Ovarian Reserve Testing including Anti-Müllerian hormone - AMH

Acubalance can now order ovarian reserve testing which includes the hormone test for Anti-Müllerian hormone  (AMH).  Currrently, AMH testing is available through BC labs for $225 but it is not covered by MSP. Acubalance can now order AMH test as part of the full Ovarian Assessment Report (OAR) for $183 USD which includes AMH as well as FSH, Estradiol, LH and Inhibin B. The five hormones along with your age are included in an algorithm to accurately predict how you will respond if you were to do an IVF.  At Acubalance we are using the OAR to objectively measure any changes in your Ovarian Reserve by comparing your OAR from when you start your Acubalance preconception and/or IVF preparation programs to when you retest after you have finish your Acubalance treatment program.

I have been working on bringing this test to British Columbia for Acubalance patients for over 18 months.  I am proud to announce that as of June 2010 we can now order the Ovarian Assessment Report (OAR) for our patients. The fee of $183 USD paid directly to the private lab is reasonable when compared to the $225 CAD fee for the sole hormone test of AMH through BC labs. Please discuss with your Acubalance practitioner if the OAR testing is appropriate for you.

Although AMH testing is not common in British Columbia, it is so in Europe and in the United States. Here is an excerpt on the predictive value of testing AMH.

“AMH’s role as a peripheral signal of the size of the growing follicle pool may have important clinical benefits. In women undergoing treatment for infertility, ovarian aging is characterized by decreased ovarian responsiveness to exogenous gonadotropin administration and poor pregnancy outcome. On the one hand, correct identification of poor responders by assessment of their ovarian reserve before entering an in vitro fertilization (IVF) program is important. On the other hand, assessment of the ovarian reserve may also benefit patients that would generally be excluded from IVF programs because of advanced age.”

Resources

• To read about the OAR test Click here
• To watch an educational video Click here.
• To read why some studies suggest AMH is more predictive of ovarian reserve than using FSH, E2 and Antral follicle Count (AFC) please Click here

Anti-Müllerian hormone: a new marker for ovarian function
Excerpt from Conclusion below. 

"The studies described here indicate that serum AMH levels decrease with age in premenopausal women. In addition, serum levels of AMH correlate strongly with the number of antral follicles, suggesting that AMH levels by extension reflect the size of the primordial follicle pool. Assessment of the ovarian reserve is particularly important in the IVF clinic, where AMH may be useful as a predictor of poor response. Since a considerable proportion of subfertility is due to postponement of childbearing, measurement of AMH levels to assess the ovarian reserve may also be of interest in women in general. Assessment of the ovarian reserve, at least of the size of the ovarian follicle pool, may provide insight into the number of fertile years a woman has left. However, in order to determine whether serum AMH level has prognostic value, additional prospective studies in a normal population are necessary to provide definite proof for this concept.

In conclusion, recent studies have validated the use of serum AMH levels as a marker for the quantitative aspect of ovarian reserve. Because AMH levels are strongly correlated with the size of the follicle pool, and because of the lack of cycle variations, serum levels of AMH are a good candidate for inclusion in standard diagnostic procedures to assess other ovarian dysfunctions, such as premature ovarian failure. Knowledge of the serum AMH levels in such conditions might provide more insight into the possible cause or effect of altered AMH levels. Genetic studies of well-defined population cohorts would also provide more knowledge about the role of AMH in ovarian physiology."

Full Study click here

Lorne Brown B.Sc., CA, Dr.TCM, FABORM
Acubalance Wellness centre
Founder, Clinical Director