Wednesday, January 15, 2014

Testing your ovarian reserve (AMH). Is it accurate?

So I'm sure that the spike in my page views was full of people who were thinking, "Ew, why is she talking about this?" "This won't happen to me." and "If I can't get pregnant, I'll just adopt, babies from Africa are a-DOR-able!"
These were pretty much my thoughts as well, before I fell down the rabbit hole.
The thing is, infertility affects approximately one in ten couples. That doesn't seem like too many, but when I think about it, say, in terms of my students in my classroom, that means that 3 of them are going to have to deal with this in their lifetime, at least. There are a lot of problems plaguing our environment that people are speculating are contributing to the rise in infertility. Another aspect that people don't consider, is the fact that if you are a woman who will suffer from premature ovarian failure (or early menopause), you may not know until it is too late. By the time my husband and I were ready to consider having children, my body was already in a state of decline.
Let us begin, however, with what you can expect if you are diagnosed with infertility. Mine is unexplained. I've been to many doctors who applaud my healthy "numbers." They really don't know why I can't get pregnant. All of my lady numbers are in the normal range, some on the lower end, but still within the normal range.
In the beginning, I thought, "Okay, we'll go see this other doctor, and she'll tell me everything is fine, and we may just need more time." However, she did not say that. She looked at ONE number on my chart that gave her pause. It's called Anti-mullerian hormone, or AMH. It is basically determined in a blood test to find out how many eggs you have left in your ovaries. . .FUN! So, they took a look at my blood and said, "Woah, girl, you are really on the low end." So I cried, pulled myself together, cried some more, and then decided that we needed to start some invasive procedures.
We tried three rounds of IUI (turkey basting), to no avail, and I told them I wanted my AMH tested again. They assured me that it was not going to be much different...
THEY. WERE. WRONG.
So, this "reserve" level (I feel like my ovaries are a fine wine), should be what you are born with, and decline over time. The only direction it should go is down, right? As eggs die off, there are fewer, hence a lower AMH. Well, when I went back and got tested again, it was UP. Nearly a whole point. In these matters, a point can mean everything.
I asked my doctor, "What is this? Why the change?" to which she replied that it was not an exact science and they're still working out the kinks.
And this is the part that really bothers me. Just the week before, this same doctor had told me that based on my current levels (before the new blood test), I should consider IVF. In-Vitro Fertilization. I'm sure they have higher success rates, and no doctor wants their patient to suffer through the agonizing hurry up and wait scenario, but the fact that she told me that one of my best chances was to pay for a $20-30,000 procedure was based on an inaccurate number that they know little about? Sounds sketchy to me.
So, here's where the insecurity and uncertainty comes in. My husband and I have worked really hard to save what we do have, and of course it's not enough, but do we throw it all at IVF and hope for the best? Should we start to consider adoption? It's hard to know which direction to go when the information you are getting from your doctor is based on a science that appears to be in it's infancy.
I will recommend, however, that even though my numbers are off, they are still at the low end. Knowledge is power. If you are thinking of having a family, I would urge you to just ask your doctor to perform this simple blood test. You may think you know how you will feel, but in my humble opinion, I wish that I would have known there was a test like this out there. I believe it would have let me understand what was going on in my body before there was really a problem to worry about. Even if I still had waited to have children, it would have been a choice that I would have made and I would have been more accepting of the idea that I may never carry a child. All I'm saying is, it couldn't hurt to know.

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