Research indicates that ovarian reserve testing may not be a good predictor of fertility – Tucson IVF clinic
Ovarian reserve testing has been a mainstay of fertility treatment for years. However, a recent study conducted by researchers at the National Institutes of Health (NIH) may call this practice into question. The study indicates that ovarian reserve testing may not be the best predictor of outcomes. What might this study mean for you?
What is ovarian reserve testing?
The ovarian reserve is the number of eggs remaining in the ovary. A baby girl is born with all of the eggs she’ll ever have, because the ovary doesn’t make new eggs during a woman’s life. As a woman ages and an egg is ovulated each month, the number of eggs remaining slowly declines. A number of different tests are used to try to measure a woman’s ovarian reserve.
One test measures levels of Anti-Mullerian hormone (AMH) in the blood. This hormone is secreted by cells in developing follicles in the ovary. As the number of eggs in the ovaries declines, there will be less AMH in the blood. This happens because the pool of immature eggs is smaller, and so the number of eggs that begin the process of development is also smaller. (Each month, several follicles begin the process of development, although usually only one of these will complete this process and be ready for ovulation.)
More about the recent study
The study enrolled women ages 30 to 44, who had no known medical cause of infertility (such as PCOS) and who had been attempting to conceive for three months or fewer. The women’s AMH levels were tested. Their levels of FSH, a hormone linked to fertility, were also tested. (As women approach menopause, the amount of FSH secreted by the ovary in the days leading up to ovulation generally increases.) The researchers then followed the women for a year to see if they were able to conceive naturally.
The results surprised many in the infertility community. There was no significant difference between the rates of conception in those with low levels of AMH and those with normal levels. Similarly, rates of conception didn’t differ significantly in those with normal levels of FSH and those with high levels. In other words, neither the AMH test nor the FSH test was predictive of fertility.
What does this mean?
This study indicates that young women don’t need to worry about their potential fertility based on an AMH test. When a woman has a low result on an AMH test, she often begins to worry about her fertility. She may believe that her chances of becoming a mother are low, and she may feel pressured to start trying right away to have kids, whether or not she feels ready. The results of this study suggest that such worry is unfounded. A low result on an AMH test doesn’t mean that a healthy woman is likely to have trouble conceiving.
Ovarian reserve testing may measure the number of eggs remaining in a woman’s ovaries, but doesn’t measure the quality of those eggs. Because a baby girl is born with all of the eggs that she’ll ever have, the eggs age along with her. In general, the eggs will start to degrade in quality as she gets older. Some of them will become incapable of successfully developing into a baby. This issue of egg quality could help to explain why AMH testing doesn’t predict the response to IVF. An AMH test only measures the quantity of eggs, but not the quality.
Is it time to visit a fertility specialist?
If you’d like to have a baby, there’s no need for any testing before you start trying to conceive. If you’re under 35 and have been trying to conceive for a year without success, then it’s time to visit a fertility specialist. If you’re 35 or older, then you should visit us after six months of trying to conceive.
Reproductive Health Centers is a leading Tucson IVF clinic and fertility specialist. If you’d like expert advice in a compassionate environment, Dr. Hutchison and our staff would love to meet you. Please contact our office to schedule your appointment.