October 16, 2017Women's Health
As a woman ages and her egg supply declines, cells in the ovary secrete lower amounts of inhibin B and anti-Mullerian hormone, substances considered to be indicators of ovarian reserve. The ovaries also produce higher amounts of follicle stimulating hormone (FSH) in the days before ovulation. Although there is little research to support their use, tests for anti-Mullerian hormone are routinely offered in many fertility clinics on the assumption that women with a lower ovarian reserve would be less likely to respond to treatment. Moreover, home fertility tests of urinary FSH are commercially available.
According to a study published online in the Journal of the American Medical Association (10 October 2017), tests that estimate ovarian reserve, or the number of a woman's remaining eggs, before menopause, do not appear to predict short-term chances of conception. According to the NIH, the study suggests that testing for biomarkers of ovarian reserve does not predict the chances for conception in older women still of reproductive age.
The study enrolled 750 women from 30 to 44 years of age who had been attempting to conceive for three or fewer months. Women were ineligible to participate if they had known fertility problems, such as polycystic ovarian syndrome, tubal blockage or endometriosis. The women provided a urine and blood sample and checked for conception with home pregnancy test kits. The authors statistically corrected for factors known to reduce fertility, such as smoking, recent use of oral contraceptives and obesity. After six cycles of attempting to conceive, results did not differ significantly between women with low levels and normal levels of anti-Mullerian hormone -- a 65% chance of conception, compared to a 62% chance. Similarly, results were not statistically different after 12 cycles: 82% versus 75%. Chances for conception also did not differ significantly according to high versus normal levels of FSH, with conception rates of 61% versus 62% after six cycles and 82% versus 75% after 12 cycles. The authors found no association of inhibin B levels and conception after six cycles or 12 cycles.
The authors concluded that the study suggests that younger women with biomarker levels indicating lower ovarian reserve should not become anxious that they won't be able to have a baby.