Should I take an AMH test or an FSH test to evaluate my ovarian function?
A patient who came to the clinic couldn't wait to ask about egg freezing and the checkups about ovarian function. She just turned 35, single, and very stylish. She said she did some research and knew that the best time to do FSH (Follicle-stimulating hormone) blood test for ovary function evaluation is at menstruation cycle day 1-3. FSH result can be explained as the following meanings :
FSH mlU | ovarian reserve | stimulated follicles estimation |
<8 | abundant | >10 |
8~10 | slightly diminish | 10±2 |
1012 | mild diminish | <8 |
12~25 | sever diminish | <5 |
>25 | almost at menopause | 0~1 |
But more than 10 years ago, AMH(Anti-Müllerian Hormone) had begun to be used extensively as an evaluation for ovarian function. The good thing about AMH is that the value is quite stable throughout the menstruation cycle. You can do the blood test at any time and it is also much more accurate at predicting the stimulated follicles while treatment. AMH result can be explained as the following meanings :
AMH(ng/ml) | ovarian reserve | stimulated follicles estimation |
<0.8 | severe diminish | <2 |
0.8~2 | diminish | <4 |
2~6 | adequate | 4~10 |
>6 | abundant | >10 |
Apart from the blood tests, using ultrasound tests at the beginning of treatment to count the AFC(Antral follicle count) can also help estimate stimulated follicles. However, those are only for reference only as the final egg retrieval result depends on how the ovaries react with the medication or injections. Therefore, at around mid-time of the treatment, blood and ultrasound tests are still needed to determine the rest of the treatment.
To conclude, AMH is a crucial index to evaluate ovarian reserve. The higher AMH means the more ovarian reserve and more chances you will have for future reproduction. However, the oocytes' quality and quantity decrease with increasing age, and they accelerate decreasing especially after 35-year-old. Therefore, if your Mr.Right has not appeared yet, or you plan to work for a few more years before organizing a family, egg freezing is the best insurance for future reproduction!