21st January 2019
We fundamentally believe in the importance of tackling myths and misinformation about fertility (that sadly is rife on the internet). That’s why our approach, product and tests have all been developed by leading fertility and gynecology Doctors. There’s been a lot of speculation about the role of AMH in fertility hormone tests, our fertility specialist Dr Linda Farahani blogs on why it’s important to have the whole picture, and importantly what fertility tests can and can’t tell us.
The first point that is important to make – is that there is no absolute predictor of fertility.
Fertility tests will not tell you if you are infertile. One in five couples will experience unexplained infertility, and for some of them their fertility tests will report no problems at all.
Fertility is complex and we still have a lot to learn, however the science is developing and testing your fertility hormones can flag important issues if you’re planning to get pregnant. This includes:
- Your egg reserve, including the potential of premature ovarian insufficiency
- Whether you are ovulating regularly
- Reproductive health problems like PCOS
- Thyroid problems that can significantly impact your ability to conceive
- Whether you are likely to hit the menopause before or after the average
- Your potential response to IVF drugs
- Your general hormone health – eg. whether prolactin is causing irregular cycles
There is a lot of misinformation about the value of these tests, and what hormones you should and shouldn’t test, in this blog I set out the facts about AMH.
What is AMH?
You are born with a certain number of eggs that decline over time. Your eggs live in little fluid-filled sacs called follicles that are in your ovaries. AMH is a hormone released by these follicles and therefore this hormone is a good reflection of the number of eggs you have.
Why you shouldn’t test AMH on it’s own
It’s important to not just test AMH on it’s own. In fact, you need to look at your fertility hormones in context. Fertility hormones are complex, and you can’t derive conclusions from looking at one of them in isolation. This is why we test a panel of six fertility hormones.
It’s particularly important to look at your AMH in the context of a hormone called FSH. FSH is released by the pituitary gland in the brain. It’s job is to tell the ovary to develop a follicle (and by extension an egg) every month and also stimulates the follicles to produce oestrogen. If this hormone is within normal range, this is a good indicator that the pituitary gland and ovary are working normally and that you have a good number of eggs. This hormone rises when there are fewer eggs because the body needs to “work harder” to ovulate.
Just looking at AMH or just FSH means you miss important flags. For example you could have a normal FSH but a high/low AMH or a normal AMH and high/low FSH. Just testing one of these hormones could mean the test fails to pick up the potential for PCOS, how you might respond to IVF drugs and reduced ovarian reverse.
Why your egg reserve is not indicative of your ability to get pregnant naturally
It’s important to remember that having your levels of AMH and FSH are not indicative of your ability to get pregnant naturally. Your AMH and FSH are indicative of your egg reserve, but even if your results indicate a low egg reserve as long as you are ovulating each month you still have the potential to conceive naturally. This has been confirmed in research studies.
Just because AMH isn’t an indication of your ability to get pregnant naturally, it doesn’t mean it can’t offer a lot of valuable information about your hormone health when taken in context of the other hormones.
What can you learn from AMH
- High AMH levels can indicate PCOS – if you know this you can take proactive steps with your Doctor to balance your hormones and make a plan
- Taken in context of your FSH, it’s a good indicator of your egg reserve and fertility potential and can help you to plan when you start trying to conceive.
- Whether you’re likely to experience an early menopause (see research study here) – again if you know you’re likely to hit the menopause early than average and you want children, you can plan ahead
- Whether you’re likely to have a good response to IVF drugs – if your AMH is less than , some fertility clinics will not offer IVF
We hope this has answered some of your questions about the role of fertility hormones. Any questions please do reach out, and one of our fertility specialists will get back to you – we’re here to educate you on the options available to you.
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