As a reproductive endocrinologist, I meet with countless couples who are surprised that they are having trouble getting pregnant. While their reactions and emotions are often similar, the couples do not fit one mold. They can be in their 20s, 30s or 40s; they can be healthy and fit or obese; they can be any race or religion. It is important for us as doctors to remember and to communicate to our patients that we cannot determine a patient’s reproductive health by appearances.
At my practice, we determine a woman’s level of fertility based on her medical history, age, basal antral follicle count, day 3 follicle stimulating hormone (FSH) and anti-mullerian hormone (AMH) level. Collectively these factors give us a complete picture of a woman’s reproductive health; however, AMH testing is the most recent ovarian reserve test and generally considered to be the most reliable.
AMH levels are measured by a simple blood test. Because AMH tests measure the protein as it secretes in to ovaries, it is not affected by estrogen and other hormones, and can therefore be tested at any point in the menstrual cycle and even in patients on birth control pills levels. Healthy women under 38 years old typically have AMH levels of 2.0 - 7.0 ng/ml.
Women with low egg/ovarian reserve have several options. If they are considering having a family, they may decide they are ready to start trying. If they are not ready to start a family, they can freeze eggs for the future. Alternatively, they can continue to monitor their egg reserve or seek further testing to get a better understanding of their reproductive health. All of these options benefit from early detection; the earlier we know if there is an issue, the more we can help.
While it is true that the likelihood of getting pregnant decreases dramatically after 35 years of age, any woman in her reproductive years can be affected by infertility. Women should be able to get pregnant within a year of trying. If they have not, then they should see a fertility specialist. If they are over 35 years old, they should see a reproductive endocrinologist after trying for six months.
Reproductive Medicine Associates of Connecticut is hosting two events in October with free AMH testing. Each event will include an opening presentation about infertility, including an explanation of the AMH test. Attendees will then have a blood test taken and a nurse will call with the results within 10 business days. The events are being held:
RMACT Stamford, CT Office
1290 Summer Street, suite 3200
October 11, 2012 at 6 p.m.
RMACT Danbury, CT Office
67 Sand Pitt, suite 300
October 11, 2012 at 6 p.m.
We hope you encourage your patients to start thinking about their family plans in their 20s. And if they are in the Connecticut area, we hope to see them on October 11.