Written by Loren Solomon Tuesday, August 07 2012
I always knew I would have children. I never even thought about it. I worked at a camp with hundreds of kids every summer for over 20 years; taught Sunday School; have godsons, nieces and nephews; and taught dance to kids for as long as I can remember.
In my 20s and 30s, I talked to my OB/GYN about how not to get pregnant. In my mid-thirties, I talked to him about how long I had to get pregnant and if I should be concerned.
He patted me on the head and said no, that he’d known me since I was a little girl, and I’d always told him that it was more important to find the right partner than it was to have kids.
By the time I was 42, I’d had four five-year relationships. None of them was the right partner. And so at 42, I asked again and was told that basically there was no real way to know – I could either try to get pregnant or decide to adopt. I asked about freezing eggs, and because it was 2008, I was told that it was “more fiction than science” and so to just keep looking for my right guy.
I felt weird. I set up an appointment with a female OB/GYN. She drew blood tests and checked estradiol and FSH levels – voila! I was fine! I was fertile – my results were awesome! But just in case, she suggested I go see another doctor, a fertility specialist, just to get more specifics and details.
The first thing this specialist, Dr. Mitchell-Leef, asked me was if I had my AMH test results. And considering the fact that I had never heard of an AMH test, the answer was clearly no.
So then she drew an AMH test.
And then it came back.
And then I couldn’t have my own biological children.
The AMH Test: Now You Know
What was this AMH test, and why had I never heard of it? My doctors were Ivy-League educated and chiefs of staff at hospitals. No one mentioned it. Ever.
After I was hysterical in Dr. Mitchell-Leef’s office and after she told me that she saw scores of ladies a day and had to watch them weep in her office, and after I talked to all my brilliant, successful women friends of all ages and found out that no one had heard of this test and almost all of them thought, like me, that there were plenty of options and that we didn’t really need to worry about it ‘til much later (turns out that the options included egg donors and expensive IVF treatments that mostly didn’t work after 40 or surrogates with egg and sperm donors), I decided to figure this out.
I went back to talk with Dr. Mitchell-Leef about why this information was not out there – why the AMH test, which was clearly the most important test to tell women how long we have to get pregnant was not common knowledge.
She said she’d been talking about the reality of women’s biological clocks since 1995 when she was interviewed for The New Yorker and scores of other news outlets. She spoke at medical conferences and reproductive conferences all over the world. She wasn’t sure why no one wanted to hear about it, but perhaps it was because the FDA has not yet approved the test.
So while the majority of the medical community knows about it, and 96 percent of reproductive practices in the country use the AMH test, no one’s talking about it.
But I am. And so is my firm - a cause-based marketing firm called Advertising For Good. And hopefully so will you.
At 21, in college, I want young ladies to know there’s a test that can help them plan their families like they’re planning their careers. At 31, I want women on the career path to put a plan in place that helps them be successful and have a family if they want. At 41, I want women to have already had their AMH test and to therefore be in the process of making well-informed decisions.
What women do with this information is up to them.
They might go home and talk to their husbands about not waiting to try. They might decide to get a sperm donor and be a single mother. They might decide to not get pregnant. They might decide to freeze their eggs or embryos so they can continue climbing the corporate ladder and have their frozen embryos implanted – which you can do until you’re 51.
Point is, they’ll know. They’ll have the information. They can make good, conscious decisions – before it’s too late, and they no longer have choices.
The 45-plus-year-old celebrity women in People Magazine who are having twins used egg donors or surrogates or both. In 30 years of practice, Dr. Mitchell-Leef has only helped six women get pregnant over the age of 44 with their own eggs.
So, please. Get the test. If you ever want a child, if you ever think you might consider being a mother, get the test. If it’s ever possibly even an inkling in your mind, get the test. Just so you know. And then you can decide.
The Medical Facts from Dr. Dorothy Mitchell-Leef
“Most women do not realize that their ovarian reserve, the number of eggs they have, decreases over time. Most women believe they will have sufficient eggs to allow them to achieve a pregnancy into their late 40s. Unfortunately, egg quality and quantities decrease markedly after age 37-39. What has been touted in the press about women using their own eggs to achieve a pregnancy in their mid- to late 40s is not what is seen in infertility practices.
The inexpensive, simple AMH (anti-Müllerian Hormone) blood test is one of the most accurate predictors of ovarian reserve and gives women a marker for how long they may have to conceive. In the past, the usual labs that would be drawn to evaluate ovarian reserve was the follicle stimulating hormone (FSH) and estradiol on day three of the menstrual cycle. Unfortunately, the levels could only be to be done when women were not on birth control pills and on the designated day three only. oday, the AMH is available to measure the size of the group of growing follicles in women or the size of the remaining egg supply, which is the ovarian reserve. This is a blood level that can range over 4ng/ml that reflects that the woman has a large number of eggs remaining and go down to < 0.1ng/ml, which represents ovarian failure or the lack of viable eggs. Results can vary slightly, but the lower the number is toward < 0.1ng/ml the lower chances of achieving pregnancy.
The most important concern is that women need to be proactive in requesting that an AMH level be drawn each year (starting as early as age 30-32) by their physicians, so that they can make educated decisions about their reproductive futures. If women have family members that have early ovarian failure or menopause, they may wish to have the test done as early as 25-28 for their personal information. There is no specific age that has been targeted at this point, although there may be in the future as we see the numbers work out over time. Oocyte cryopreservation is available in some centers that would allow women the ability to freeze their eggs and therefore decrease their chances of missing the opportunity of using their own eggs in the future. For those women who are married and desire children, it is better to consider attempting pregnancy before her ovarian reserve is depleted.
The option to measure ovarian reserve with AMH levels may not be exact, but it can give a relative gauge of changes that may suggest significant decreases that may warrant a woman to decide to preserve her potential to have her own children in the future or to move forward in having children before the option is lost. Being their own advocate is truly important to all women who have the desire to have a child.”
Now You Know™:
- The AMH test is currently the standard of care in Europe
- Approximately 96 percent of American reproductive clinics routinely use the AMH test to determine the viability of IVF
- The AMH test is routinely used for women with cancer considering having a baby prior to undergoing chemotherapy
Baby Steps: Plan Your Family™
Baby Steps: Plan Your FamilyTM is a national public education campaign to educate women about the AMH test and to encourage them to be their own advocates in planning their families in the same way they do their careers and finances. Baby Steps: Plan Your Family is sponsored by the Partnership for Fertility Awareness (PFA), a national coalition of concerned people, nonprofits, and corporations who want to educate women about their fertility and demonstrate real world solutions that will make a difference as they plan their careers and their future. PFA is currently in discussions regarding FDA approval for its widespread use in the U.S. as well as sponsorship discussions with pharmaceutical companies, insurance companies and women-focused consumer brands.
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