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Blood Test Helps Measure Women’s Ovarian Reserve.

April 1, 2016

Blood Test Helps Measure Women’s Ovarian Reserve.
At JCRM we are happy to assess a woman’s fertility potential and think it should be done for anyone who plans to put childbearing off until age 30 or later. A significant number of women are affected by diminished ovarian reserve. Conservative estimates would be 8-12% but our thought is that it could be as high as 30-35%. Those are not small numbers.

AMH testing alone can be very misleading. Probably 40% of the population has insulin resistance and at least a PCOS like syndrome that artificially normalizes the test. Another large % of women have hypothalamic stress disorder that likewise normalizes the test. Therefore, if the AMH level is taken out of clinical context, the test will be falsely reassuring to a number of patients. For patients at risk for this AMH inconsistency, the more thorough Clomid Challenge Test will be much more accurate. Through our research, we have developed questions in the history of a woman that would strongly suggest diminished ovarian reserve that would also prompt us to do more specific testing.

Unfortunately, the AMH test has rapidly replaced more specific testing in the reproductive endocrinology community. These limitations to the test are not well known and for the most part the test is interpreted at face value. Utilizing careful attention to history, looking for signs of Diminished Ovarian Reserve or Endometriosis (the most common cause of DOR), we can tailor testing and be far more accurate in predicting fertility potential. Waiting to have children until a woman is over 30 if she has diminished ovarian reserve can make successful pregnancy difficult and certainly can limit family size.

Michael D. Fox, MD
Jacksonville Center
Reproductive Medicine

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