The average age of a first-time mother in Australia has gradually increased and is now 28. This delay in starting a family is due to a range of reasons, including careers, travel and other matters.
What it means, though, is that many women are having their first child well into their 30s, and unfortunately, the facts are that as a woman’s age increases, her fertility decreases, particularly after 35.
Females are born with their lifetime supply of eggs, which naturally declines gradually in quantity and quality from the age of 25 until being almost non-existent by the time of menopause.
So with this increase in maternal age, more women than in previous generations are experiencing fertility issues, often due to their declining ovarian (egg) reserve.
When investigating the cause of infertility in a couple, I look at a variety of factors that may be impacting on their ability to conceive. Checking a woman’s anti-Mullerian Hormone (AMH) levels is one such test that can help towards giving an indication of what is going on from a medical perspective.
The AMH or “egg timer” test, as some dub it, measures the blood’s AMH levels, which reflect the number of small follicles in a woman’s ovaries. These follicles enable reproduction by ensuring monthly ovulation (release of eggs).
Low levels of AMH in the blood are indicative of poor ovarian reserve and in many cases are therefore a useful marker of fertility.
However, it is important to note that many women who have low AMH levels still fall pregnant. It is therefore essential for this test to be ordered by gynaecologists and fertility specialists who are trained to interpret the results and explain them in detail to the woman involved.
When should a woman consider an AMH test?
A common question I’m asked is: “When should a woman consider having her AMH levels tested?” Below are three groups of women I believe could consider having an AMH test.
Young women wishing to delay childbirth
Women under the age of 35 who seek fertility advice because they want to delay childbearing may request testing of ovarian reserve.
Failure of IVF cycles in young women with low egg count achieved
Some young women respond poorly to stimulation unexpectedly. A low AMH level can sometimes be the reason for this and indicate why they are having a lower chance of success with IVF treatment.
Women at increased risk of low ovarian reserve
Women who have a family history of premature menopause, have had multiple operations on their ovaries or have undergone chemotherapy may be at risk of premature menopause or low future fertility.
Over the past few years, AMH has emerged as a marker for ovarian reserve as testing is reliable and inexpensive and can be done at any time of a menstrual cycle. However, it is impossible to entirely predict a woman’s chances of conception, so a normal result should always be considered cautiously in relation to future fertility.
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