Dr Brad Robinson Friday 14 October 2011 1:27pm

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Just a few weeks ago we ran a terrific post about the growing number of Australian women (and men!) who are actively and happily choosing to be child-free.  But on the flip-side, thousands of women are dealing with unwanted childlessness — battling infertility, on the IVF superhighway or just panicking about not meeting the right partner in time. And that’s what it’s all about. A Fertility Test 101 — a guide to what they are and what they can tell you written by OBGYN Dr Brad Robinson:

An increasing number of Australian women are reaching the end of their reproductive years without having children.  Incredibly, almost one in four women find themselves childless at this time.

The reasons for this increasing incidence of unwanted “childlessness” are as diverse as they are complex.  Some women develop unexpected illness rendering them infertile.  Some don’t want to procreate with any ol’ toothless wonder and are still waiting to meet their life’s partner.  Others put career first, sometimes, sadly, without a true understanding of how their biological clock is winding down.  Kind of like a game of ‘Ovarian Russian roulette’.

Whatever the reason, make no mistake – such irretrievable loss of parenthood can be the most traumatic event in a person’s life.

The good news is that there are now ways women can find out their “reproductive potential”.

Your fertility

As a woman you are born with a finite number of eggs – around one to two million.  By the time you reach puberty this reserve has already declined to a paltry 200,000.  During your reproductive years this number continues to fall, and after the age of 35 it falls at an accelerated rate.  By the time you hit menopause, which occurs on average at the age of 51 for the average Australian women, there are less than 1,000 left.  Actually, they’re less like eggs and more like ovarian dust.  Obviously the more eggs there are left, the more likely a woman is, all things being equal, to conceive.

Unfortunately, many women have ovaries with a biological and reproductive age above their chronological age.  In fact, as many as 10 percent of women in their early thirties are at risk of nearing a peri-menopausal state. This risk is heightened in women who have had chemotherapy or radiotherapy, suffered from endometriosis or had ovarian surgery.

So the trick is trying to figure out how many eggs a woman has left.  How do we do that?  Well, as Dr Deane Hutton from the Curiosity Show used to say, I’m glad you asked!

The answer is the Anti-Mullerian Hormone (AMH) blood test.  As the name suggests, this test measures the amount of AMH in a woman’s blood stream.  This hormone is produced by specific cells, called Granulosa cells, which surround each and every egg in a woman’s ovary.  So obviously, the more eggs, the more granulosa cells.  And the more granulosa cells, the more AMH produced.  Capiche?  Essentially, this information provides a quantitative guide in relation to an individual’s ovarian “age” and may assist women in making a decision about when to commence their attempts at falling pregnant.

Here’s an example. Let’s say you’re a 31-year-old woman with plans to start trying for a family at, say, 35.  As a precaution you have the AMH test and discover that you actually have a low ovarian reserve. With that information you decide to fast track those plans to have a baby and er, get on the umm bike, so to speak.  On the other hand, a high AMH may give you some peace of mind to more safely delay conception until you’ve ticked some of life’s other boxes e.g. travel, career, paying down the mortgage etc.

The Egg Timer Test

AMH is commonly used as part of the so-called “Egg Timer test”.  This test basically combines blood test measurements of AMH and follicle stimulating hormone (FSH) with an ultrasound assessment of ovarian follicle counts and overall ovarian volume to provide a measurement of ovarian reserve. So in other words when you have the Egg Timer Test you have a blood test AND an ultrasound scan to help determine your fertility.

What the AMH test can’t do

It’s important to remember that while this test can indicate how many eggs you have left, it can’t tell you about the QUALITY of those eggs.   So as useful as the AMH test is for those seeking information about starting a family, it’s important to bear in mind that this test is but one component of what should be a complete and thorough fertility assessment.

For more information talk to your GP about booking in for an AMH test. After all, knowledge is power.

Have you had your fertility tested? Would you be interested to know how fertile you are and would the results of the tests change your life plans in any way?

We will be chatting about this tonight on Mamamia on Sky News tonight so don’t forget to check in…