflection of a follicular reserve status when the patient is 25 - 45 years old. An AMH blood test performed before 25 can lead to grave miscalculations in the prognosis.
If FSH is higher than 9 IU/l and AMH is lower than 1.0 ng/ml it is time to focus on the preservation of the reproductive function. Or rather, it is already a bit too late but we can still try to fight for it.
If your doctor has detected a negative tendency in the ovarian condition and if pregnancy does not occur, an oocyte cryoconservation programme may be an option. Our patients have figuratively called it "half-IVF". Superovulation stimulation is carried out to instigate the growth of a maximal number of oocytes and after a certain follicular size has been reached, a puncture under an i.v. anaesthesia is performed. Usually, patients go home in two hours after the manipulation whereas the process itself takes less than two weeks, and you know that there is a baby waiting for you should the need in it arise. It would be nice if, should you decide to get pregnant, you were able to manage to do it yourself but if not, we have already prepared for such a case in advance. We would not want this procedure to become very popular but in some cases, it is indeed a way to get off easy.