A new study has found home fertility tests—or ‘egg timer tests’—are not actually a reliable predictor of fertility, despite websites that sell them claiming otherwise.
Anti-mullerian hormone (AHM) tests are a common part of fertility testing in the medical profession. However, they are only one piece of the puzzle, with no evidence supporting the idea that they can be used to predict fertility.
Meanwhile, new research conducted by the University of Sydney and Monash University found that “most” online vendors selling at-home AHM tests direct to consumers, make misleading claims that can encourage a belief that the tests are able to predict one’s ability to conceive.
The study of 27 websites across the world showed that the “amount and type” of information available regarding the tests was “highly varied” among sellers, and “most contained statements about the AMH test that were not supported by evidence, including that it can reliably predict fertility potential or age of menopause”.
“These findings suggest false claims about the AMH test are common, misleading consumers to purchase an AMH test in the belief that it can predict current or future fertility, which may lead to misplaced anxiety or reassurance about one’s fertility,” the study concludes.
The risks, of course, are not only anxiety related to fertility or menopause, but the potential to cause women to adjust their contraceptive use or plans to conceive.
How Do AMH Tests Work?
Anti-mullerian hormone levels in the blood can correspond to the number of follicles in the ovaries that could produce an egg. In turn, an AMH test is used to estimate an individual’s ‘ovarian reserve’—how many eggs they could reasonably produce.
However, egg reserve estimates are only one measure of fertility, and an at-home test can not reliably conclude whether or when a person will be fertile.
What’s The Problem With Some At-Home AMH Tests?
The primary issue with AMH testing is that there is no evidence to suggest they predict fertility.
Per the research report, “evidence consistently suggests AMH levels are a poor predictor of current and future fertility, in part because they do not provide any indication of egg quality, nor how quickly a woman’s egg count is declining”. In fact, one study of women aged 30 to 44 found no correlation between diminished ovarian reserve and risk of future infertility.
Specialist in Reproductive Endocrinology and Infertility at Monash IVF Dr Katrina Rowan, even said they shouldn’t be called “fertility tests”.
“AMH just tells us about a woman’s reserve of eggs, and, in fact, there’s no reliable data that this predicts if she can fall pregnant now or in the future. So, really, it shouldn’t be called a fertility test at all. It’s an assessment of egg reserve, and that’s all,” she told ELLE Australia.
Furthermore, a number of conditions can interfere with the reliability of the results, particularly Polycystic Ovarian Syndrome (PCOS), which can elevate AMH levels without accurately indicating your egg count.
Dr Rowan adds there are a lot of factors that can affect the results, “such as vitamin supplements and being on contraceptives”.
Despite the aforementioned limitations and lack of evidence linking egg reserve to an ability to conceive, of the 27 websites analysed in the study, 20 sites (74%) stated the test could indicate likelihood of conceiving, and only 9 (33%) stated it could not.
Eleven of the websites also claimed the test result would be useful in enabling women to adjust their reproductive timeline.
Meanwhile, only 13 of the sites (43%) included information about the limitations of the test, including PCOS falsely inflating AMH levels.
Finally, Dr Rowan acknowledged that the topic of fertility can be fraught for many women, and at-home testing can leave women vulnerable without adequate support.
“I think the other danger [of home AMH testing] is not having appropriate counselling in place afterwards,” Dr Rowan shared.
“If a test is ordered, as currently is done by a GP or fertility specialist, there’s a doctor in place to give perspective on that result and to discuss what to do about that result.
“[With home testing] There’s also the risk of them either being falsely complacent about their fertility in the future, or creating a whole lot of worry when there’s no actual problem.”
Are There Upsides To AMH Testing?
While the study warns against fraudulent claims from direct-to-consumer AMH test vendors, ELLE spoke to a woman who found the process positive—if the right information and education is provided.
Taylor*, 27, took a home test at the age of 26 “out of curiosity” and felt both well-informed and supported by an at-home test service, which included online consultations and support.
“The consult I had was sensitive to my feelings and even though my result was lower than they would like for my age, I felt a peace of mind at least knowing that,” she said.
“In terms of reliability, I was fully briefed that an AMH test is not a confirmation of fertility. This is not a result you should base your entire family planning on, but it may help reinforce your path. For me, it means that when I get my IUD changed next, I will request more in depth testing through my GP, and have some proof that I require it.”
To this end, Taylor shared that she’d heard of GPs refusing or dissuading young women from fertility testing because they weren’t immediately trying to conceive.
“I’ve had friends see GPs who refused to test their fertility until they’d been trying for a baby for a year, which is really disempowering to single women who might want information about their own bodies,” she said.
Dr Rowan encouraged young women who find themselves in this situation to always seek a second opinion, or request a referral to a fertility specialist.
Taylor also concedes her personal experience was less about wanting to have a baby in the near future and more about wanting to know about her egg reserves with the question of whether she would potentially need to pursue egg freezing in the near future.
“Ultimately, everyone’s fertility journey is different. For me, I did my research, and understood the way the testing worked before testing. That’s my experience, but, as perhaps this study says, other women are not feeling that way.
“Potentially there needs to be more clarification about what these tests are for and what they don’t cater to, so people understand exactly what they’ll get out of it, and what they won’t.”
This article originally appeared on ELLE Australia.