Tsawg AMH thiab cev xeeb tub tus kheej: ua rau poob qis, kuaj mob, kho cov kev xaiv, cov lus qhia los ntawm obstetricians

2024 Tus sau: Priscilla Miln | [email protected]. Kawg hloov kho: 2024-02-18 01:25

Thaum npaj yuav xeeb tub, tus poj niam yuav tsum xub xav txog nws txoj kev noj qab haus huv. Tom qab tag nrho, nws yog cuam tshuam los ntawm ntau yam. Thaum pib, nws raug nquahu kom kuaj cov tshuaj hormones. Qhov nthuav tawm tshaj plaws yog cov tshuaj tiv thaiv Mullerian (AMH) uas tsim los ntawm zes qe menyuam. Nws qhov kev sib txawv ntawm cov qauv tuaj yeem ua rau muaj qhov tshwm sim loj. Wb saib seb cev xeeb tub puas ua tau nrog qis AMH.

AMH functions

Antimüllerian hormone plays lub luag haujlwm tseem ceeb hauv poj niam lub cev. Undoubtedly, txiv neej kuj muaj nws, tab sis nws qib qis dua. Hauv cov poj niam, nws yog tsim los ntawm zes qe menyuam thiab tswj lub maturation ntawm qe. Yog li ntawd, nws zoo li tias cev xeeb tub nrog qis AMH yog ua tau, txawm tias nyuaj heev.

AMH hauv txiv neej

Nws tau raug tshawb fawb pov thawj tias, txog rau ib qho taw tes, txiv neej thiab poj niam embryospoj niam loj hlob tib yam. Lawv muaj lub raj tshwj xeeb hu ua Mullerian duct. Nws muaj npe tom qab tus kws tshawb fawb German uas nrhiav pom qhov tsim no. Los ntawm 9-10 lub lis piam ntawm embryonic txoj kev loj hlob nyob rau hauv cov tub hluas, qhov ducts daws. Tib yam tshuaj tiv thaiv-Mullerian yog lub luag haujlwm rau qhov no. Nyob rau yav tom ntej, nws tseem yuav tsim tawm hauv cov noob qes me me.

Raws li cov poj niam fetuses, lawv tsim lub tsev menyuam thiab ib feem ntawm qhov chaw mos los ntawm Mullerian duct. Thaum 32 lub lis piam, cov ntxhais pib tsim cov tshuaj no, tab sis nws qib tseem qis. Nws tseem yog li ntawd kom txog thaum tus ntxhais mus txog hnub nyoog.

AMH and FSH

AMH cuam tshuam rau kev tsim cov tshuaj estrogen raws li kev cuam tshuam ntawm pituitary follicle-stimulating hormone (FSH). Txawm li cas los xij, kev sib raug zoo ntawm ob cov tshuaj hormones no tsis muaj kev cuam tshuam rau tus poj niam lub cev xeeb tub. Qhov no yog vim cov tshuaj tiv thaiv Mullerian yog tsim los ntawm FSH. Yog li, cev xeeb tub nrog qis AMH thiab siab FSH yog qhov ua tau. Los ntawm txoj kev, qis AMH feem ntau ua rau siab FSH.

FSH ntau lawm yog ywj siab heev. Nws tsis yog nyob ntawm txoj kev ua neej uas tus poj niam coj, lossis noj zaub mov, lossis txawm tias siv tshuaj hormonal. Tsis tas li ntawd, nws tsis cuam tshuam txog kev xeeb tub yav dhau los lossis kev yug menyuam.

Yog tias thaum lub sijhawm puberty qhov taw qhia ntawm cov tshuaj hormone no tsis sib haum rau cov qauv, ces qhov kev kuaj mob ntawm kev xeeb tub yog qhov zoo.

Ntawm qhov taw qhia ntawm cov tshuaj no cuam tshuam tsuas yog cov qe hauv poj niam lub cev. Tias,lawv siv sai npaum li cas qhia txog qib AMH.

