AMH Test

The naturopath that I was seeing commented that I might be pre-menopausing. Hmm? I am only 30! Needless to say, I freaked out after she told me and fired her on the spot. LOL. Even though I am convinced that was not the case, the thought that maybe, just maybe I might be menopausing scared the hell out of me.

A friend of mine suggested to go for an AMH test.

What is Anti-Mullerian Hormone (AMH)

"The AMH is a hormone produced by the granulosa cells of the early developing antral follicles." These are the immature eggs from their 'dormant' state and develop into mature eggs. As a woman runs out of eggs, the number of these small antral follicles decline in number and as a result the serum Anti-Mullerium hormone falls. This is why serum Anti-Mullerian hormone testing is a good estimate of residual egg number.

The test gives us some insight into the remaining quantity of eggs and number of fertile years you may have, but it doesnt provide the number of eggs you have left.

What is Ovarian Reserve

Ovarian reserve is the term used to describe the number of good quality eggs left within a woman's ovaries. "A woman is born with approximately 1 million eggs and over her reproductive life the egg numbers will decline as they are lost through natural attrition and ovulation. Only approximately 400 eggs are lost through the process of ovulation."

During a woman's reproductive years the number of eggs we have left continues to fall, and after the age of 35 it falls at an accelerated rate. By the time a woman hit menopause which occurs on average at the age of 51 for the average Australian women, there are less than 1000 eggs left. Actually they are less like eggs and more like ovarian dust. Obviously the more eggs there are left, the more likely a woman is, all things possible being equal, to conceive.

The AMH  test alone can be used as an initial screening test for ovarian reserve. Women with diminished ovarian reserve have diminished fertility and an increased risk of miscariage. It is important to identify these women early on so that they can make decision on when to start having a family and when to access assisted reproductive technology if required.

Who should have the test?

Women like me who are absolutely paranoid? :P

Women who have been trying to conceive for over 6 months and want to check.

 

But generally women under the age of 38 years who are considering delaying pregnancy for social/personal reasons are the best candidates for ovarian reserve testing. Women who are identified as having diminished ovarian reserve can then bring forward their plans for having children and boost their chances of success. 

Women older than 40 years are not ideal candidates for ovarian reserve testing as they will all have diminished ovarian reserve. Furthermore, irrespective of the results of the AMH test, it would be unwise to ever advocate a women of 40 years and older to delay pregnancy. 

Women who considering IVF or other fertility treatments, a low levels of AMH could indicate a potentially poor response to IVF. Conversely, a high level may indicate an exaggerated response to th IVF medication. 

The other group that is well suited to AMH testing is those who are at increased risk of diminished ovarian reserve. These would include women with a family history or ovarian failure, autoimmune disease, chemotherapy or previous surgery to the ovaries.

I am glad I did the test regardless. My results came back normal which is 20.6. Those of you who are concerned about menopause or are thinking in delaying motherhood, I would strongly recommend to have an AMH test. 

AMH levels fluctuate very little during the menstrual cycle and therefore can be taken at anytime during your menstrual cycle. Note that the AMH test is not covered by Medicare. Therefore, the cost of a single test is $65 in IVFAustralia. 

I had to get my GP to write me a referral to IVFAustralia for an AMH test. I did mine in their Sydney branch and the results were sent to my GP.

It is also important to remember that while this test can indicate how many eggs you have left, it can't tell the quality of those eggs. So as useful as the AMH test is for those like me who are seeking information about starting a family, its important to bear in mind that this test is but one component of what should be a complete and thorough fertility assessment.