HORMÔNIO ANTI-MULLERIANO


O que é Hormonio Anti-mulleriano ou AMH:

Os níveis de hormônios da mulher alteram com a idade e o AMH ou hormônio anti-mulleriano é hoje o melhor marcador da reserva ovarina e nos permite ter uma visão mais precisa da resposta ovariana à estimulação para quem deseja fazer tratamento para engravidar. A dosagem deste hormônio é rotina para o tratamento do casal infértil.

O AMH também pode ser útil na predição de hiper-respostas em pacientes com síndrome dos ovários policísticos (SOP) e colaborar para individualizar protocolos de estimulação mais adequados ao perfil de cada paciente e para o sucesso final do tratamento.

A síndrome dos ovários policísticos (SOP) é a causa mais comum de oligo anovulação, infertilidade e hiperandrogenismo e afeta cerca de 5% a 10% das mulheres em idade reprodutiva em todo o mundo. A SOP caracteriza-se por um excessivo número de folículos em crescimento de até 2-5mm de diâmetro, duas a três vezes mais do que o observado em ovários normais. 

Em pacientes com SOP a seleção e a maturação do folículo dominante dentro desse grupo maior de folículos não ocorrem, sendo a ação local inibitória do FSH essencial nesse processo. Desse modo, em mulheres com SOP os níveis circulantes do AMH são duas a três vezes maiores do que em mulheres saudáveis.  

O aumento dos níveis de AMH pode não ser causado somente pelo acúmulo excessivo de folículos antrais, mas pelo aumento da secreção do AMH pelas células da granulosa. Os níveis de AMH são, em média, 75 vezes mais elevados em células da granulosa de pacientes com SOP em comparação com células da granulosa em ovários normais. Ele oferece 92% de especificidade e 67% de sensibilidade como marcador diagnostico para SOP.

O valor de referência universal, para determinar a provável resposta à indução da ovulação, pode ser diferente para as mulheres de acordo com a idade, por exemplo: A reserva ovariana de uma mulher jovem pode estar diminuída como consequência de uma cirurgia ovariana (muito comum em cirurgias de Endometriose Ovarina).

Na Clinica Fertilizar utilizamos os níveis de AMH (Hormônio Anti Mulleriano) para avaliar com precisão o status de uma reserva ovariana.

Encorajamos as mulheres diagnosticadas com baixos níveis de AMH para não atrasar o tratamento de fertilidade porque a reserva ovariana vai continuar diminuindo.

DHEA (suplementação para baixos níveis de AMH)

O DHEA (Dihidroepiandrosterona) é um hormônio normal no organismo fabricado no ovário e nas glândulas suprarrenais. Diminui progressivamente com a idade. É essencial para a fabricação do hormônio estrógeno da mulher e é vendido como suplemento alimentar com o objetivo de combater o envelhecimento e melhorar a sensação de bem-estar. 

A falta reduz o desejo sexual, a massa muscular e as ações do sistema imunológico.

Mulheres com baixa reserva ovariana se beneficiam mais com protocolos de FIV bem gerenciados. Os planos de tratamento para estas mulheres envolvem suplementação de DHEA. Estudos realizados nos EUA mostram eficácia nas taxas de gravidez. Mulheres com menos de 38 anos apresentam melhora nas concentrações dos níveis de AMH após suplementação com DHEA, em comparação com mulheres mais velhas.

O DHEA foi amplamente vendido em todo o mundo durante a década de 90, como uma medicação milagrosa no combate ao envelhecimento, prevenção de doenças cardíacas, obesidade e até na prevenção à doença de Alzheimer. Entretanto, os seus efeitos benéficos não foram comprovados e por isso, em alguns países, como o Brasil, a venda foi proibida, embora a sua aquisição possa ser feita sem dificuldades pela Internet. 

FIV com níveis baixos de AMH

A probabilidade de sucesso da fertilização In vitro depende em grande parte do ovário da mulher e sua capacidade de produzir um grande número de óvulos de boa qualidade.

Mesmo quando o AMH (Hormônio Anti Mulleriano) é baixo (normalmente abaixo de 1,05ng/ml) e o FSH elevado, sugerindo uma habilidade comprometida dos ovários para produzir óvulos conseguimos boas taxas de gravidez envolvendo suplementos de DHEA e protocolos de estimulação bem desenhados.

