Several women may spend the early years of their lives trying very hard to avoid pregnancy. When they finally decide they’re ready for motherhood, they are frustrated to find that it may not be that easy for them to get pregnant after all. And since we have the tendency to directly correlate our self-worth with our ability to give birth, we start perceiving the failure to conceive as a central failure to ourselves as human beings.
It is to avoid this feeling of failure that often drives so many mothers to endocrinologists and gynecologists, seeking for fertility tests that will claim otherwise. One such test involves examining a woman’s ovarian reserve – a measure of both the quality and quantity of eggs remaining in her ovaries.
It turns out, however, that this particular test may not be an accurate measure of a woman’s fertility at all. Here’s what research has to say.
Details Of The Research
There has been previous evidence that states that women with normal ovarian reserve are more like to respond well to fertility treatments like in vitro fertilization as compared to those with poorer reserves. However, there wasn’t any study that proved whether the measure plays a role in a woman’s ability to bear children naturally.
To address this, researchers recruited 750 women aged between 30 to 44, who had been trying to get pregnant for three months or less. The women were all instructed to provide blood and urine samples, and they were closely observed for the followed for the next 6 to 12 months.1
During this timeframe, 487 women were able to conceive naturally. The researchers adjusted various factors like body mass, age, and recent contraception use that could have influenced these results.2
According to the results, 84 women with low anti-mullerian hormone (AMH) levels were just as likely to become pregnant over the course of 12 months as the 579 women with normal AMH levels. Also, the 83 participants who showed high follicle-stimulating hormone (FSH) levels didn’t have a significantly different chance of becoming pregnant than the 654 women with normal FSH levels.3
What Does This Mean?
For those who aren’t aware, an ovarian reserve test generally involves a blood and/or a urine analysis test so as to successfully determine the levels of the hormones inhibin B, AMH, and FSH. When a woman’s egg count and quality diminish, the first two hormones usually decrease while the third tends to increase. By measuring the individual levels of each of these hormones, one can find out the status of one’s ovarian reserves, and can thus, apparently help a woman find out if she’s capable of getting pregnant or not.
Naturally, the researchers were surprised to find that it was just as possible for the women with low AMH levels and those with high FSH levels to get pregnant as it was for those who had normal levels of AMH and FSH respectively.
It becomes evident that the levels of AMH, FSH, and inhibin B had no effect on both the women who got pregnant and on those who couldn’t. In other words, the status of a woman’s ovarian reserve can’t be used to predict whether she has the ability to get pregnant or not.
Conclusion: No Fertility Test Is Perfect
While the blood tests do predict how well a woman will respond to fertility treatment, their ability to predict a woman’s reproductive potential remains uncertain.
A woman’s body is designed to hold eggs in different stages. Some of these eggs are made to remain dormant within the reserve, while a few are made to start maturing every month. One egg makes it out of the reserve to the fallopian tubes, either to be fertilized or to give you a period.
Doctors assess a woman’s fertility by evaluating her ovarian reserve, or in other words, the ability of her ovaries to provide egg cells that can go through this process of fertilization to result in a healthy pregnancy. But there is no test that can measure either the number or the quality of the eggs a woman has in her reserve. So any test that a doctor uses to evaluate a woman’s ovarian reserve test is an indirect measure.
Additionally, there are various outside factors that can be responsible for altering a woman’s blood-test results. For instance, if a woman is consuming extra estrogen (through a birth control pill) her FSH levels can be falsely low.4 Even an ovarian cyst, which is very common in women these days can cause the FSH levels to drop.5 On the other hand, obesity can cause a woman’s AMH levels to nosedive.6
Fertility is thus very complicated, and doctors need to look at many different elements to get a sense of what the problem really is before they can come up with the necessary course of action. The bottom line? If you’re really concerned about your fertility health, consult your doctor to seek help in putting the pieces together.
|↑1, ↑2, ↑3||Steiner, Anne Z., David Pritchard, Frank Z. Stanczyk, James S. Kesner, Juliana W. Meadows, Amy H. Herring, and Donna D. Baird. “Association between biomarkers of ovarian reserve and infertility among older women of reproductive age.” Jama 318, no. 14 (2017): 1367-1376.|
|↑4||Birth control pill – series. University of Maryland.|
|↑5||Biljan, Marinko M., Louise Lapensée, Neal G. Mahutte, François Bissonnette, Robert Hemmings, and Seang Lin Tan. “Effects of functional ovarian cysts detected on the 7th day of gonadotropin-releasing hormone analog administration on the outcome of IVF treatment.” Fertility and sterility 74, no. 5 (2000): 941-945.|
|↑6||Moy, Vicky, Sangita Jindal, Harry Lieman, and Erkan Buyuk. “Obesity adversely affects serum anti-müllerian hormone (AMH) levels in Caucasian women.” Journal of assisted reproduction and genetics 32, no. 9 (2015): 1305-1311.|