Why Anti-Müllerian Hormone (AMH) Testing is Important

Female Fertility and the impact of age.
A female is born with all the eggs (oocytes) she will ever have, around 1 to 2 million.  As females age, there is a continual decline in the total number of eggs each month, and by the age of 25, a rapid decline in egg quality begins¹.  Age is an important factor in a female’s ability to conceive, and it is important to consider early if you want children at some time in the future and to understand what options are available if you are not ready right now.

Over the past five years, social egg freezing has more than doubled for several reasons, including delaying childbearing to focus on career and travel, the impact of COVID-19 lockdown and restrictions on social interactions, and waiting to form a relationship with the right partner. 

What is Social Egg Freezing?
Social egg freezing is the retrieval and storage of eggs (oocytes) of a healthy female for non-medical reasons, intending to preserve the eggs at an optimal reproductive age for use at a later stage of life.  From a purely scientific perspective, women could preserve their fertility (freeze their eggs) at around the age of 25; however, it is most common at age 35.8 years in Australia and New Zealand².
 
What is the egg collection process?
Egg collection is conducted during your natural cycle and involves hormonal stimulation over ten days to encourage multiple eggs (oocytes) to mature and be available for collection.  The process requires self-injection, blood tests, and ultra-sound to know the optimal time for collection.  Egg collection takes place in a day surgery setting with the person under a local or light general anesthetic and guided by ultra-sound to view the eggs for retrieval and takes around 10 to 20 minutes. 

Why should I freeze my eggs, and what is the best age to do it?
As your egg quality and quantity decrease as you age, and if you want to have children one day, you might consider egg freezing at your prime reproductive age, in your twenties. However, for many women that’s not the right time personally, for a number of reasons.  It is recommended to do it before you are 35, as your eggs decline rapidly after that, to give you the best chance of conceiving a baby in the future.

What do I need to know or do before freezing my eggs?
The first thing is to speak to a Fertility GP or your own GP about the reason for freezing your eggs, and they will recommend some simple tests that will prepare you for the next step, which is to see a Fertility Specialist.
Your GP should recommend the following tests:

• Hepatitis B, C and HIV
• Anti-Müllerian Hormone (AMH) - refer below for information about this test
• Antral Follicle Count – which can be measured using an ultrasound of the ovaries and to indicate how you may respond to treatment (must be conducted between days 5 to 9 of the menstrual cycle)

These tests can be ordered when you see a Genea Fertility GP or your own GP. You can book a Genea Fertility GP here.
To find out more, including the cost of social egg freezing, Genea offer a free consultation with a Fertility Advisor – either book via the Genea website here or call 1300 361 795.
 
What is AMH?
Anti-Müllerian hormone, or AMH, is produced by ovarian follicles and represents the ovarian reserve (number) of eggs.  AMH is produced by the follicles that contain developing eggs and, as a result, is reflective of the number of available eggs each month – and, in turn, the number of eggs remaining in the pool of eggs that the woman was born with. If there is a lower than usual number of remaining eggs (oocytes) for a given age, the AMH result will, in turn, be lower. 
 
Why is measuring AMH important for Egg Freezing?
AMH gives an indication as to how many eggs might grow with ovarian stimulation. The more eggs you can produce, the higher the number that can be retrieved in one cycle and frozen using vitrification, the best freezing technique.  Follicle stimulation hormone (FSH) is also used to increase the number of eggs and works directly on the ovarian follicles to stimulate multiple follicles to produce multiple eggs for collection in one cycle.  FSH will be used as part of your 10-day hormone stimulation.

Testing AMH levels will assist your Fertility Specialist in understanding your egg quantity, your ability to produce eggs and in managing your medication in the lead-up to egg retrieval and freezing, so you have the maximum number of eggs from one cycle and the best chances of falling pregnant when you are ready.
 
Talk to your GP or a Genea Fertility GP to discuss AMH testing today – call 1300 361 795 or visit Genea.com.au to book an appointment.
 
References:

1. Wunder, D. (2013). Social freezing in Switzerland and worldwide—a blessing for women today?  Swiss Medical Weekly. 2013 Feb 27; 143: w13746. Doi: 10.4414/smw.2013.13746
2. Assisted Reproductive Technology in Australia and New Zealand 2018, released September 2020. https://npesu.unsw.edu.au/sites/default/files/npesu/data_collection/Assisted%20Reproductive%20Technology%20in%20Australia%20and%20New%20Zealand%202018_0.pdf

Disclaimer: Please note that this is a Genea Group blog and as such information may not be relevant for all clinics. We advise that you consult clinics directly for further information. Please note that this is a Genea Group blog and as such information may not be relevant for all clinics. We advise that you consult clinics directly for further information.