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Following the news of what Nike has planned for Jordan Brand and Air Jordan products in 2018, we also received info that there will be two Nike Flyknit Air Max new signature basketball shoes coming too.Nike CEO Mark Parker confirmed that both Russell Westbrook and Giannis Antetokounmpo will be getting their own signature shoe, Westbrook Nike Janoski for Jordan Brand and The Greek Freak for Nike.“In the next several weeks alone, we’ll deliver the next version of the industry’s biggest signature shoe Nike Air Max Thea with the Kyrie 4,” said Parker. “We’ll build on the incredible first year of Paul George’s signature shoe with the PG2. We’ll introduce an all-new Nike Air Max 2016 Flyknit construction with Kobe’s next performance design. And Jordan Brand will launch its first signature shoe with reigning MVP Russell Westbrook. We’re also thrilled to Nike Internationalist expand our relationship with Giannis Antetokounmpo as we bring his unique personality to life through new signature product and storytelling next year.”No word on when Nike Roshe Flyknit both signature shoes will be revealed, but you can expect more news on the upcoming Antetokounmpo and Westbrook lines to come in the coming months.
KD Shoes />The Nike Air Max 180 OG Ultramarine will be making a retro return ahead of this year’s 2018 Air Max Day celebration.Last seen back in KD 10 2013. This Nike Air Max 180 release will comes dressed in the original White, Ultramarine, Solar Nike Flyknit Trainer Red and Black color scheme. Featuring a full White-based upper highlighted with the Ultramarine accents throughout atop a Black rubber outsole.Look for the Nike Air Max 180 OG “Ultramarine” to release this February 2018 at select Nike Sportswear retailers and Nike.com. The retail price tag is Nike Outlet Store set at $130 USD.
The latest Nike LeBron Soldier 11 is a straight nod to the past inspired by the original Air 180 runner.Having a Nike Air Max 2015 similar “Ultramarine” aesthetic that first appeared on the Nike Air 180 OG. This release comes dressed in a White, Racer Blue and Infrared color scheme. KD 9 Shoes Featuring a White mesh and perforated leather upper paired with Blue and Infrared accents. Aside from the traditional branding in its usual areas, an added Nike Flyknit “NIKE” logo is seen on the lower strap.While these Nike LeBron Soldier 11s have yet to officially hit retailers, you can already find sizes available Nike Outlet via eBay.
Kevin Durant’s Nike KD 10 will celebrate Black History Month with a special edition release on Martin Luther King Jr. Day.This KD 10 Nike Flyknit Racer comes dressed in this year’s signature Black History Month color scheme. Featuring a Black-based upper with with Red and Green knitted detailing. Its midsole dons KD 9 the colors of the Pan-African flag colors along with Metallic Gold branding. A historical date of 05-06-2014 is embossed on the media side above the New Nike Shoes 2017 midsole.Look for the Nike KD 10 “BHM” to release on January 15th at select Nike Basketball retailers and Nike.com. The retail price tag is set Nike Free Flyknit at $150 USD.
Virgil Abloh has designed two more Off-White x Nike Air VaporMax colorways for 2018. One will come dressed in Black and the Nike Shoes other in White. Here’s a first look at the Black pair.Very similar to the original release, this Nike Air VaporMax features an all-Black upper with Nike Air Force 1 a Black stitched Nike Swoosh on the sides. Signature White writing, a Black tongue instead of White is added while sitting atop a clear VaporMax Nike Flyknit Lunar 3 sole unit completes the design.Look for this Off-White x Nike Air VaporMax in Black to release sometime in 2018 at select retailers. The retail price Nike Shoes tag is set at $250 USD.
Paying respect to Chinese fans, Nike Basketball debuted the Nike LeBron 9 China on December 17th, 2011 with a NIKE HYPERADAPT 1.0 retail price tag of $170 USD.Dressed in a Neptune Blue, Current Blue, and Total Orange color scheme. This Nike LeBron 9 was highlighted with a Nike Air Max Tavas dragon graphic on the tongue. Its mix of Blues throughout the upper and Orange pops were complimented with a translucent outsole.While many consider the Nike Nike Roshe Run LeBron 9 as one of LeBron James best signature shoes, where would you rank these amongst the colorways that debuted? Leave your thoughts in the Nike Flyknit 4.0 comments section.
Tinker Hatfield debuted the Nike Air Huarache back in 1991. As a nod to one of his original releases, Nike will be re-releasing Nike Air Max a popular colorway that’s dubbed the Nike Air Huarache ’91 QS.Dressed in a White, Game Royal, Black, and Dynamic Pink color scheme. The shoe features Nike VaporMax a leather upper with a neoprene sleeve and its signature heel counter.Look for the Nike Air Huarache ’91 “OG” to release on January 11th at KD 10 Oreo select retailers and Nike.com. The retail price tag is set at $130 USD.
The Nike Komyuter made its debut in 2017 and for the winter KD 10 Shoes season the Swoosh will be releasing an all-new “Obsidian” colorway.Dressed in a mix of Obsidian, Wolf Grey, and White. Made for the modern urban commuter, Air Max 90 Shoes the shoe features a water-repellent design to help keep your feet dry and comfortable. The shoe’s signature buckle strap and rigged outsoles completes the design.Look Nike Juvenate for the Nike Komyuter Obsidian to release very soon at select Nike Sportswear retailers and Nike.com. The retail price tag is set at $150 USD.
Cheap KD 10 Shoes />While Nike Sportswear celebrated the Nike Air Foamposite One with a few classic releases in 2017. It now looks like they’ll be going in a Air Max 2017 different direction for 2018. A perfect example of what’s to come is this Nike Air Foamposite One Abalone release, scheduled for early 2018.Designed to look Nike Air Max like an Abalone sea snail’s shell. This “Abalone” Nike Air Foamposite One PRM with come with a multicolor iridescent upper covering its Foam shell. Featuring Nike Air Max 2017 a Black upper, sock liner and carbon fiber midfoot shank. Other details will include Teal accents on the Penny logo and Nike Swoosh atop a Nike Air Max Zero Black rubber outsole.Look for the Nike Air Foamposite One PRM “Abalone” to release on January 20th 2018 at select Nike Sportswear retailers. The retail price KD 10 Anniversary tag is set at $250 USD.
Isaiah Thomas was a huge fan of the Nike Kobe AD while with the Boston Celtics. As he prepares Air Max 95 Shoes for his return with the Cleveland Cavaliers, one of the colorways you can expect him to wear is this exclusive Nike Kobe AD Slow Grind Nike Factory Store PE designed by Nike Basketball.Dressed in a sleek Black colorway. This Nike Kobe AD is highlighted with a Yellow embroidered Nike Swoosh, matching colored “Slow Nike VaporMax Flyknit Grind” message on the heel atop a colorful rubber outsole.No word of these releasing anytime soon, but you can get a teaser look provided by Nike Flyknit Chukka IT below. Let us know what you guys think in the comments section.

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