Yog li ntawd, peb tuaj yeem xaus tias kev xeeb tub tus kheej nrog FSH siab thiab qis AMH yog ua tau, tab sis tej zaum yuav nyuaj. Tom qab tag nrho, qhov piv ntawm cov ntsuas no qhia tau hais tias cov qe nyob rau hauv lub zes qe menyuam txaus, tab sis lawv tseem tsis paub qab hau. Nyob rau hauv rooj plaub no, ua ntej xeeb menyuam, koj tus kws kho mob gynecologist feem ntau yuav pom zoo kom kho cov tshuaj hormone kom nce cov qe loj.

Vim li cas koj thiaj paub AMH?

Tsawg AMH thiab kev xeeb menyuam tus kheej yog cov ntsiab lus zoo sib xws. Thiab yog hais tias ib tug poj niam xav xeeb tub yam tsis muaj kev kho mob, ces koj yuav tsum paub cov tshuaj hormones.

Ntxiv rau, siv qhov ntsuas no, koj tuaj yeem txiav txim siab cov ntsiab lus hauv qab no:

• probability of muaj me nyuam;
• probability of muaj me nyuam;
• rooj plaub qhov twg yuav tsum muaj kev sib txuas ntxiv;
• lub sijhawm pib ntawm lub cev tsis muaj zog (muaj peev xwm kwv yees li 4 xyoos ua ntej qhov poob qis hauv kev ua haujlwm me me).

Cov kws tshaj lij pom zoo kom saib xyuas qib AMH hauv cov ntshav tsis tu ncua. Koj tuaj yeem pib ua qhov no twb tau los ntawm qhov pom ntawm thawj zaug kev coj khaub ncaws. Cov tshuaj no feem ntau txo qis. Lub caij nyoog ntawm cev xeeb tub nrog qis AMH yuav siab dua yog tias qhov kev poob qis no tau pom nyob rau lub sijhawm. Txwv tsis pub, koj yuav tsum khov tus poj niam cov khoom lom thaum cov tshuaj hormones tseem zoo li qub.

AMH hloov nrog hnub nyoog

Cov lus nug ntawm AMH qis thiab kev xeeb tub ntawm tus kheej tuaj yeem tshwm sim hauv tus poj niam txhua lub hnub nyoog. Nws yog ib qho tseem ceeb kom paub tias cov tshuaj hormone no coj li cas ntawm ntau theem ntawm tus poj niam lub neej. Txawm li cas los xij, tsis txhob hnov qab tias txhua yam kab mob yog ib tus neeg thiab qhov ntsuas tshuaj hormone yuav nyob ntawm seb tus poj niam lub qe tau pib li cas. Tias yog vim li cas ntau tus poj niam tsis tuaj yeem xeeb menyuam thaum muaj hnub nyoog 25, vim tias lawv cov qe qhuav.

Yog li, cov ntsiab lus ntawm cov tshuaj hormone pib nce thaum lub sijhawm puberty. Qhov no yog hais txog 12-14 xyoo. Tom qab ntawd, tau kov yeej tag nrho cov kev hloov hormonal, thaum muaj hnub nyoog 20-30, cov ntsiab lus ntawm cov tshuaj hormones ua qhov siab tshaj plaws. Nws yog lub sijhawm no uas obstetricians-gynecologists pom zoo kom yug menyuam. Tseeb tiag, tom qab 30 thiab txog thaum pib ntawm cev xeeb tub, cov tshuaj hormones poob qis, thiab cev xeeb tub nrog qis qis ntawm AMH yuav nyuaj.

Thaum menopause, zes qe menyuam tsis ua haujlwm thiab, raws li, cov tshuaj hormones poob rau xoom.

