TTC? How Reliable Is Your AMH Result?by Ellie Thompson
If you’re struggling to conceive and going through fertility testing, you might have come across the AMH test. The AMH test (anti-müllerian hormone) is a blood test that can be done at any time during your cycle and is thought to be a marker for egg reserve.
We remortgaged our house off the back of our first AMH result, done at a respectable laboratory in London. It came back as just 6.6 which is classed as pretty damn low. Without a moment to lose (or so we thought), we signed up to our chosen fertility clinic in Surrey expecting to fast-forward treatment as a result. (MY EGGS ARE RUNNING OUT, SOMEBODY HELP ME!) Only for that clinic to run the AMH test again, to confirm a level of 20.6, which was apparently, pretty normal for a woman in her mid-thirties.
I’d been obsessing about that first result, and preparing myself for the worst while waiting for the results of the second AMH test, a few months later. I had to steady myself when the receptionist came back on the line after shuffling about at her desk.
‘Ah yes,’ she confirmed. ‘Ellie Thompson – completely normal’.
‘Err – NORMAL? Hang on, what was the score?’ I asked incredulously.
‘20.6 pmol/litre, which is perfectly normal.’
I was stunned, elated, and then confused. ‘But the previous test I had done elsewhere confirmed my AMH was lower than normal for my age, at just 6.6?’
‘This is why we always insist on testing again.’ She reassured me. ‘We use a testing centre in Glasgow that has a bigger database to compare the result to.’
Thank you, Scotland! Forty-seven pounds well spent.
It started to dawn on me just how much worrying and obsessing I had been doing over an inaccurate AMH result. Off the back of a lowly 6.6, I was told at the time not to panic, but to consider starting private treatment soon as. Aka, start panicking! The way I saw it, there were no two ways about it, apparently, my biological clock was ticking. Loudly. We needed to find cash for treatment. And lots of it. Quick.
I was devastated at the time. I thought menopause was knocking on my door. I blamed my body for not working properly, I felt inadequate and at fault for not being able to fall pregnant. I was stressing over my AMH result so much that my best mates and my sister offered up donor eggs.
And then I got to thinking, who knows what effect the news of an abnormal AMH result has had on me physically, how much stress and pressure has taken its toll on my body in that time? Perhaps having only received the second (and supposedly more accurate) result, a positive mindset following the reassurance of my fertility may have led to us conceiving? Instead, we found ourselves bogged down by the huge pressure of time, and we made certain life-changing choices in light of that. Making the decision to remortgage our home was one of those choices.
I also wondered how on earth two different clinics with two different testing centres can produce such different results, and how on earth that’s allowed? One thing’s for sure, there's an outrageous discrepancy between an AMH of 6.6 and an AMH of 20.6, so what the hell is going on?
With private clinics placing so much emphasis on AMH, who knows how many other women have been in my situation, or worse with lower scores? I’ve spent half an hour googling ‘AMH, reliability, interpretation, private clinics’ and other keywords in an attempt to find this topic discussed online, but really worryingly there seems to be very little.
For anybody out there making decisions about fertility and IVF treatment, please take this account into consideration. AMH can't ever be the full story if results are so skewed across the country. And although I didn’t ever get pregnant naturally following either AMH result, I had 2/3 successful cycles, the first in 2016 gave us our now 5-year-old daughter, and the second in 2018, gave us our now 3-year-old son.