Sunday, September 02, 2012

AMH Antimullerian Hormone Unreliable


If you have been on my list then you know what I think of AMH levels.  Despite what you hear or have heard they are extremely inaccurate at determining your fertility.  They have nothing to do with your supposed egg count and can improve based on what we have seen in our clinic.

However a new study has just shed more light on to why AMH levels are truly only a representation of the acronym for FEAR, i.e. False Evidence Appearing Real.

It has been shown that two common tests for AMH are actually inaccurate and it is being recommended that AMH is NOT a good test to use in the clinic to determine a patients fertility potential.  Here is the link if you want to see for yourself.  http://humrep.oxfordjournals.org/content/early/2012/07/09/humrep.des260.abstract

Lately I have seen doctors rushing patients into procedures based solely on low AMH levels saying they are out of time and every month they waste could be detrimental to their fertility. Since the only data that is consistent regarding AMH level being low is that you are less likely to respond to IVF meds and when AMH levels are significantly low you may not respond at all, I have a hard time supporting this recommendation.  Wouldn’t it make sense to help the patient prepare for a procedure to attempt to help them respond better than to start something straight away where they have such a minimal chance of it working?  One of my patients said it best when she said, “sometimes medical sense is very different from common sense”. 

I strongly recommend that if your AMH levels are out of the normal range which by the way is NOT adjusted for what is normal in your age category, then you take your blood tests to someone that can help you interpret them to see if they are optimal based on their fertility population of patients.  We have been looking at optimal levels based on our patients for the last 7 years. And have them work with you to prepare you for a procedure and optimise your chances of becoming pregnant naturally as well.

A recent patient did just that.  Her AMH was 1.3 and at 33 the doctors told her she was on the verge of menopause.  She didn’t feel her body was ready to deal with IVF at this point. After just a few months which is even quick on our program she was pregnant naturally.

I hope you spread the word about the unreliability of AMH to your friends on your forums, and even to your doctor by showing them this study because it is time that FEAR (false evidence appearing real) is not used to encourage people to make decisions that they otherwise wouldn’t make had they had all the relevant information to make that decision.