Ovarian reserve

Kev kawm txog qhov kev cia siab no thaum npaj cev xeeb tub yog qhov tseem ceeb ntawm kev kuaj mob. Nws tseem hu ua follicular reserve. Ntawd yog, qhov no yog tus naj npawb ntawm cov follicles thaum pib ntawm kev coj khaub ncaws, uas tuaj yeem dhau los ua cov qe loj hlob tuaj.

Paub txog qhov tshwj xeeb no, npaj cev xeeb tub lossis tsim kev tsim tawm. Kev tshuaj xyuas ntawm cev xeeb tub nrog qis AMH qhia tau hais tias lub qe muab los ntawm qhov chaw cia thiab khov yog qhov lav ntawm niam txiv yav tom ntej.

Lub xeev ntawm zes qe menyuam cia nyob ntawmcov hauv qab no:

• hnub;
• kab mob ntawm kev ua me nyuam;
• hluav taws xob, tshuaj khomob;
• smoking.

NWS AMH

Yog tias koj AMH siab dua 7.3 ng / ml, nws txhais tau tias koj muaj qib tshuaj hormones siab. Qhov no yuav qhia tau tias muaj cov txheej txheem pathological hauv zes qe menyuam. Tsis tas li ntawd, cov nyhuv no tuaj yeem pom nrog qhov pib lig ntawm kev puberty lossis tom qab kev kho tsis muaj menyuam nrog tshuaj hormonal (ovarian hyperstimulation).

Qhov nruab nrab AMH yog 4-7.3 ng / mL. Ntxiv mus, qhov ntsuas ntawm 2, 2-4 ng / ml kuj suav hais tias yog qhov txawv ntawm cov qauv.

Yog tias qhov ntsuas yog los ntawm 0.3 txog 2.2 ng / ml, ces qhov no suav tias yog qis AMH thiab kev xeeb tub ywj pheej tsis zoo li, tab sis tseem ua tau. Tab sis nrog qhov ntsuas tsawg dua 0.3, nws tsis tuaj yeem xeeb tub.

Txo cov tshuaj hormones: ua rau

Zoo li qib siab ntawm cov tshuaj hormones, qib qis kuj tsis qhia txog kev ua haujlwm ntawm zes qe menyuam. Qhov no yuav qhia tau ib qho ntawm cov xwm txheej hauv qab no:

• pathology ntawm zes qe menyuam kev loj hlob;
• pib pib pib ua tiav;
• tsis txaus ntseeg hauv kev ua haujlwm ntawm gonads thiab tsis muaj cov tshuaj hormones;
• menstrual irregularity;
• txo qis cov qe noj qab nyob zoo;
• kev txo qis hauv paus hauv paus;
• early menopause;
• ovarian dysfunction;
• endometriosis;
• kab mob oncological ntawm kev ua me nyuamlub cev.

Qhov tseem ceeb tshaj plaws hauv qhov xwm txheej no yog kev kuaj mob ntxov thiab kho. Tom qab tag nrho, yog tias koj pom qhov txo qis hauv cov tshuaj hormones hauv lub sijhawm, koj tuaj yeem kho qhov xwm txheej. Thiab tom qab ntawd txawm tias cev xeeb tub nrog AMH qis heev tuaj yeem ua tau. Nws tsuas yog ib qho tseem ceeb kom tsis txhob poob siab thiab ua raws li cov lus qhia ntawm tus kws tshaj lij.

Puas siab AMH txaus ntshai?

Pom tseeb, kev xeeb tub AMH qis heev yuav muaj qhov cuam tshuam ncaj ncees. Txawm li cas los xij, cov ntsiab lus ntau ntxiv ntawm cov tshuaj hormones tuaj yeem ua rau muaj teeb meem. Namely:

• kev muaj menyuam;
• kev sib deev qeeb;
• kev ua txhaum ntawm kev ua haujlwm ntawm endocrine thiab qog nqaij hlav sib deev thiab, vim li ntawd, qhov tsis muaj ovulation;
• txo qis rhiab heev ntawm receptors rau luteinizing hormone;
• kab mob oncological ntawm zes qe menyuam thiab tag nrho cov kab mob kev loj hlob.

