Causes & Treatment

Approaching 35, is my egg count on the slide? Let’s get checked for AMH

Eloise Edington  |   2 Jan 2023


Article updated in January 2024. As one of our most popular features, we’ve checked and updated this article to give our readers the best support possible. Let us know if there’s anything else you’d like to see on AMH, LetsGetChecked, ovarian reserve and at-home fertility testing.

Turning 35, AMH and egg reserve

Since I found out we needed IVF back in 2015 (aged 30), it’s been ingrained in my mind that fertility starts to diminish when you reach 35.

If you haven’t been through a fertility struggle, this may come as new info. But to be honest, I think there’s been a huge jump in our awareness, as women, across the last decade. Age 35 isn’t a set-in-stone cliff-edge – there’s no established ‘use-by’ date we’re working with – but it’s now more widely known that female fertility does on average see a steeper decline in our mid-to-late 30s.

The problem is, so far we’ve had very little access to the testing which would empower us with vital insight into our individual fertility profile. It’s all very well to talk about ovarian reserve and age, and what the averages say. But what about us, and our specific situation?

Knowledge (and test results), I’ve found, is power. Power over my fertility journey, and the choices and decisions I make as a result. If age is a factor, surely it’s best not to grope around in the dark with our own health and wellbeing, guessing our way and putting focus in – all too often – the wrong place.

I turn 35 next month. And I’ve been on quite the journey so far, with IVF and fertility. So for me, the time is right to see if and how my AMH levels have declined since I had them tested at age 30, when we were embarking on IVF for the first time.

Why AMH?

Anti-Mullerian Hormone (AMH for short) is a marker for ovarian egg reserve, often assessed using a simple blood test. Research suggests that on the whole, AMH levels don’t fluctuate during your menstrual cycle, so the test can be taken at any time of the month – even if you’re taking oral contraception.

This test is normally one of the preliminary tests that a doctor would ask to see if you’re struggling with trying to conceive (TTC). And crucially, whilst it gives an indication on egg reserve (amount), it doesn’t tell us anything about the egg quality.

With a super-impressive 81% 5* rating on Trustpilot, free shipping and fast lab results in two to five days, the LetsGetChecked Ovarian Reserve Testing is my AMH test go-to right now. Check out their easy home sample collection kits and keep reading for all the detail on AMH, and what my results are looking like at (nearly!) age 35.

Podcast pointers – Fertility Springboard: Embarrassing fertility questions & how to optimise sperm / egg quality

What does LetsGetChecked check for?

LetsGetChecked offers a range of health tests, covering sexual health, women’s health, men’s health, general wellness, and coronavirus. There are also corporate options for employers, providers and the public sector – testing is designed to be accessible and easy-to-use, cutting wait times and unlocking patient understanding of their own whole-body health, from home.

LetsGetChecked female fertility testing options – the category I’m focusing on right now – include:

  • progesterone testing
  • ovarian reserve testing (AMH)
  • female hormone testing
  • plus, other tests for micronutrient deficiency, thyroid and sexual health

Not part of my story – but crucial for many – LetsGetChecked also provide fantastic options for male health and fertility testing. Check those out here.

My ovarian reserve (AMH) testing

A few years back, I had my initial AMH test done on the NHS, although it took a lot of persuasion to get this booked in, with my GP.

Unless there’s a known fertility issue or you’ve been trying to conceive for over a year, it’s pretty rare to be able to get a GP’s support with booking this test, or fertility care in general.

AMH-test-LetsGetChecked-ovarian-reserve
AMH-blood-test-process

It’s only since launching The Ribbon Box that I’ve become aware of new and more straightforward at-home tests. Once initiated, I couldn’t believe the difference. No stress of stopping at the surgery on your morning commute, or waiting nervously for blood to be drawn out your arm, and then a few puncture wounds later (when they can’t find the veins in your arm), being attacked in your hand.

