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The Guardian - AU
The Guardian - AU
National
Melissa Davey

Widely advertised hormone test unreliable as fertility prediction tool for women, researchers say

Gloved hand holding a Syringe
A blood test primarily used to determine the amount of eggs in a woman’s ovaries is being marketed as a fertility or menopause prediction tool, experts say. Photograph: Kanok Sulaiman/Getty Images

Accredited fertility clinics are among companies misleading women about a blood test used to indicate fertility, resulting in women potentially making misinformed health decisions, researchers say.

Dr Tessa Copp, from the University of Sydney’s school of public health, says she and her colleagues are concerned by an increasing number of advertisements that overstate what the anti-Müllerian hormone (AMH) test is useful for.

The blood test measures levels of anti-Müllerian hormone, which is linked to the number of eggs in a woman’s ovaries. As the number of ovarian follicles declines with age, AMH concentrations also decrease.

The AMH test can be helpful for women considering fertility treatment as it indicates the approximate number of eggs that can be retrieved for IVF or egg freezing.

But it cannot reliably predict the chances of conceiving, fertility status, the health of eggs, or the specific age of menopause for individual women. It can also be inaccurate.

Despite this, Copp said many fertility clinics, online companies and social media influencers were marketing the test as a fertility or menopause prediction tool, using phrases such as “take charge of your fertility”.

“There have also been a few academic papers out there concluding that the public want this test and that it is so in-demand that it should be freely available,” Copp said.

“We were also hearing of friends who were tested for inappropriate reasons, thinking it was a test of their fertility, and who then subsequently made significant life changes based on the test result.”

For example, Copp said she heard from a woman in her early twenties who rushed into trying to conceive earlier than planned after she took a test and was told she had the same number of eggs as a woman in her forties. Despite thinking this meant she would struggle to conceive, she conceived almost immediately.

“My colleagues and I wanted to know whether women would still want the test if they are actually informed about its limitations and that it is not very reliable for many of the uses it is being advertised for,” Copp said.

To do this, they conducted a study of 967 women aged between 25 and 40 years living in Australia or the Netherlands who had never given birth, were not currently pregnant but would like to have a baby at some point and who had never had an AMH test.

They randomly allocated participants to receive either an evidence-based pamphlet specifying the limitations of the test or a pamphlet containing content from an existing website promoting the test direct to consumers in Australia.

The women then answered a questionnaire about their interest in having a test, their intention to discuss the test with their doctor and their attitudes towards and knowledge about the test.

“The women given the evidence-based information were not interested, on average, in having an AMH test, while women in the control group were interested, on average,” Copp said.

“Women who viewed the evidence-based information had a more accurate understanding of what the test could tell them. They also saw it as a less valuable test and were less interested, on average, in discussing it with their doctor or getting tested, compared to the control group.”

The findings were published on Monday in the journal Human Reproduction. Copp said women deserve evidence-based information to inform their health decisions. The researchers will share the findings with fertility clinics.

“Clinics that provide misleading information are breaking codes of practice, and should be held to account,” Copp said. “Regulatory bodies need to do better at ensuring clinics are transparent and provide accurate information.”

Guardian Australia has contacted the Therapeutic Goods Administration for comment.

Prof Susan Davis, an endocrinologist and women’s health researcher with Monash University, described the study as “a really important piece of work”.

Davis has co-authored a review on the limitations of AMH, which found the test to be “helpful when a woman is undergoing assisted reproduction as it can provide some helpful information for the approach”.

“But when just randomly used as an indicator of fertility, it can be misleading,” she said. “I share concerns regarding the use of AMH as a spot test.”

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