Ovarian Reserve Tests May Not Be a Good Indicator of Fertility

Every woman is born with a finite amount of eggs in her ovaries — about one to two million. 

As you get older, the number of eggs you have diminishes, so some women have turned to fertility tests to gauge the number and quality of eggs they have. However, recent research suggests these tests may not be as accurate or as effective as one would hope. 

One of the most popular tests is an ovarian reserve test, which measures the anti-müllerian hormone (AMH). Low levels of this hormone indicate lower ovarian reserve. 

To assess the link between AMH levels and fertility, a team of researchers decided to test whether low levels of this hormone were linked to infertility in women who were in their later reproductive years. The study, published in the Journal of the American Medical Association, involved 750 women age 30 to 44 who didn’t have a history of infertility. The average age of study participants was 33 years old and all of the women had been trying to get pregnant for three months or less. Researchers collected blood and urine samples from the women to gauge their levels of AMH, inhibin B and follicle-stimulating hormone (FSH) (high levels of FSH typically indicate that a woman has low ovarian reserve). Researchers tracked the women for a year to see if they got pregnant. 

They discovered that women with low AMH levels had an 84 percent chance of getting pregnant compared to a 75 percent chance of pregnancy in women with normal AMH levels. This suggests that reduced ovarian reserve isn’t linked to infertility — at least in these women — and that fertility tests that measure AMH levels may not effectively gauge how fertile a woman truly is. 

This news could be disappointing to many women who rely on these tests to learn more about their fertility and who make decisions about their reproductive health based on these test results. These tests can be costly, whether you use an at-home test kit or go to your doctor’s office and undergo blood or urine testing. Secondly, some women may make decisions about when to freeze their eggs based on these tests. If the results are inaccurate, a woman could be scared into freezing her eggs sooner than she should, and unwittingly undergo a very time-intensive, challenging and costly process when there was no need to.

On the other hand, these tests also could give women false reassurance that they have adequate ovarian reserve when they may not. As the study indicates, low levels of AMH didn’t correlate with a woman’s ability to get pregnant within a year. In fact, women with low levels of AMH had a slightly higher chance of getting pregnant (84 percent) than those with normal levels of the hormone (75 percent).

So what should women do if these tests may not be entirely accurate?

Age is a better indicator of fertility than these biomarkers, the study’s researchers say. If you are in your 30s and 40s and are trying to get pregnant and have no prior history of infertility, you may have a higher likelihood of getting pregnant naturally than you think. Still, it’s important to talk to your doctor about your reproductive plans and about your options. He or she can give you sound medical advice and let you know when and if testing may be necessary.  

However, you also should consider that the older you are, the longer it may take to get pregnant. Even if you don’t do an ovarian reserve test, it may be best to start trying to conceive as soon as you and/or your partner make the decision to grow your family.