During the pandemic, a surge of interest in anti-Müllerian hormone (AMH) testing emerged among my 30-something peers, driven by social media ads for at-home kits and upscale fertility centers. Previously unknown to me, AMH testing—often dubbed the “egg timer” or “biological clock” test—soon became a trending topic in my feeds.
Dr. Aimee Eyvazzadeh, an OB-GYN and reproductive endocrinologist who hosts the podcast The Egg Whisperer, describes AMH as a hormone produced by cells surrounding eggs. Its levels decline with age and become undetectable post-menopause. “Unfortunately,” Eyvazzadeh notes, “AMH levels can drop before a woman’s desire for a child fades.” The test, therefore, measures ovarian reserve—essentially the number of eggs remaining—which appears useful for fertility assessments. Many direct-to-consumer platforms promote AMH tests as indicators of future fertility and family planning.
However, medical professionals caution against over-reliance on AMH tests. The American College of Obstetricians and Gynecologists asserts that AMH tests “should not be used to evaluate reproductive status or future fertility potential in women who are not already experiencing infertility.” Despite this, many of my peers, not struggling with infertility, based their fertility expectations on AMH results.
Reproductive endocrinologist Dr. Lucky Sekhon of RMA of New York emphasizes that AMH tests primarily inform ovarian stimulation responses in fertility treatments, not overall egg quality or natural fertility. A 2021 meta-analysis reaffirmed this stance, indicating that AMH levels are not strong predictors of natural pregnancy and low levels do not necessarily correlate with diminished fertility.
Eyvazzadeh points out that while AMH testing offers insights similar to a semen analysis for men, it doesn’t guarantee egg quality. “AMH helps project potential fertility but cannot definitively confirm it,” she explains. Although AMH is crucial for assessing response to IVF or egg freezing, its levels indicate only how many eggs might be produced per cycle, not their quality or likelihood of successful embryo development.
This caution is not always reflected in marketing claims. A study from last August scrutinized 27 English-language websites and found that 74% falsely suggested AMH tests predict conception likelihood, and 41% claimed they could adjust reproductive timelines. Tessa Copp, who led the study, criticized these claims as “blatant falsehoods,” warning that they can lead to misguided decisions or unnecessary anxiety.
Furthermore, AMH levels can fluctuate frequently. Eyvazzadeh describes it as the “always meandering hormone,” with variability from month to month and even among different labs. Incorrect results may lead to misplaced reassurance or missed opportunities for egg freezing, as observed in some cases.
Experts advise consulting an OB-GYN for comprehensive fertility evaluations rather than relying solely on AMH tests. Eyvazzadeh uses the acronym TUSHY—fallopian tubes, ultrasound, semen analysis, hormone tests, and genetic profile—to cover essential components. Sekhon prefers a broader assessment, including other hormones and a pelvic ultrasound, and notes that AMH tests ordered through a physician may be covered by insurance, unlike the more expensive direct-to-consumer options.
Sekhon warns against clinics that focus solely on AMH and egg freezing, recommending a thorough discussion with a fertility specialist about personal medical and family history. “Question the credibility of any provider making AMH the central focus,” she advises. Ultimately, while AMH can be a useful tool, it’s essential to consider it within the broader context of age and comprehensive fertility evaluation.
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