A simple ovarian hormone test performed before IVF can help predict the number of eggs that will be produced and help to fine-tune the dosages of gonadotropin hormones required for each woman. Select infertility clinics have been using this test for many years but a 2011 study is lending credence to the assay which may make it available to more women. The test may be a very valuable tool for helping to get IVF right the first time.
The test measures levels of an ovarian hormone called anti-mullarian hormone (AMH) which is thought by many to be a more accurate indicator of ovarian aging than the standard follicle-stimulating hormone (FSH) test in common use. When the ovaries are young and vibrant they produce good levels of AMH and as ovaries age they produce less reflecting their inability to produce as many healthy eggs.
The 2011 study by researchers at Warren Alpert Medical School of Brown University and Women's & Infant's Hospital demonstrated that testing antimullarian hormone (AMH) before IVF could predict the number of eggs that were produced in an IVF cycle. Lead researcher and co-author of the study Geralyn Lambert-Messerlain stated that;
"Clinicians can measure AMH before or during ovarian stimulation to counsel couples about their likelihood of success,"
The study measured the blood levels of AMH in 190 women aged 22-44 at the onset of the follicle stimulating phase of their IVF cycles. Women with AMH levels below 1 ng / ml which is considered low had an average of six eggs retrieved and about a quarter of them became pregnant. Women with hight levels (three times the lower levels) had an average of twenty eggs retrieved and three out of five were pregnant at six weeks.
The study is to be published in the American Journal of Obstetrics and Gynecology.
For many years I have encouraged my female clients to have their AMH levels tested - along with other ovarian hormones - and have found it to be invaluable in helping women to make better decisions about their fertility treatments. When AMH levels are found to be low reproductive endocrinologists are more likely to tailor an IVF cycle to the aging ovaries. IVF protocols such as the low-dose Lupron flare protocol and other protocols that avoid over-suppressing the ovaries are more likely to be chosen to help the ovaries to perform better. Higher doses of gonadotropins may also be used and a client may be more likely to choose a clinic that specializes in helping women with poor ovarian reserve to succeed.
When AMH testing - and other ovarian reserve tests - are skipped before fertility treatments the chance of an IVF cycle failing or being cancelled due to poor ovarian response may be increased. When prior AMH testing is not used the first IVF itself becomes a kind of ovarian reserve test: if the IVF is cancelled - or if a low number of eggs is produced - poor ovarian reserve may be diagnosed. The physician may then suggest that *next time* the IVF protocol will be changed to help their ovaries perform better. Testing before IVF can help you to get the right protocol first time and increase the chances of IVF being successful sooner, with less cost and heartache.
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ScienceDaily accessed June 9 2011