Is diminished ovarian reserve, as measured by low antimüllerian hormone (AMH), associated with infertility among women of late reproductive age? Many people working in OBGyn or the fertility IVF fields would say ‘yes’ but until the recent study finds that Ovarian reserve tests aren’t a good predictor of fertility. the new research, published in the Journal of the American Medical Association JAMA October 10, 2017 issue, looked at three markers: anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), and inhibin B. Article “Association Between Biomarkers of Ovarian Reserve and Infertility Among Older Women of Reproductive Age”, it presented:
“Findings In this time-to-pregnancy cohort study of women aged 30 to 44 years without a history of infertility, women with a low AMH value had an 84% predicted cumulative probability of conception by 12 cycles of pregnancy attempt compared with 75% in women with a normal AMH value, a nonsignificant difference.
Meaning Among women attempting to conceive naturally, diminished ovarian reserve was not associated with infertility; women should be cautioned against using AMH levels to assess their current fertility.”
“Previous research has correlated levels of the three hormones with the number of eggs a woman has in her ovaries — a measure known as “ovarian reserve.” Studies have suggested that information could be used to predict how well a woman will respond to in vitro fertilization. But in recent years, as more women are delaying pregnancy until later ages, ovarian reserve tests have begun to be used as a way to test for future fertility…
But the new study finds that looking at levels FSH, AMH, and inhibin B isn’t an answer to the question of fertility.
Steiner and her colleagues analyzed data from 750 women between ages 30 and 44 who didn’t have any known fertility problems, had been trying to get pregnant for three months or less, and lived with a male partner. Women who had lower levels of the biomarkers — indicating “diminished ovarian reserve” — weren’t any less likely to get pregnant in the first year than women who had higher levels of the biomarkers.
In other words, ovarian reserve tests run the risk of giving women an inaccurate impression of their future chances of having children.” said https://www.statnews.com/2017/10/10/ovarian-reserve-tests-fertility/
So what does this mean to TCM practitioners, the evaluation of reserve is only a part of diagnosis which we relate it to Kidney Yin and Jing. There are other parameters in the tongue/pulse/asking which can indicate the fertility capacity. When we look at those blood test result, we need to recognize the limitations of those numbers.
For conventional medicine, I wonder what would be the next indicator of ovary capacity? How do we evaluate the quality of egg?
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