# Test helps older women decide about IVF treatment



## longbaygirl (Aug 19, 2004)

Saw this - thought it might be of interest.

Test helps older women decide about IVF treatment


Ian Sample, science correspondent
Friday November 17, 2006
The Guardian


Doctors have developed a test to predict the chances of successful fertility treatment in women over 40 years of age.

The test is being made available over the internet and measures three hormones that together indicate how many eggs a woman has left in her ovaries.

Specialists at the assisted conception unit at Jessop hospital in Sheffield are recommending the test to older women and those with a history of fertility problems to help them make informed decisions before paying for fertility treatment.

More than one in seven women in England and Wales conceive over the age of 35. Researchers said the test would help older women to decide whether to proceed with treatment, and to prepare psychologically for failure if the test suggested they had a low chance of success.

Doctors believe the test will help reduce the number of fertility cycles which have to be abandoned, and save money from being wasted on treatment which is extremely unlikely to work.

Bill Ledger, who led the team, said: "It's hard to dissuade women from having a go at IVF even when they're older and the chances are it's not going to work. We wouldn't propose stopping people having IVF if the test result was bad, but we hope this will help with counselling if their treatment does turn out to fail."

In an editorial in the British Medical Journal last year, fertility specialists including Susan Bewley, a consultant obstetrician at Guy's and St Thomas' hospital in London, warned women that by delaying having children they risked "defying nature and risking heartbreak".

Figures from the Human Fertilisation and Embryology Authority show that fertility rates plummet beyond the age of 35, reaching almost zero by 45. Miscarriage also becomes a risk the older women conceive. At 40, the risk is double that at 20 years, with 40% of all pregnancies leading to miscarriages.

The test measures levels of two ovarian hormones, called inhibin B and anti-mullerian hormone (AMH), and follicle stimulating hormone (FSH), that together indicate how many eggs a woman has left in her ovaries.

In a report published today in the journal Human Reproduction, the researchers tested blood from 84 women aged 40 or older before they were given fertility treatment.

Thirteen patients - 15% - had their treatment cancelled because they did not respond to drugs and 48 patients - 57%, produced four eggs or fewer. Typically, fertility clinics hope to collect 12 eggs from women after treatment.

The researchers found that levels of AMH and the two other hormones were able to predict which patients would not respond well to treatment and which were at risk of having their therapy abandoned.

The Sheffield team have been supplying the test privately, but are now making it available publicly on boots.com for £179 under the name Plan Ahead.
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## three_stars (Jan 19, 2006)

Hi
Thanks for posting that..... all I can say is that is about blxxdy time!!!  I had heard of this some months ago in Uk but good to see it is being published more in the media.

I had these tests done in France last OCt and Nov... and had everything good but the AMH which was nil.... and therefore the GYN would not proceed with IVF for me.  He said this test has been used as the deciding factor in France for last 2 yrs.  But as I could not find much at all on it anywhere... few if any clinics or DRs knew of it or were using it ( outside France)... so I went ahead anyway.  Now I did get 2 eggs fertilizex and we had MF so could not say for sure that the eggs could not have made it with donor sperm  But may have very likely miscarried later even if they had implanted.  AFter this I decided that the test must be right.  I would like to see it more widely used and have more studies on it.  If it really can ( together with the other tests) give a definitive result, it will really help so many women from wasting precious time, money and emotions by continuing to try to use bad eggs.
I have no way of knowing if the OTC boots type tests are as good as going to a lab...let's hope so for that price.There is a thread right now about a few ladies doing AMH test and I think it listed some clinics... BUt if more women ask for it maybe it will start to more widely available. 
b123


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## longbaygirl (Aug 19, 2004)

Hi B123 - as you say, if it is accurate it is well worth the money to save a lot of heartache and waste of money further down the line.

Where are the threads on AMH?


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## three_stars (Jan 19, 2006)

do a search and try anti-mullerian hormone.  AMH is to  short to find anything.  Maybe also hormones.  Inhimbine B.


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## three_stars (Jan 19, 2006)

Ok  I had another look.  due to my typos     seems best if you try  a search for mullerian 

I think I may have posted a lot on PMs so does not show up here on search.  A google search may be helpful as well.

I think you are wise to look into if you have not had it done.
Good luck.  b123


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## bluebell (Dec 9, 2004)

Hello,
Thanks for that info and great to hear this test is more widely availiable now. 
A word of caution though .. the test is great for giving one piece of the information jigsaw, but there are so many other factors in infertility other than number of eggs.  I always had plenty of eggs in txs with my own eggs  ... twice over 20 eggs !  However, without ICSI none fertilised at all, and even with ICSI the embryos were poorish quality, without any evidence of sperm factor. 
Also I have dense pelvic adhesions.  I had 4 cycles with my own eggs, all with plenty of eggs, but all with very few embryos, all grade 3, and all BFN.
I saw a programme on the box about this test, and it said that it can give women false security who are delaying a family, if the test reveals that they still have plenty of eggs.
However, combined with other tests I am sure it is useful.  
Good luck to you all on your journeys.
Bluebell xxx


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## three_stars (Jan 19, 2006)

my understanding it the AMH test would indicate egg quality.  I still got 2 eggs fertilised when I went ahead... then who knows as there was MF , illness, etc that could have contributed.

I agree that it really needs to be the AMH Inhibine B LH FSH and estradiol ( e2) tests all looked at together.  As I have never used this box test I am not sure if it will completely accurate... I think I would still reccomend tests done with a good lab and with proper evaluation by a fertility specialist.  IMO.
But at least it seems a step towrads wider range of tests used. 
b123


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