I saw an article recently titled “A new hormone test can give Utah women a glimpse of their fertility…” written in 2016. This article was about a hormone called AMH. And, what shocks me is that they called it a “new test” in 2016. This test is anything but new! More so, I want to dispel some misconceptions about this test.
AMH is anti-mullerian hormone. When this hormone and test were discovered, fertility doctors rejoiced that perhaps this was the test that they could use to predict the future. Was a woman to conceive and have a child or not?
However, the fertility world has stopped looking to this test as if it’s the holy grail. Well, it’s not a holy grail. But, when used correctly can be helpful.
First let’s understand more about this hormone in clinical practice:
1) Reproductive endocrinologists (REs) tend to only consider its validity after 35.
2) REs utilize this test to understand ovarian reserve in a woman and if she would be a good candidate for IVF treatment.
3) REs believe that even if this number increases, your fertility has not improved because “the AMH can fluctuate.” Many patients have called me in tears because their RE said that even though their AMH increased from 0.03 to 1.2, it means nothing and that they will only consider the lowest value.
In my opinion, AMH is a reasonable marker for ovarian reserve. And, it’s true — ovarian reserve (i.e. how many eggs you are left with from when you were born) can never increase, and only declines. However, I have seen this value literally increase from what would indicate almost no reserves of eggs to plenty of eggs to have one child. What is happening here is not an increase in reserve, but rather, an improvement in the environment of the ovaries that allows eggs that were perhaps sleeping (and not visible to this test marker) to become awake and ready for action (now detectable by an AMH test). So, I think an increase in AMH is quite an indicator that things are moving in a positive direction.
However, AMH is not a good solo marker for ovarian reserve. As ovarian reserves decline, FSH (Follicle stimulating hormone) increases and estradiol can decrease or increase. So, AMH should never be used as a solo marker — but rather is a better evaluation of fertility when used in conjunction with FSH and estradiol.
These three combined, to a trained eye, can help determine fertility levels. There is not anyone that can tell the future — I believe that there is room for an educated, scientific guess. And, for women that are choosing to wait to start a family, this information can be crucial to making the right empowered decision for them.
If you’re in the place of trying to decide what to do or where you are in your journey to motherhood, reach out for support! You can schedule a free 15 minute consult with me to review your situation and what you can do about it.
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