For some it happens at 27 or 28, for others it doesn't happen until they’re well into their 30s—but at some point in young adulthood, many women start to worry about their fertility. Whether you’re single, in a relationship but not ready for a child, or more focused on other priorities, there are dozens of reasons why you may put off having children. But if you know that you want to wait a while, it's totally normal to wonder how long you can delay pregnancy—and if you can or should take any other measures, like egg freezing, in the meantime.
One of the most frustrating things about fertility is that there are no guarantees. Different experts rely on different predictors and indicators of your current fertility levels—but even those don’t guarantee how many eggs you’ll have in the future. And even if you do make a decision to address your fertility by freezing your eggs, there’s no guarantee those eggs will result in pregnancy. So trying to understand your fertility levels and plan for the future can be an overwhelming, confusing process, which is why it’s so crucial that you do thorough research. Even though there are no guarantees, you can make sure you’re making an informed decision, comfortable in knowing that you’ve considered all of the options and factors.
One of the most recent "trends" in fertility predicting is focusing on the anti-Müllerian hormone (or AMH)— but is it as effective and reliable as some experts say? Here’s what you need to know.
Why Are People Using It?
To put it simply, AMH is produced by your ovaries and the cells around the eggs inside of your ovaries. The reason AMH is thought to be indicative of fertility is that it stands to reason that the more eggs you have, the more AMH your body will produce. Normal AMH levels would normally sit at above 1.0, while an AMH level of less than 1.0 could indicate a fertility issue.
How Accurate Is It?
This is the tricky part—AMH can be indicative of your eggs and fertility, but one study found that it wasn’t actually a reliable determining factor in predicting fertility of women under the age of 35. Which isn’t to say that it can’t be useful. In women over the age of 35, AMH was found to be correlated with a higher level of live birth rates for women who were undergoing IVF—which is useful information to have if you're in either of those categories. But generally women who are worried about fertility or considering egg freezing tend be younger than than 35, meaning the uncertainty of the hormone isn't as helpful.
The societal pressure to take care of your ‘ticking clock’ mean that women start to worry about their fertility as soon as they see 30 in their future, if not before. Touting AMH as a predictor for these women might not be wise. In fact, if a 28-year-old, who should have a lot of fertile years ahead of her, gets an average reading, it may just confuse the situation further. The numbers seem to suggest that AMH is more useful in older women, in a situation where their fertility is already in decline or who require producers like IVF.
What’s Best For You?
This isn’t a clear distinction. The reason it’s so important to understand exactly how AMH—and other predictors of pregnancy—work is because these are huge life decisions. Freezing eggs, hormone therapy, even just seeing a reproductive specialist can come at a huge cost, both financially and emotionally. It’s a big commitment. One hormone level, unless it falls on the extreme side of the scale, probably won’t be able to tell you what’s right for you.
Instead, you need to consider all of the factors in your life. Not just your age, job status, and relationship status, but your reproductive goals, your financial situation, and a holistic look at all of the science and test results available to you. One of the most important things to remember is that, when it comes to fertility, there is no guarantee—so the best thing you can do is focus on making the most informed decision you can.
So be wary of any clinic or doctors who speaks in absolutes. Hormones like AMH can be a very useful guiding tool for certain women in certain positions—and you may want to get the test done yourself, just to see if your result sends any obvious signals. Do your best to educate yourself, work with doctors who understand your personal goals, and do what’s right for you. It’s your body, after all.