Article Text
Abstract
Objectives The anti-Mullerian Hormone (AMH) test is a blood test indicating ovarian reserve (i.e. the number of eggs left in a woman’s ovaries). The test is helpful in assisted reproduction (indicates the potential number of oocytes retrieved for in vitro fertilisation or egg freezing). However, studies have found that the test cannot reliably predict the likelihood of pregnancy or timing of menopause. It is unclear what people in Australia know about the AMH test or how widely it is being used, particularly for women without infertility. We therefore aimed to assess community awareness of the AMH test and estimate AMH test usage in Australia.
Method Data were collected via an online or telephone survey of the ‘Life in Australia’ probability-based population panel in January 2022. All active female panel members aged 18–55 years were invited to participate. Socio-demographic characteristics (e.g., age group, educational attainment, state, region, socio-economic index for area, country of birth, indigenous status) were assessed. Questions about AMH testing included if and how participants had heard about AMH testing, whether they had ever had an AMH test, the main reason for AMH testing, and how they accessed the test. To ensure the sample was representative of the Australian population, results were weighted to population benchmarks using propensity scores.
Results 1773 of the 2423 women who were invited responded (73% response rate). Of these, 229 participants (13%) had heard about AMH testing and 124 had had an AMH test (54% of those who had heard of the test and 7% of the total sample). Having had the test was associated with age and educational attainment (p<0.05), but no other socio-demographic characteristics. The highest rate of testing was for those aged 35–39 (14%), followed by 10% for those aged 40–44, and 8% aged 30–34 years. Most participants had accessed the test through either a fertility clinic (63%) or general practitioner (31%). 63 women (51% of those who had had the test) had the test during infertility investigations, 24 (19%) because they were considering pregnancy and wanted to understand their chances of conceiving, 11 (9%) because they were curious, 14 (11%) to find out if a medical condition had affected their fertility, 6 (5%) because they were considering egg freezing, and 3 (2%) because they were considering delaying pregnancy.
Conclusions Whilst a substantial proportion of women underwent AMH testing for reasons supported by evidence (e.g. as part of infertility investigations), many did not. Potential implications of AMH testing in scenarios not related to infertility investigation include a false sense of security about delaying pregnancy, unwarranted anxiety about not being able to conceive, pressure to conceive earlier than planned or desired or unnecessary procedures (e.g., egg freezing). That over half of the women who had heard of AMH testing had undergone it is also notable and suggests that testing prevalence may increase as marketing of the test intensifies.