Does AMH Matter When Choosing an Egg Donor?
Case Study - Carla and Theo
There are several tests available that can help with establishing ovarian reserve, but singly, they are not direct predictors of IVF success rates. Recently the test for AMH (AntiMullerian Hormone) has become popular because it is easy to obtain and does not need to be tested at a particular time during a woman's menstrual cycle. We find that many Intended Parents to negate a donor because of a low AMH. Our advice? Remember that a single fertility test result will not guarantee a successful pregnancy or live birth and it's up to your doctor to review ALL her tests.
Carla and Theo came to Donor Concierge after several months of searching for an egg donor on their own. They had signed up with several egg donor agencies and spent countless nights and weekends, poring over the online agency databases. Yet they just did not find the right donor for them who was available to be matched. They were looking for a donor with Spanish heritage, a four year college degree and a nice smile. Sounds simple - but it became a frustrating and fruitless journey.
Theo, 47 and a chef, and Carla, a 45 year old lawyer from New York had spent years trying to have a baby of their own through IVF. Sadly, all their attempts were unsuccessful. When they finally made the jump to using an egg donor, they were keen to find someone with excellent fertility hormone levels. They noticed that some agencies would publish a “Fertility Rating” or offer an 'AMH' result but others would not. They'd signed up for our Premium Search service, meaning that I would do all the calling to the agencies on their behalf, check the donors' availability and ask any questions they might have. I found 36 egg donor candidates for them and helped them narrow down those candidates to 3 top choices. They wanted me to check on each of the candidates’ individual AMH results. Out of the 3 candidates that they picked, two were previous donors and had AMH/cycle results and one was a first time donor and therefore, had not had any preliminary testing done.
Despite being listed as available two days' before, we discovered that the two previous donors were reserved by other IPs, leaving them with their final choice - a first time donor who had not had any AMH testing done. Many intended parents falsely believe that agencies present donors who are medically cleared to cycle. Unfortunately, this just isn't the case - it is too costly for egg donor agencies to have tests done on every young woman who wants to be an egg donor. Some are starting to do this as a matter of course, but smaller agencies just can't afford this, and leave that to the hopeful intended parents who want to match with her.
After Carla and Theo paid the full agency fee, arrangements were made to have the egg donor's AMH test. Typically, the agency works with the fertility clinic to obtain a doctor's order, the egg donor visits a lab to have her blood drawn and the results can come back within a week. I explained to Carla and Theo that AMH testing alone is not a guarantee that the donor will be approved by your RE. This donor came back with a below normal AMH, but her antral follicle counts were normal, so the RE decided to approve her to cycle. Had they seen her profile and made the assumption themselves that her AMH wasn't acceptable, they could have lost out on a good egg donor match.
The best predictor of success is still the age of the egg donor. That is why, here at Donor Concierge, we only send out donors between 21-29 yrs old and we encourage you to look at all of the great qualities presented by an egg donor, rather than being fixated on one thing that 'isn't quite right'. It is our job to help you find donors that are healthy and have the best chance of helping you create your family.
Anna Baylon is a registered nurse and Senior Case Manager at Donor Concierge