17.5% of the adult population worldwide is currently struggling with infertility, according to the World Health Organization (WHO). With a growing awareness around fertility and its importance in relation to age, more and more women want to get a deeper understanding of the state of their reproductive health. Whether you’ve been trying to conceive for a while or are only just starting to look at your fertility levels, you may be considering trying the Anti-Mullerian Hormone (AMH) test. With the AMH test widely advertised online as a straight-forward at-home fertility test, it’s no wonder that it’s one of the most popular fertility tests on the market. But what is it? And is the AMH test alone enough to give you an accurate understanding of your fertility?
What is the AMH test?
The AMH test is ultimately a type of fertility test for women. It is used to help gauge fertility levels. The AMH test is a form of hormonal blood test which can be carried out at any stage of the menstrual cycle. With the way the AMH test is advertised online (as a way to determine your fertility with one single test), it’s no surprise that women and couples are making decisions about their fertility based on their AMH test results, but is this the right way to go?
How is AMH relevant to fertility?
Anti-mullerian hormone levels are used to give an indication of your ovarian reserve. This is the amount of eggs left in the ovaries. Whilst it can’t determine exact amounts, it can provide a reasonably accurate estimate of where your levels are in comparison to what is considered normal for your age. Low levels indicate poor ovarian reserve and that it may be more difficult to conceive (although this is not always the case). High AMH levels can indicate certain health conditions that impact fertility, such as Polycystic Ovary Syndrome (PCOS).
Why the AMH test alone isn’t enough to give a good indication of fertility
The issue with the AMH test is not that it’s inaccurate, it’s that those test results when used alone, without wider consideration of the many other factors involved with an individual or couples fertility, can be highly misleading. The risk is that an individual can take an at-home AMH test, get a ‘normal’ result, and assume that there is nothing else affecting their fertility. No matter how good your AMH levels, they are just one part of the larger picture. An AMH test will not reveal other physiological issues such as scarring in the uterus or fallopian tubes, that could be preventing you from conceiving. When used alone, the AMH test can give false hope, and potentially mislead individuals into thinking that everything is ok, when they may still have a potential fertility issue. It also doesn’t take into consideration lifestyle issues that can play a role in infertility, such as weight; toxins exposure; diet; smoking; and alcohol consumption. These are all important considerations that are best discussed with a fertility consultant.
At-home AMH tests often use fingerprick lancets to take the blood sample and these come with their own challenges; such as drawing enough blood; not contaminating the sample; getting it back to the lab in good time. It’s often preferable to have your AMH test at a clinic where a nurse will ensure that the test is carried out correctly, in sterile conditions.
Are there factors that influence AMH levels in the body?
AMH levels may not always give you an accurate understanding of your fertility levels. It’s important to keep in mind there are multiple factors that influence the AMH levels in a woman’s body. Advancing age tops this list. As discussed above, AMH levels indicate the number of eggs available in the female ovarian reserve. However, what many people don’t know is that for women over the age of 30, this number can be significantly lower. Research has shown that a woman may have as many as 2 million eggs at the time of birth, which may drop to 400,000 by adolescence, and to just 25,000 by the age of 37. This means that the chance of getting pregnant often decreases with age.
In addition to the above, another important factor which influences the AMH levels in the body is underlying health conditions. Problems such as PCOS (Polycystic Ovarian Reserve Syndrome), endometriosis and other autoimmune diseases can significantly alter the levels of AMH in the body. Women diagnosed with PCOS may have higher levels of AMH as a result of increased antral follicles in the ovaries. Similarly, women with endometriosis or autoimmune issues may have lower levels of AMH due to ovarian dysfunction. This makes AMH testing an unreliable standalone factor, requiring further fertility tests.
When taking into account lifestyle factors, genetic predispositions and undiagnosed health conditions, an AMH test is unlikely to reveal the full picture. A fertility expert can overcome this issue by recommending additional fertility tests, enabling them to get a better understanding of your fertility, and putting them in a better position to treat fertility issues.
Can I get an AMH test on the NHS?
Another question that many couples ask: Can they access AMH testing services via the NHS? At the time of writing this article, unfortunately the NHS doesn’t fund AMH testing. However, if this is a test you and your partner would like to undergo, then you can fund it privately by visiting a private fertility clinic. Thankfully, most fertility clinics now offer highly advanced treatments and accept multiple types of payment options, including payment plans, so you and your partner can remain worry-free on your fertility journey.
Your wellbeing
We understand that involuntary childlessness can have a huge impact, both emotionally and socially. While the road may seem long, it is important to remember that there are many different fertility tests and assisted reproductive technologies available to help improve your chances of getting pregnant. Getting help from an experienced fertility doctor can help you understand your reproductive abilities as a couple, allowing you to make informed decisions about your pregnancy journey.