Five things you should know about ovarian reserve testing

Five things you should know about ovarian reserve testing

AMH blood test offers answers and options

It’s a fact of life. A woman is born with all of the eggs she is ever going to have. As she ages, the number of eggs available for fertilization decreases and the percentage of eggs with chromosomal abnormalities increases. Consequently, as a woman reaches thirty-something and beyond, she is likely to have lower fertility and a greater chance of miscarriage.

Age remains the best predictor of ovarian reserve, but is it really the only indicator of a woman’s ability to have a baby? Not necessarily so! There are several tests that can help predict whether a woman has a faster-than-normal biological clock, such as the anti-Müllerian hormone (AMH) test.

AMH is a protein substance produced by granulosa cells in ovarian follicles. The AMH test can estimate what is called “ovarian reserve” by measuring the number of follicles developing in the ovary at a particular time. If AMH levels are too low, a woman may have trouble conceiving.

Here are some important facts about AMH testing:

1) It’s a simple test.

Checking AMH levels involves a quick and easy blood test. Testing can be completed at any time. The menstrual cycle does not affect AMH levels, so doctors do not need to plan testing for a specific day in the cycle. AMH testing is also less expensive than some alternative tests because it uses one simple blood draw. Some medicines, however, may alter AMH levels, including birth control pills.

2) It’s a useful test.

According to the American Society for Reproductive Medicine, AMH testing is especially useful for those who have a higher risk of diminished ovarian reserve including:

  • Women over age 35;
  • Women with a family history of early menopause;
  • Women with only one ovary;
  • Women with a history of ovarian surgery or chemotherapy;
  • Women who have shown poor response to ovarian stimulation; and
  • Women with unexplained fertility.

Based on the available data and expert opinion, I would highly recommend ovarian reserve testing for any woman older than 35 who has not conceived after six months of attempting pregnancy.

3) It can pinpoint a piece of the infertility puzzle.

Although AHM testing can’t tell you exactly how many eggs you have left – or the quality of those eggs – it can tell you if there is an inadequate supply. Conversely, it cannot and does not predict certain fertility failure. With AMH test results in hand, we can discuss a woman’s reproductive options and develop a treatment plan. For example, if a woman is not in a situation to get pregnant quickly, she may choose to have her eggs frozen for the future.

4) It’s not the only predictor of infertility.

Without question, age is the most important factor for fertility—and AMH testing helps us identify those who might have lower fertility than expected for their age. However, there is no evidence to suggest that “good” AMH levels mean that a woman will have higher fertility; and normal AMH levels do not exclude other possible causes of infertility. Additional testing may be recommended to provide a more complete picture of a couple’s fertility.

5) You can request the test.

Many women request AMH testing to clarify current and future fertility. If she is thinking about waiting to have children and her AMH levels are below normal, she might reconsider as her “window of opportunity” to conceive may be shorter than anticipated. AMH testing cannot predict reliably when your eggs will run out. Female age is a better predictor of egg quality than AMH level alone. A low result does not mean you cannot get pregnant.

You should seek the help of a Reproductive Endocrinologist and infertility specialist if you have been trying to get pregnant for six months or more. You should also talk to an infertility specialist if you have had more than one miscarriage or are considering your options for fertility preservation.

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