One of my biggest bug bares is having so called specialists tell women that AMH (Anti Mullerian Hormone) levels alone are indicative of their ovarian reserve and having them freak out that they now have little, or no eggs left. Nothing could be further from the truth.
AMH levels alone ‘are not’ indicative of ovarian reserve. There is no test on this planet that can tell you how many eggs you have left. There never has been and there will probably never will be.
AMH levels are not a definitive diagnosis for ovarian reserve and their predictive value alone is very questionable. It just gives a ‘rough’ guide that someone may be a poor responder to Assisted Reproductive Therapies (ART) and that is it. Even then, you will often see women with low AMH levels still producing 5-8 eggs a cycle many times while doing IVF etc.
What has inspired my to talk about this, is that last year I had a friend come to see me and she told me she couldn’t have children because she had no eggs left. I found this quite disturbing and continued to ask how she had come to this conclusion.
What was most disturbing is that her whole basis for not being able to have children, was based around the fact that some ….ummmm… and I can’t really voice it any other way… but some “A-Hole” specialist had told her she can’t have children because she had low AMH levels.
No other investigations, no trial of IVF to see if she can respond and get eggs, just one lousy blood test.
This is so disgusting and such BS, they I couldn’t contain myself and had to sit this poor woman down and tell her the facts. Worse still this was from a Fertility Specialist who basically calls himself God and believes he is the best specialist here in the city where I live.
This idiot has basically had someone believe they cannot have children based on one single blood test. This is the sort of thing I see everyday and it shouldn’t happen. The saddest part of this story is that this person is no longer with us and tragically lost her life in a car accident. She never got the opportunity to try and have children all based on some egotistical horrible man who has no idea around the facts about fertility.
I always talk about this subject to other healthcare practitioners and as part of my education in my seminars. AMH alone “Is Not”… repeat “Is Not” indicative of ovarian reserve and nobody can tell you how many eggs you have left anyway. It is utter BS.
To get an “Idea” and I mean a “rough idea” of how well you may respond to producing eggs, AMH levels give us a “rough idea” or a pointer to “maybe” how many eggs you may have left, or if you will respond to fertility drugs. It is not a definitive diagnosis on its own.
To get a more accurate picture of Ovarian Reserve, there also needs to be other tests factored in too. All of these things I discuss when I evaluate someone as part of my fertility program and their initial consultation. Then after these levels and a special test is performed for 5 days, then we evaluate all these factors to basically give a rough idea how well a person will respond to produce eggs. Again this is not an exact, or not precise.
Then if it does look like the person is a poor responder, we put them through a stimulated cycle (basically an IVF cycle) and follicle track (check to see if they produce eggs and how many). Then we can truly evaluate a person for ovarian reserve.
But even if you do have low AMH levels, it does not mean you have a limited number of eggs. It means you might be a poor responder and not produce as many eggs. That is all.
High AMH levels are indicative of PCO/PCOS however and could also be signs of a granulosa cell carcinoma (which is what the test was originally designed to detect)
I have women with AMH levels less than 1 ( <1) still producing 5-7 eggs per IVF cycle, then go onto have a child, or several children with low levels like this.
Yet based on this rude, arrogant, obnoxious specialists evaluation, he would have told women with low AMH levels they can’t have children and many of them may have given up, despite the fact that they may have actually been able to have children. This makes me so upset.
AMH levels only give us a rough idea of how you will respond to fertility treatments and how many eggs you may produce. It is an estimate, or should I say “Guess-timate”
I see so many women come to see me who are freaking out after getting low AMH levels and then being told they have little, or no chance of conceiving, when actual fact they might.
Many of these ladies are also Dr Googling too, which is also spreading BS about AMH levels, just through ignorance and perception and lack of understanding of what these levels actually mean.
As someone with a Reproductive Medicine and Women’s Health Medicine Specialisation, please let me tell you the fact and that AMH levels only give us a small, inaccurate insight into what is going on in the body.
AMH levels are not a diagnostic tool on its own and it is never meant to be a diagnostic on its own. There are many other tests that need to be done first and along side this to come to a conclusion of low ovarian reserve, or being a poor responder. Sure, some women may have low AMH levels and after all the testing, we actually do find out they are a poor responder, but not all women will be poor responders.
I hope this story helps those who might have been given the same diagnosis my late friend was given. This is why everyone should get a second opinion, or a third, or even a 5th, when it comes to fertility treatment.
The fertility profession is not well regulated and there are a lot of underqualified people out there saying they are fertility specialists, when they are not. There are also a lot of “A-Holes” with no bedside manner out there and telling people lots of things that just aren’t true as well.
Sorry for having to use some swear words, but as someone with a Reproductive Medicine & Women’s Health Medicine Specialisation, and who knows the facts, I need for everyone to be aware of this information.
Take care everyone and I’m here to be a voice for anyone wanting have a baby and I’m here to keep the bastards honest as well.
Dr Andrew Orr
-Women’s and Men’s Health Advocate
-No Stone Left Unturned