What do ovarian reserve tests really tell you, and do you even need one?

 

By Dr. Nazaneen Homaifar

“Ovarian reserve” is a term that takes into account that a woman’s ability to get pregnant is determined by the number and quality of her eggs. 

Anti-Mullerian Hormone (AMH) is a blood test that helps evaluate ovarian reserve. It has also been advertised as a way to tell a woman “how fertile she is.” However, multiple studies show that AMH doesn’t correlate with how likely you are to get pregnant. Getting pregnant depends on many different factors, and AMH does not assess egg quality or the quality of the ovaries.

One study tracked 981 women aged 30 to 44 years. The women had their ovarian reserve tested using three hormones (AMH, FSH, and inhibin B) and were followed for a year. The study showed that there was not a correlation between a woman’s ovarian reserve and her ability to conceive, and that a low ovarian reserve was not associated with reduced fertility. The researchers concluded: "These findings do not support the use of urinary or blood FSH tests or AMH levels to assess natural fertility..."

"Ovarian reserve tests run the risk of giving women an inaccurate impression of their future chances of having children."

Megan Thielking, Stat News

Here's when AMH and other ovarian reserve tests are useful: If you are undergoing egg freezing or in-vitro fertilization (IVF), your doctor will order a blood test for AMH, Follicle Stimulating Hormone (FSH), and other hormones. They may then use these results to determine the dosing regimen required to stimulate your ovaries to produce the best response to your IVF cycle as possible.

So given the chance, should you test your AMH level? It depends on the context. With the guidance of a trained fertility specialist, it could be valuable. But if you’re not actively trying to get pregnant, these tests results don’t tell you much, and could lead to unnecessary stress, or worst yet, false reassurance. When it comes to your reproductive health, information is power. We are committed to supporting you with the most evidence-based information to help you make informed decisions on your pregnancy journey.