Raws li qib qis ntawm cov tshuaj hormones, nce qib yuav tsum tau kho. Ua ntej ntawm tag nrho cov, nws yog ib qhov tsim nyog los tshem tawm qhov ua rau ntawm kev nce hauv kev ua haujlwm. Hmoov tsis zoo, tseem tsis tau tsim cov tshuaj kom txo qis AMH hauv cov ntshav.

Yuav ua li cas nce AMH?

Hmoov tsis zoo, lo lus teb rau lo lus nug no yuav poob siab. Feem ntau yuav, vim li cas rau qhov qis qis no yog ib qho kab mob ntawm poj niam cev xeeb tub. Nyob rau hauv tas li ntawd, nws yog ib qho tsim nyog yuav tsum tau mus soj ntsuam xyuas.

Raws li peb tau hais lawm, tus nqi qis yog los ntawm 0.3 txog 2.2 ng / ml. Yog tias qhov ntsuas qis dua 0.3 ng / ml, ces nws yog lub sijhawm los suab lub tswb, vim tias tus mob no tseem ceeb heev rau tus poj niam uas xav cev xeeb tub. Low AMHthiab kev xeeb tub ywj pheej hauv qhov no tsis tuaj yeem ua tsis tau.

Tshuaj tseem tsis tau tsim cov tshuaj uas tuaj yeem nce qib ntawm AMH. Yog lawm, thiab koj yuav tsum tau tawm tsam tsis yog qhov ntsuas qis, tab sis nrog qhov ua rau, uas yog, nrog tus kab mob, uas qhia txog cov ntsiab lus qis ntawm cov tshuaj.

Txoj hauv kev tawm hauv qhov xwm txheej no yuav yog txheej txheem ntawm kev sib xyaw ua ke. Tab sis txawm nyob ntawm no muaj teeb meem. IVF xav tau cov qe loj, uas, hmoov tsis, tus neeg mob tsis muaj. Tom qab ntawd koj tuaj yeem siv lub qe pub dawb.

Kev cev xeeb tub nrog qis AMH

Nyeem tshuaj xyuas txog AMH qis thiab kev xeeb tub ywj pheej, peb tuaj yeem xaus tias nrog kev tshawb pom raws sij hawm ntawm qhov ntsuas qhov txo qis, muaj peev xwm xeeb menyuam. Nws yog ib qho tseem ceeb los xaiv txoj kev kho mob thiab ua raws sij hawm. Koj tuaj yeem nce AMH los ntawm kev tshem tawm qhov ua rau txo qis.

Txo cov tshuaj tiv thaiv-Müllerian cov tshuaj hormones tuaj yeem ua rau muaj kev ntxhov siab thiab ua kom muaj zog. Yog li ntawd, nws tuaj yeem nce ntxiv los ntawm kev tshem tawm cov xwm txheej no. Nyob rau hauv rooj plaub no, kev ua siab ntev thiab so yuav yog cov tshuaj zoo tshaj plaws.

Tab sis los daws qhov teeb meem xws li qhov pib thaum ntxov ntawm lub cev tsis muaj zog yog qhov nyuaj dua. Tsis tas li ntawd, tus mob no ntawm tus poj niam lub cev yog feem ntau ua rau txo qis hauv AMH. Raws li koj paub, tsis muaj tshuaj rau cov laus. Thiab menopause tsuas yog qhia tias lub cev pib muaj hnub nyoog thiab kev ua me nyuam ua haujlwm raug kev txom nyem thawj zaug.

Tsis tas li, thaum kuaj AMH, nws yuav tsum tau qhia txog kev noj tshuaj hormonal. Tsis zoo li FSH, anti-Mullerian hormonecuam tshuam los ntawm cov tshuaj hormonal. Tag nrho cov no tuaj yeem cuam tshuam qhov tshwm sim ntawm kev tshuaj ntsuam.

