How fertile are you?
A diagnostic test helps women understand fertility levels and plan their pregnancies, writes Meera Murugesan
THE pitter-patter of little feet is always much anticipated. A baby signals hope, joy and marital bliss but infertility can hamper this beautiful dream and result in significant emotional stress in a relationship. Understanding fertility is therefore an increasingly important subject for every couple so they can plan and prepare for a pregnancy.
One easy way to access this information is by using an AMH test. It is a simple blood test which indicates a woman’s fertility. Blood levels of the Anti-Mullerian Hormone (AMH) are used as a marker of a woman’s ovarian reserves (remaining supply of eggs available for fertilisation) — an important consideration for women who are either planning for pregnancy or struggling with infertility.
Prior to the introduction of AMH testing, the most conventional female fertility test involved an invasive trans-vaginal ultrasound procedure. The AMH test is far more convenient by comparison, cutting out both discomfort, waiting time and confusion, as women can request a test from their physician at any time.
Whatever the reason for the delay, they may still want to experience motherhood, and the AMH test helps them match their career and parenthood goals.
Dr Eeson Sinthamoney
THE BIOLOGICAL CLOCK
As the trend is moving towards conceiving at a later age, the need to ensure women understand their chances of becoming pregnant is crucial, as this knowledge will allow them to engage in well-informed family planning.
Dr Eeson Sinthamoney, president-elect of the Obstetrics and Gynaecology Society Malaysia (OGSM), says it is widely believed by the professional community that the infertility rate has increased. Women are born with around two million eggs and these continue to decrease throughout their lives.
The AMH test acts as a measure of how many eggs they have left and therefore how many fertile years remain for them, and their doctor can then advise them on how to best plan parenthood.
“Over the past five years, I have seen more and more women in their early 30s come to me to find out how they can plan ahead, so that if they decide to delay parenthood, their chances are not diminished. Whatever the reason for the delay, they may still want to experience motherhood, and the AMH test helps them match their career and parenthood goals,” says Dr Eeson.
“And assume you meet a group of 10 women. Statistically, out of these women, one will be unlikely to conceive due to seriously reduced ovarian reserve. If you, as a woman, are concerned about whether you fall into this category, an AMH test would help you gain an understanding of this,” he adds.
In women, the Anti-Mullerian hormone is exclusively produced by cells in the ovarian follicles. AMH concentrations slowly decrease with increasing age, becoming undetectable around five years before menopause, when the stock of these follicles is exhausted.
However, the pace at which these follicles deplete varies greatly from person to person, reflected by a wide range of ages at which a woman hits menopause.
Another function of AMH testing is to predict a woman’s response to ovarian stimulation — a procedure which is the first step towards personalised infertility management such as in vitro fertilisation (IVF).
Testing blood levels of AMH before initiating IVF is a useful indicator of ovarian reserve and a woman’s potential response to IVF treatment. If AMH levels are within the normal range, the ovaries are likely to react more positively to stimulating drugs and more eggs are likely to be retrieved, often resulting in a higher IVF success rate.
Chai Yin Heng, general manager of Roche Diagnostics Malaysia, says planning for pregnancy and parenthood can be a stressful and emotional time.
The AMH test can assist women in answering deeply personal questions about their fertility in a private and measured manner, with careful guidance and support from a specialist doctor. This guidance and support will help women make informed decisions and take proactive measures.
“The AMH test is an important example of our focus on improving diagnostics in the area of women’s health — delivering medical value to both physicians and patients.”