Should you Rely on an Anti-Mullerian Hormone (AMH) Test Alone?

Much attention has been given to a study recently published in JAMA and in a New York Times article, on how useful anti-mullerian hormone (AMH) testing is in predicting fertility.  AMH is a hormone produced in the ovary – generally, the more AMH, the higher number of potential eggs a woman has. AMH levels can be determined by a simple blood test on any day of a woman’s menstrual cycle.   This test is typically done for patients who are having trouble getting pregnant to see how many eggs exist and to assess how many eggs could be retrieved during IVF stimulation.  An important but commonly overlooked point about the JAMA study is the women who participated had not been diagnosed with infertility.

For patients struggling with infertility, about 15 out of 100 people (15%), there is little doubt that AMH provides insight into the cause of infertility and helps tailor treatment for women trying to conceive.  Furthermore, when AMH is combined with other information, such as FSH (another blood test), AFC (an ultrasound test), age, prior attempts at conception, and other medical conditions, an infertility specialist can better assess your situation to customize your treatment.

The population studied in the JAMA article was the fertile population, which is the other 85 out of 100 people (85%) without a diagnosis of infertility.  Infertile patients were excluded from the study by design.  The JAMA study confirms AMH levels are not a definitive indicator of the likelihood of getting pregnant for fertile women– something many infertility specialists have suspected.

What if you have not been trying to become pregnant but want information that may be useful in getting pregnant?  The quick answer is there is no single blood test at this point, but you can still discuss AMH testing with your doctor or reproductive endocrinologist, a doctor specializing in reproductive medicine.

Without trying to become pregnant, there is no way of knowing if you are in the 85% of fertile people that may not benefit from the test versus the 15% of infertile people that may benefit from it.  This is like shaking a wrapped gift before you are supposed to open it to guess what’s inside.  If you are the type of person that likes to shake the gift before opening it, then you may also be the person that wants the AMH test even if you haven’t tried to become pregnant.

As infertility specialists, every member of the physician team at Reproductive Medicine Associates of New Jersey (RMANJ) is here to help you make the most informed decisions on your path to parenthood by combining multiple pieces of information, not just AMH testing alone. Consider it our gift to you!

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