Feem ntau, thaum kuaj pom qhov ntsuas qis, lawv tsis nrhiav kev nce ntxiv. Qhov teeb meem ntawm qhov ua tau zoo ntawm stimulating zes qe menyuam nrog tshuaj hormonal thiaj li yuav tsim tau lub qe loj hlob tuaj. Los yog npaj txoj kev IVF. Los ntawm txoj kev, follicle stimulation yog ib qho ntawm cov theem kev npaj ntawm cov txheej txheem insemination.

Nyob rau hauv qhov xwm txheej zoo li no, nws yog ib qho tseem ceeb tsis txhob kho tus kheej. Thaum koj muab koj tus kheej nrog cov txhais tau tias tsis muaj txiaj ntsig, koj tau ploj mus rau lub sijhawm muaj txiaj ntsig los xeeb menyuam. Tom qab tag nrho, tsis paub qhov tseeb ntawm qhov kev txo qis hauv AMH, koj tsuas tuaj yeem ua mob rau koj txoj kev noj qab haus huv xwb, yog li ntawd yav tom ntej koj yuav tsis muaj menyuam li.

Thaum twg kuv yuav tsum tau kuaj?

Thaum tus poj niam xav los ua niam, nws yuav tsum tau kuaj xyuas. Qhov no muaj tseeb tshwj xeeb rau cov niam txiv uas tsis tuaj yeem ua niam txiv tau ntev. Los ntawm txoj kev, nws yog ib qho tseem ceeb rau kev xeem tsis yog rau ib tug poj niam, tab sis kuj rau ib tug txiv neej.

Nws tseem pom zoo kom tau txais kev sim hauv cov xwm txheej hauv qab no:

• menstrual irregularities;
• kev kuaj mob pojniam menyuam;
• phais;
• failed IVF sim;
• kev npaj cev xeeb tub lig;
• ovarian dysfunction;
• early puberty.

Kev tshuaj ntsuam: koj yuav tsum paub dab tsi?

Thaum npaj cev xeeb tub, txhua tus poj niam yuav tsum tau kuaj AMH. Paub cov txiaj ntsig ntawm kev sim rau gonadotropic thiabCov tshuaj hormones kev sib deev yog qhov tsim nyog rau kev xeeb tub thiab kev xeeb tub. Tom qab tag nrho, hauv qhov no, koj tuaj yeem kho lawv raws sijhawm.

Yuav ua li cas tsom xam rau AMH, cov ntshav tau muab los ntawm cov leeg. Ib tug poj niam ntawm lub sijhawm no yuav tsum nyob rau hnub 5 ntawm nws qhov kev coj khaub ncaws. Tsis tas li ntawd, 3 hnub ua ntej qhov txheej txheem, koj yuav tsum tsis txhob muaj kev ntxhov siab thiab tsis suav nrog kev ua lub cev. Nws tseem txwv tsis pub noj cov dej haus cawv ib hnub ua ntej kuaj ntshav. Kev noj tshuaj hormonal uas nce lwm cov tshuaj hormones tuaj yeem cuam tshuam cov ntaub ntawv kuaj.

Raws li noj, zaum kawg koj yuav tsum noj ob peb teev ua ntej yuav mus pw. Kev tsom xam yog noj ntawm lub plab khoob, koj tsis tuaj yeem noj lossis haus dab tsi. Nws kuj raug pom zoo kom tsis txhob haus luam yeeb ua ntej kev sim.

Koj yuav tsum qhia rau koj tus kws kho mob thiab koj tus kws kho mob yog tias koj muaj mob hnyav tsis ntev los no.

Nws yog ib qho tseem ceeb kom tsis txhob poob siab thaum koj pom qhov tshwm sim uas txawv ntawm cov qauv. Txhua tus neeg yog tus kheej thiab tej zaum hauv koj rooj plaub txhua yam yog thim rov qab.