Fertility testing can be misleading, let me explain why...
Now I am all for empowering women or people with female reproductive organs to be proactive about their fertility, as long as the test or service they are undertaking has been thoroughly explained to them and they understand that there is no actual test that can 100% test fertility. Fertility is complex and not determined based on one factor as there are many factors involved that could potentially impact fertility!
Fertility testing is usually marketed as an "egg timer test" or a way to test your "ovarian reserve" and how many eggs you have left. But promoting this is somewhat inaccurate, as it's only looking at one particular marker called the Anti-Mullerian Hormone (AMH). AMH is a protein hormone that appears to be important in the early developing stages of follicles within the ovaries. It is said, that the more ovarian follicles you have, the more AMH that is produced by the ovaries. Hence, it has gained popularity as a way to give you more insight into your fertility and chances of becoming pregnant. But...there is always a but....
An AMH test CANNOT reliably predict the likelihood of conceiving or how long it will take you to get pregnant. It also can not tell you about the quality of your eggs or how quickly your egg count or ovarian reserve may be declining. The results of the AMH blood test can also fluctuate all the time and be unreliable if tested while on the pill. And despite all of this, it's still being promoted as a way to assess current and future fertility.
Be careful not to get sucked into the hype that it can predict your chances of conceiving or how long it will take you to get pregnant!!
Yes, it can be beneficial for some things, like for those completing egg freezing or In-Vitro Fertilisation (IVF) as a way to determine the dose of medication required for treatment and suggests how many potential eggs a woman or person with ovaries may collect at an egg collection. However, even the American College of Obstetricians and Gynecologists recommends against AMH testing in women who are NOT seeking fertility treatment as it states the test: should not be ordered or used to counsel women who are not infertile about their reproductive status and future fertility potential.
So the bottom line is, it's not the be-all and end-all or some miraculous test that can predict the future. If you want to get your AMH tested, I'd recommend speaking to a healthcare provider who specialises in fertility and can appropriately interpret and explain your results in an easy-to-understand way. Ironically, deciding to get an AMH test without being thoroughly informed about what the test is and isn't capable of is the opposite of empowering. And unnecessarily testing could influence you to make decisions based on false assumptions of the results. For example, getting a low result could cause anxiety that you're infertile or cause pressure to get pregnant sooner than you desired or urgency that you have to freeze your eggs to preserve your fertility. Then on the other hand, a normal or high AMH result may give you a false sense of security that they can delay getting pregnant when in fact age is the most important factor of female fertility.
Interestingly, women with low AMH levels have the same chance of conceiving as women with normal AMH levels. But you're not being told this on any marketing campaigns! Remember, it doesn't tell you anything about the quality of your eggs. So, even if you have a low number of eggs, they could still be of good quality to achieve a pregnancy. The only real way to find out and "test your fertility" in some way, is to try to get pregnant unassisted when you're ready.
If you do want to discuss your fertility with a healthcare provider, I'd be making sure it's a thorough reproductive health assessment, than just a stand-alone AMH test.
What could be included in a reproductive health assessment?
Detailed health history
Family history
Thorough menstrual cycle assessment
Review of chronic medical conditions or medications
Lifestyle assessment
Blood tests (AMH, hormones)
Pelvic ultrasound
A reproductive health assessment can include an AMH test as one piece of the puzzle but also takes a holistic approach and will give you more of an understanding about your individual circumstances and factors that may affect your fertility.
What I also believe health professionals should be doing when you speak to them about wanting to know more about your fertility, is to explain to you that tests are just one part of the equation, education and increasing knowledge are just as important. Providing you with factual information about fertility, such as age is the biggest factor impacting fertility or educating you on healthy lifestyle changes that can help with your egg quality and increase your fertility potential can be empowering for anyone wanting to learn more about their fertility. Regardless if you want to have a baby right now or in the future, at least you can take this information with you wherever you go, whatever you do over your reproductive life.
So let's stop creating fear in women or people who menstruate and actually start helping more people learn about their amazing, wonderful, incredible bodies! You may not need fertility testing, maybe you just need some more individualised, specific education. Something that I am more than happy to help with!
References
1.Johnson A, Thompson R, Nickel B, Shih P, Hammarberg K, Copp T. Websites Selling Direct-to-Consumer Anti-Mullerian Hormone Tests. JAMA Netw Open. 2023 Aug 1;6(8):e2330192. doi: 10.1001/jamanetworkopen.2023.30192. PMID: 37603332; PMCID: PMC10442712.