Women are born with their lifetime supply of eggs which naturally decline gradually in quantity and quality from the age of 25. So what if you could take a test to discover how many you have left?
By Dr Marcin Stankiewicz, Medical Director of City Fertility Centre, Adelaide
The average age of a first time mother in Australia has gradually increased and is now 28 years of age. This delay in starting a family has happened due to a range of reasons including careers, travel and other matters.
What it means though, is that many women are having their first child well into their thirties, and unfortunately, the facts are that as a woman’s age increases, her fertility decreases, particularly after the age of 35.
Females are born with their lifetime supply of eggs which naturally decline gradually in quantity and quality from the age of 25, until being almost non-existent by the time of menopause.
So with this increase in maternal age, more women than in previous generations are experiencing fertility issues, often due to their declining ovarian (egg) reserve.
When investigating the cause of infertility in a couple, I look at a range of factors that may be impacting their ability to conceive. Checking a woman’s anti-mullerian hormone (AMH) levels is one such test that can help towards giving an indication of what is going on from medical perspective.
The AMH test or as some dub it “egg timer” test measures the AMH levels in the blood which reflect the number of small follicles present in a woman’s ovaries. These follicles enable reproduction by ensuring monthly ovulation (release of eggs).
Low levels of AMH in the blood are indicative of poor ovarian reserve and in many cases is therefore often a useful marker of fertility.
However, it is important to note, that many women who have low AMH levels still fall pregnant. It is therefore essential for this test to be ordered by gynaecologists and fertility specialists who are trained to interpret the results and explain them in detail to the woman involved.
When should a woman consider an AMH test?
A common question I get is: “When should a woman consider having her AMH levels tested?” Below are three groups of women I believe could consider having an AMH test.
- Young women wishing to delay childbirth
Women under the age of 35, who seek fertility advice because they want to delay child bearing may request testing of ovarian reserve.
- Failure of IVF cycles in young women with low egg count achieved
Some young women respond poorly to stimulation unexpectedly. A low AMH can sometimes be the reason for this and indicate why they are having a lower chance of success with IVF treatment.
- Women at increased risk of low ovarian reserve
Women with a family history of premature menopause, women who had multiple operations on the ovaries or have undergone chemotherapy may be at risk of premature menopause or low future fertility.
Over the past few years AMH has emerged as a marker for ovarian reserve as it is reliable, the test is inexpensive and can be tested at any time of a menstrual cycle. However it is impossible to entirely predict the future of a woman’s fertility chances and a normal result should always be considered cautiously in relation to future fertility.
This article is provided by Dr Marcin Stankiewicz, Medical Director of City Fertility Centre Adelaide and has been reproduced with permission.