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Get Your Baseline AMH or Anti-Mullerian Hormone Level Test

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A blog by Jenn Nixon, April 25th, 2016

Recently, the state of Oregon implemented a new initiative aimed at encouraging an open dialogue between doctor and patient about reproductive plans. “One Key Question” focuses on having doctors ask, “Would you like to become pregnant within the next year,” during each medical visit whether it’s an OB/GYN or a Primary Care Physician.

If the patient says yes, preconception planning and prenatal counseling are offered as a means to encourage a healthy pregnancy. If the patient is not planning on becoming pregnant, the dialogue focuses on preventive measures such as birth control. If the woman is unsure about her future family plans, the doctor will suggest using contraception until a decision is made. The goal is to support women in their reproductive health, whether preventing an unplanned pregnancy or planning for a healthy one.

This initiative is long-overdue, but a much needed solution to the lack of future reproductive conversation between doctor and patient. But it can’t just end with, “here’s some birth control, see you next year.” The conversation needs to continue with, “when do you plan on having children?”

A 28 year old who doesn’t plan on becoming pregnant until she’s 35, needs to be aware of the decline of fertility with age. While 35 is young by societal standards, egg quality and quantity have already begun to decrease. At birth, a female has over 1 million eggs, but once she reaches puberty only 300,000 remain. When she is ready to try for a baby, it’s not just how many eggs she has left that matter in her fertility success, it’s also how well her eggs have aged.

Testing for AMH or Anti-Mullerian hormone level is an easy way to determine a woman’s ovarian reserve and is a good indicator of future reproductive success. If ovarian reserve is low, this knowledge can allow plans to be made ahead of time to either freeze eggs for future use or prepare for an alternate path to parenthood. This test is rarely used in standard healthcare monitoring, but is so simple and inexpensive to have done.

We look to doctors to help us make good decisions about our healthcare and the subject of fertility needs to be a part of that, but the responsibility doesn’t just lie with our physicians, we as patients need to be our own advocates. Go to appointments prepared to speak about your health concerns and future plans. It will go a long way in advocating for your best care.

This step that we are taking toward an honest fertility conversation is something I hope other states will be a part of. While I applaud Oregon for their wonderful initiative, I hope that the discussion about future fertility planning can continue to grow with each patient that is asked.

Comments (4)

Yes, but at 41 despite having an AMH of 2.9 they still pushed me towards IVF (despite the fact that I had no issues conceiving, had a child already, but had suffered a miscarriage). Fortunately we got pregnant again (and successfully) on our own soon after - if you are still fertile in your early 40s, the fertility clinic only has one answer for you, regardless of your AMH, and that is IVF.

Hi True,

It sounds like you need a second opinion! There are a handful of clinics in the United States that will allow a woman in her 40s to cycle with IUI, or do mini or natural cycle IVF with her own eggs. However, when a clinic recommends IVF to you, it is because based on statistics, you will have better success with IVF. They also don't want you to waste your money on other treatments which may total more than IVF in the long run.

Good luck!

Thanks, Kim! In my case, the right answer would have been, you don't need any treatments right now (assuming your miscarriage panel checks out) - come back if you are not pregnant in 6 months or a year. But nobody dares to say that to a 40 year old...

It's amazing how many women call FertilityAuthority for a doctor's appointment just for a baseline health reading of their AMH levels and discover they have an issue. We encourage everyone to ask for this test at their next appointment and if your levels indicate premature ovarian aging - call FertilityAuthority for information on Egg Freezing or a Fertility Doctor recommendation.

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