Anti-Mullerian Hormone, or AMH, is a hormone produced by cells in the ovary during reproductive years and can be detected with a blood test. Declining AMH levels has been shown to correlate with poor response to in-vitro fertilization, a marker of poor ovarian reserve. This has led to the idea that the test could be used to predict the start of the menopausal transition. However, because the marker has not been studied systematically, it is unclear what different AMH levels mean. For example, what is a normal AMH level? As a result, AMH levels should be interpreted with some caution.
This story reports on results from a new study whose results are to be presented at the European Society of Human Reproduction and Embryology. The study investigators developed an algorithm using AMH levels to predict onset of menopause. However, the full results of the study have not been made available and have not been evaluated by experts.
This story does little to explain to the reader the limitations of the AMH test. It presents the assertion that the test is reliable as fact and does not discuss any potential downsides. False positive results, for example, could cause unnecessary worry and anxiety and lead to needless fertility treatments. The story also does not say whether the AMH test is new or not. In fact, it is not new and is one of group of tests that are intended to evaluate ovarian reserve. However, the study does not mention any of those other tests that are available.
This area of research is important because the duration of fertility is of great interest to many women. A method that could accurately predict menopause could be a proxy for predicting the end of the fertility period. But, as noted, it’s too early to say that about this reported method.
The story does not mention costs, or potential costs of the test. On one website, the cost was of the test was $183. It is unclear whether insurers would pay for this, unless in the setting of an infertility evaluation.http://www.acubalance.ca/ovarian-reserve-testing-including-anti-müllerian-hormone-amh.
The story does not quantify the potential benefits of the AMH test.
The story provides no mention of any potential downsides of the testing. False positive results, for example, could cause unnecessary worry and anxiety and lead to needless fertility treatments.
The story provides no discussion of the strength of the current study. Although the story mentions that the results are "to be presented" at the European Society of Human Reproduction and Embryology, it does not discuss why that may mean it is hard to interpret the implications of the findings.
The story does not engage in disease mongering. The story should have also avoided referring to women who want a career before having babies to know how long to wait. Having a career does not preclude having a family, biological or otherwise.
The story briefly quotes one source other than the study’s lead author.
The story makes no mention of any existing alternatives, of which there are several.
The story does not describe whether the AMH test is available or not.
The story does not say whether the AMH test is new or not. In fact, it is not new and is one of group of tests that are intended to evaluate ovarian reserve.
There is no way to know if the story relied on a press release as the sole source of information.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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