Read next – Trying to conceive sucks: A man’s perspective by Mosie Baby

Keen to compare my experiences, I picked an Ovarian Reserve Testing (AMH) kit from LetsGetChecked (currently £129, but pop code ELOISE25 in at checkout for 25% off).

The test

You’re advised to do the prick blood test first thing in the morning, standing up, hydrated and before too much food – pretty much like any other blood test.

AMH-blood-test-step-by-step

How it works, step by step

This is how it worked for me – and my honest review of the test and process.

  1. Open box (love the neat, discreet packaging) and register my bespoke code on the LetsGetChecked website
  2. Enter my DOB and name inside the box (the exact spot for this is marked clearly)

  3. Watch the instruction video, so I’m prepped for each step (no panic required!)

  4. Choose my dominant hand index finger and clean the tip with the alcohol wipe provided, then dry it with a towel and take the head off the puncture device

  5. Heart racing a little, I press down to pierce my skin with the device, but in fact it just feels like a quick pin prick. I can’t believe how quickly the blood starting dripping from this small puncture!

  6. My aim isn’t good, so I find it tricky to drip the blood into the small test tube, however I soon get the hang of it and before too long I’ve filled the tube (not sufficiently, however – read my results below!)

  7. Wipe down my finger, put on a plaster (also included in the pack) and put the lid on the sample, gently shaking it a couple of times before placing it inside the sealed medical bag provided and into the pre-paid packaging

  8. Head to the post office (free post) and hand it over – DONE!

I couldn’t believe how hassle-free and easy-to-follow the process was.

Results

With a text message pinging up to let me know the results were in, my heart was racing again. I’m not sure why, exactly, but getting results in this way – so easily at home – definitely jolted my adrenaline.

I opened the results email, but frustratingly the sample hadn’t been sufficient. I had a feeling this might have been the case when I did the test, as my blood flow wasn’t playing ball that morning. And to be honest, it’s happened to me a fair few times in the doctor’s surgery too. More circulation and tip-top hydration needed, clearly!

LetsGetChecked called me to support the re-test. They sent a new test (free of charge as standard, in this situation) and I repeated the test a few days later. This time I made sure I’d glugged a tonne of water, done a few arm movement exercises to get the blood pumping and and pricked my finger at the very tip, to increase the blood flow.

Hurray – tube sufficient.

Results, take two

One text and email later, I was looking at my unique test results.

For ovarian reserve and AMH, LetsGetChecked use a measurement called pmol/l (picomole / litre) to indicate egg supply, not quality.

Here are the ‘normal’ ranges that are given:

Age 25-29 = 6.4 to 70.3

Age 30-34 = 4.1 to 58

Age 35-39 = 1.1 to 53.5

Age 40-44 = 0.2 to 39.1

Age 45+ = 0.1 to 19.3

What does this mean for me? Well, when I was aged 31 in 2016, my level was 13.7 pmol/l.

Today, my level is 4.6 pmol/l

In summary

I’m still in the ‘normal’ range for my age, but my egg supply has decreased (as expected) by 9.1 pmol/l in four years. I wanted to understand more about my results, so I requested a call with the LetsGetChecked nurse. This was straightforward, and I selected a slot for the next day.

She explained that factors such as diet and stress can affect the result. I am feeling tired and stressed at the moment, so this isn’t really a huge surprise. The nurse also said that, due to my age and the result, if I was trying to conceive, she would want me to repeat this test on a yearly basis to see how quickly my egg count was continuing to decline.

Read next – Dealing with anxiety and uncertainty on your fertility journey

If you’re starting with TTC and don’t know much about your own unique fertility numbers and profile, it could be worth taking the AMH test to check your egg supply. For me, even though I wasn’t trying to conceive at the time, it gave me sound, specific insight into where my fertility was at, and vital information to work from, in the future.

Keen to order a test? LetsGetChecked currently offer TRB readers an exclusive 25% off – just use code RIBBON25 at checkout.

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