GP fertility test requests increase 13-fold in 10 years

GP requests for anti-Müllerian hormone (AMH) tests increased more than 13-fold in the decade to 2021, according to new Australian research.
 
Despite this clinical and consumer demand, a Flinders University study concluded this ‘does not appear to be evidence-based’.
 
The study analysed the health records of almost 1.4 million females aged 20–44 attending Australian general practices from 2011–21, with AMH testing for women aged 30–34 increasing almost 20-fold.
 
Significant differences were seen between individual general practices, with one in 10 having no patients who received an AMH test during the study period.
 
The study also revealed around 20% of women received a result classified as low, but among those who repeated the test after a low result, one-third later received a result in the normal range.
 
Lead author Associate Professor Luke Grzeskowiak said while AMH can measure ovarian reserve, ‘it cannot tell a healthy woman how likely she is to conceive, how quickly, or how much reproductive time she has left’.
 
‘A low AMH result does not mean a woman is infertile, and a normal result does not guarantee future fertility,’ he said.
 
‘AMH testing can be useful in some specialist fertility settings, but it should not be mistaken for a test that predicts whether a woman will be able to have a baby.
 
‘For younger women, in particular, an AMH result should not be viewed as a crystal ball for their reproductive future.’
 
The authors linked this recent rise in testing to delayed childbearing, a growing awareness of fertility issues, social media messaging and commercial promotion of the test as a simple way to gauge reproductive potential.
 
It comes as the total fertility rate in Australia was 1.481 births per woman in 2023 – the lowest ever recorded. Median age was 32.1 years for mothers and 33.9 years for fathers.
 
‘Women deserve clear, evidence-based information about what AMH testing can and cannot tell them,’ Associate Professor Grzeskowiak said.
 
‘One of the biggest concerns is the psychological impact. Women may feel pressured to bring forward plans for children after a low result, while a normal result may provide false reassurance if other fertility issues are present.
 
‘Our concern is that women may be making important decisions about relationships, family planning or egg freezing based on information that cannot answer the questions they are most concerned about.’
 
Moving forward, researchers said their findings highlight the need for further research to better understand the factors influencing AMH testing and support its evidence-based use in clinical practice.
 
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