Francie Diep , Pacific Standard,
Dr. Reshef’s Comments: Predicting fertility potential in women is tricky. What I learned in 28 years of practice is that so far there are no tests for ovarian function that imply absolute lack of viable eggs. Menopause, the cessation of menstruation, is a fairly clear signal that pregnancy is virtually impossible. The gradual decline of egg supply, a natural phenomenon, does not exclude production of healthy eggs and pregnancy even in the pre-menopausal phase, which may last many years. We still hear stories from patients about being told that they will never conceive. Big mistake by their physician. Even today, the best we can do through testing the ovary for “egg supply” is to roughly estimate the potential for producing viable eggs. This rough estimate, however, does not imply inability to get pregnant. You can still drive your car for many miles even if your gasoline gauge is on “empty”. Many of our patients with low AMH conceive successfully. AMH testing should NOT be offered to young, healthy women with regular menstrual cycles. We offer it to women over age 35 who contemplate IVF in order to estimate the amount of medications given for ovarian stimulation but not as a faultless predictor of success. We also offer it to younger women with evidence on ultrasound for low egg supply (i.e. small ovaries with low number of antral follicles). But NEVER tell your patient that her reproductive potential is doomed based on ultrasound and/or blood test– nature easily defies logic if logic is faulty!