Doctors warn of blood tests examining women's eggs

Getting a figure on a scale that tells you how long you have a chance to get pregnant and then be able to plan your family - sounds like the dream for many women. It is about the AMH value, an abbreviation of anti-miller hormone, produced in the ovaries found in the ovaries. By measuring the level of this hormone in the blood, one can obtain a value that estimates how much egg reserve, that is, how many eggs a woman has.

But SVT News has talked to several researchers and doctors in reproductive medicine who say that the AMH value doesn't say much about a woman's chance of becoming pregnant.

"The amount of eggs is not decisive but the quality of the eggs, and it deteriorates with age," says gynecologist and chief physician Leif Bungum, who researched at the University Hospital of Skåne about the importance of the AMH value.

Egg quality is not tested

However, several private companies take about SEK 800 for an AMH test that is sold online. But what is not very clear, either in the health care or on some of the companies' sites, is that the test only shows the number of eggs, not their quality.

"A 25-year-old woman with few eggs has a much higher chance of having children than a 40-year-old woman with many eggs, because only 15-20 percent of her eggs are good," says Leif Bungum.

"False security to rely on AMH test"

His research has also shown that the AMH value can vary over time and where in the menstrual cycle you are when the test is taken.

- It is quite questionable what the private clinics do in selling tests this way. To measure the ovarian reserve, you might as well do an ultrasound with a gynecologist who is good at it.

Tekla Lind, gynecologist and director of reproductive medicine at Karolinska Hospital in Huddinge, is on the same track.

- It is a false security to rely on an AMH test. One should be aware that the risk of miscarriage also increases with age. It is pointless to go and have a blood test over and over again, she says.

Margareta Kitlinski, chief physician and section manager at Reproduction Medical Center at Skåne University Hospital, believes that it is important that companies are clear that the quality of eggs cannot be measured with the AMH value, but at the same time it is positive that the net tests can act as an awareness of fertility. .

- But the results should not be used to plan or hold as a guarantee of a pregnancy, she says.

Critical to self-diagnosis

Thomas Brodin, gynecologist at Linnaeus Clinic and researcher at Uppsala University, often meets women with high confidence in the AMH value.

- I don't think you should take samples for self-diagnosis. If you spend time thinking about your fertility, you should discuss the matter with a fertility doctor.

However, there are situations where the AMH value is important and it is mainly when assessing which hormone therapy to be used before test tube fertilization, so-called IVF. Therefore, the sample is always taken as part of a fertility study. Here, Thomas Brodin has researched the area and has been able to demonstrate that the AMH value, alone but especially with age, is important for women's chances of giving birth after IVF. However, he is clear that one cannot break down his results at the individual level. Thomas Brodin is thus, in part, a different view than the other researchers.

- Many people go and measure their AMH and dip together and think they can't get pregnant. Some, but sparse, qualitative information can be found in the AMH value in my opinion, but that connection can only be shown at the group level. The egg reserve must also be linked to much else.

Rebecca Engelbert, chief operating officer at Medisera, one of the companies offering AMH tests, says that the test response is used to give an indication of a woman's egg reserve and thus also an indication of fertility. At the same time, she is clear that it is important that you as a patient know that it does not give the whole picture.

- The blood analysis as such has a clinical value and something that can fulfill a function. You have to have confidence in people's ability to receive this information.