AMH - Why every woman should know her AMH level

A simple blood test measuring a hormone called Anti- Mullerian Hormone (AMH) is the best test currently available to estimate ovarian reserve. What this means is that this blood test can estimate your age at menopause (ie when your eggs have run out) and give you a reasonable idea of your reproductive time remaining. So if you have an AMH test performed in your 20s and it is an average result and sits on the 50th centile, then this means that your menopause will be at around 51 and your reproductive window is likely to close at about 41. How useful is that to know? You can know plan to freeze eggs if you knew that your reproductive lifespan was limited. Also super informative for women who may have had cancer treatment or ovarian surgery and are wondering how this may have impacted on their eggs.

The AMH blood test can be done at any time in the menstrual cycle, during pregnancy or on the pill. In New Zealand the test is not funded and Fertility Associates charge $75 in Auckland and slightly more outside of Auckland because of courier fees.

AMH is also useful in other scenarios. It allows IVF doctors to predict the right dose of drugs in an IVF cycle and therefore make IVF safer by reducing the chances of ovarian hyperstimulation syndrome. AMH levels are also higher in women with polycystic ovary syndrome (PCOS) and in the future may be used to diagnose PCOS.

AMH may also reflect egg quality. Our own data at Fertility Associates based on more than 2500 cycles, show that if your AMH is low (less than 3 pmol/l) then your take home baby rate on our IVF programme is significantly reduced compared to women with an AMH of 7 or more.
So really why would you not have an AMH test?

You can find out more from the PDF on our website http://www.fertilityassociates.co.nz/Downloads/0313-AMH-info-card-A5_LR.aspx 

Please choose one embryo at a time

At Fertility Associates we are thinking about becoming the first IVF unit in the world to only replace 1 embryo at a time no matter how old the patient nor how much treatment they have had previously. We perform over 3000 embryo transfers a year across our four clinics and about 20% of these cycles involve a double embryo transfer. Whilst twin rates have fallen from over 20% a few years ago to now about 8% of all of our pregnancies, we would like to see that rate fall further.

This is an ideal time to make this recommendation as freezing of embryos has become a very robust process, which means that one embryo at a  time gives the same overall chance of a baby as having two embryos at once.

Twin pregnancies have a higher rate of stillbirth, cerebral palsy and any degree of handicap in the babies. Twin pregnancies are also associated with increased maternal complications as well as relationship break ups.

Even when two embryos are replaced and  a singleton pregnancy results, the outcome from that pregnancy is not as good as when a singleton embryo transfer occurs.

I would like all of our patients to think about the risks to themselves and their children and to choose to replace 1 embryo at a time.

Information on Twin or Multiple pregnancies and the risks associated with it, can be found on our website in the Avoiding Twins PDF under Fertility Facts. http://www.fertilityassociates.co.nz/Resources/Fertility-Facts.aspx