Ovulation problems occur when a condition, usually hormonal, prevents the release of a mature egg from an ovary.
Two hormones are responsible for stimulating ovulation each month. These are the follicle stimulating hormone (FSH) and the luteinizing hormone (LH). A blood test – the FSH or AMH test – is used to support diagnosis of any hormonal imbalances.
A woman’s production of these hormones can be disrupted by a number of factors, including increased physical or emotional stress, a very high or very low body weight, or a substantial weight gain or loss.
In this presentation to health professionals, Dr Thanos Papathanasiou, Bourn Hall’s Regional Lead Clinician, compares the two most frequently used tests.
The FSH test vs the AMH test
The FSH test is the standard test and is widely used within the NHS. The other test for Anti-Mullerian Hormone (AMH) is more recent, but is gaining support – particularly as it can also provide an indication of the woman’s egg store and, therefore, an indication of her fertility.
The presentation addresses the following questions:
- What is the difference between the two tests? (0:57)
- Can you predict the chances of a live birth? (1:28)
- Is it possible to predict the response to drugs? (3:20)
- Can testing indicate the chance of over stimulation? (5:03)
- Does the AMH test provide a reliable diagnosis of PCOS? (6:20)
- Is it possible to use these tests to diagnose other endocrine conditions? (8:44)
- Can fertility testing be used to provide indication of fertility before and after chemotherapy? (9:20)
Further discussion addresses other considerations when using the tests (from 10:05), including:
- FSH has a pulse and the levels vary through the cycle, which suggests that it may be insufficient on its own and other hormones should be measured.
- AMH can be used at any time of the month
- AMH is more expensive as a one-off test, but FSH needs to be repeated so there may be little difference in the overall cost
- GPs are more familiar with FSH, so more explanation may be needed to gain acceptance of AMH
Bourn Hall’s experience
Finally, Dr Papathanasiou describes Bourn Hall’s experience (13:07) and how standard use of AMH has reduced drug usage, improved stimulation response, increased the number of embryos available for freezing, and slightly increased birth rate.