Quality and quantity of egg supply is a leading cause of infertility in women – so should you have your egg supply tested?

By Dr David Wilkinson, Medical Director, City Fertility Centre

There are two main reasons why someone would want to test their egg reserve: to test their fertility status or to test their response to fertility medication.

The commonly used test for this is the Anti-Mullerian Hormone (AMH) blood test.

The AMH hormone is produced by the small follicles in the ovary, which have not yet begun to develop into mature eggs or ova. These early developing follicles are called antral and pre-antral follicles.

The level of AMH is a measure of eggs in the ovaries (or the ovarian reserve).

Interestingly, the amount of AMH in the blood usually remains constant until the age of 25 then begins to decline. A steady decline of AMH occurs from the age of 35 until it becomes unmeasurable at menopause.

AMH testing for fertility status

Your doctor may recommend an AMH test if:

• you are wanting to delay childbirth and are under 35 years old;
• you having ongoing trouble falling pregnant;
• you are concerned about conditions that may have an impact on your fertility like a family history of premature menopause, multiple operations on the ovaries, chemotherapy, endometriosis, or PCOS.

AMH testing for response to fertility treatment

If you are undergoing fertility treatment your specialist may choose to do an AMH test to predict ovarian response to fertility medication and helps in deciding the dose of medication to be used.

What can the results indicate?

A low ovarian reserve result may indicate:

• it is better not to delay starting a family
• depending on situation and age, that further assisted fertility methods should be considered
• if already undergoing treatment,  may call for a larger dose of fertility medication.

A high ovarian reserve level may indicate:

• polycystic ovaries

About the test

The AMH blood test can be performed at any time throughout the menstrual cycle.

It may be performed in conjunction with an antral follicle count (simple ultrasound) as a predictor of ovarian reserve.

An AMH test is a good snapshot of current ovarian reserve. However it is recommended to treat ‘normal results’ with caution and ongoing monitoring is wise as AMH levels decline at predictable rates.

Patients must also remember that egg reserve levels are only one of the many factors that can impact fertility.

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.

It is important to note that many women who have low AMH levels still fall pregnant.

This article was written by Dr David Wilkinson, Medical Director at City Fertility Centre, and has been reproduced with permission.

Got more fertility questions? Contact City Fertility Centre.