Kolkata: A new fertility test known as AMH test is fast becoming the finest tool for specialists in India to determine the fertility potential of a woman. The Anti–Mullerian Hormone test –a blood test, is useful to predict ovarian response to stimulation which corresponds to the ovarian reserve of a woman.
Until now, Arundhati like any woman in her early 30’s never bothered about how many more years she can wait to have children. But she got a wake-up call when a test conducted by her fertility specialist told her that she had run through most of her eggs. Taken aback, Arundhati was clueless on how this could be possible and wished she knew about this sooner.
Most women do not appreciate the true effect age has on their fertility. Ovarian ageing is different from biological ageing. Ovarian reserve is defined as the number of eggs a woman has in her ovaries. Until now, a woman’s ovarian reserve was checked using methods such as Follicular-stimulating hormone (FSH) test, basal estradiol and antral follicular count and now measurement of blood levels of a hormone called as AMH. FSH levels and basal estradiol levels are measured using a blood test between day 2 – 5of a woman’s menstrual cycle, as it can fluctuate within a month and also from month to month. On the other hand, AMH concentrations fluctuate very little during the menstrual cycle and therefore a blood sample can be taken at anytime on any day. Experts recommend this test for any woman who is over 30 and wishes to postpone childbearingbut eventually would like to plan pregnancy. If her score is low, she might wish to re-consider her decision. If it’s normal, she can postpone childbearing but repeat the test at yearly intervals to assess if there is drop in AMH levels.
Dr. Rohit Gutgutia, Clinical Director, Nova IVI Fertility Kolkata said, “Women are born with about 1 million eggs. Egg quantity and quality declines with age but the decline isfaster in the late 30’s and early 40s. Normally there is a slow decline in the number of viable eggs in the ovaries over time, however a small number of women have a faster rate of egg loss. Low ovarian reserve would correspond to fewer eggs and therefore fewer chances of having babies. AMH is a hormone secreted by cells in developing egg sacs. As the number of these egg sacs fall over time, the level of AMH made also decreases.”
“Women with a family history of early menopause, a history of surgery to the ovary or severe endometriosis, and those who have had previous chemotherapy or radiation for cancer or will be undergoing treatment for cancer, are all at increased risk of early diminished ovarian reserve”, Dr. Rohit added.
However, vast majority of patients with diminished ovarian reserve have no clinical risk factors and these women will often have normal menstrual cycles. The only way to identify these women is with the use of an AMH assay. AMH can give useful informationabout the quantity of eggs mainly. Enough evidence that number of eggs retrieved during Ovum Pick Up procedure during IVF treatment is positively correlated with pregnancies, so lower number of eggs with conventional ovarian stimulation would mean lower chances of success.
With an increasing number of women delaying child-bearing, it is essential for them to check their chances of getting pregnant, for it can be much lower than they would like to believe. This novel marker can play an important role in helping women in managing their health and fertility issues.
Story: Siddhartha Sarkar