AMH screening of ovarian reserve in the general population: A risk-benefit analysis

Kelton Tremellen, Neerja Kamal

    Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

    Abstract


    AMH based ovarian reserve screening has generally not been supported for two key reasons. Firstly, opponents suggest that since a poor result does not necessarily suggest impaired chances of natural conception in the immediate term, then the test has no value. Secondly, these opponents believe that a poor result may cause anxiety for patients, triggering them to make potentially unwise decisions such as conceiving in an unstable relationship, or undertaking expensive and potentially harmful oocyte cryopreservation procedures. However, in this chapter we will argue that screening of ovarian reserve status does have considerable merit as it prognosticates for IVF related conception, plus identifies diminished ovarian reserve early when symptoms are absent yet the chances of conception are still favourable if plans for starting a family are brought forward. Furthermore, evidence suggests that alternatives to screening such as education of the population about the perils of delaying conception have not been effective in changing reproductive behaviour because women often overestimate their own personal fertility potential. We contend that AMH based screening of ovarian reserve "personalises" ovarian reserve status, making screening a more effective trigger for changing reproductive behaviour than mere generic advice alone. However, we do recognise that screening can trigger adverse outcomes and therefore should only be offered to those women who have undergone appropriate pre-screening counselling regarding its merits and potential actions that may arise from adverse results.

    Original languageEnglish
    Title of host publicationAnti-Müllerian Hormone
    Subtitle of host publicationBiology, Role in Ovarian Function and Clinical Significance
    EditorsDavid B Seifer, Reshef Tal
    PublisherNova Science Publishers, Inc.
    Chapter22
    Pages309-326
    Number of pages18
    ISBN (Electronic)9781634840170
    ISBN (Print)9781634840125
    Publication statusPublished - 2016

    Keywords

    • Anti-Müllerian Hormone
    • AMH
    • Ovarian Function
    • Medicine and Health
    • Obstetrics and Gynecology
    • Obstetrics and Gynecology Advances
    • AMH Screening
    • Ovarian Reserve

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