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Simple fertility test a game changer, but not covered by Medicare

Andrew Taylor
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Jamie McIntyre and Jarrad Dodson have faced greater challenges than many parents to have children.

It took five rounds of IVF for Ms McIntyre to become pregnant with daughter Madeleine, now three years old.

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"We lost the twin," she said. "But I'd been pregnant four times before that so we had five miscarriages altogether.

"That was a dreadful time. But ultimately we got Maddie and she was healthy and happy."

Ms McIntyre suffered several more miscarriages before giving birth to her son Sebastian. 

Yet Ms McIntyre and Mr Dodson, who live in the Western Australian mining town of Tom Price, may not have been able to have children if not for a simple fertility test.

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Aged 29, Ms McIntyre had become engaged to Mr Dodson but planned to wait a year or two before starting a family.

But Ms McIntyre said her father "nagged" her to have a test, common in IVF treatment but not otherwise widely used, to measure levels of the anti-mullerian hormone (AMH), which is produced by the ovaries and mirrors the number of eggs in the ovary quite closely.

"That changed our plans overnight," she said. "I was told I was peri-menopausal – that's very unusual for my age. If I wanted kids I needed to get cracking."

Prompted by the test, which revealed low levels of the AMH, McIntyre began her arduous journey to have children, including years of unsuccessful fertility treatments.

"That test I'm forever grateful for my dad pressuring me to get it done," she said. "Honestly, I didn't think anything was wrong at all. I had no clue what I was walking into when I went in and got my results."

Professor Robert Norman, of the University of Adelaide's Robinson Research Institute and Fertility SA, said measuring the hormone provides women "with more information on their own ovarian cell reserves in order to contemplate when they should have children and, for those who want to have children, assess how urgently this needs to become a priority". 

He said the anti-mullerian hormone is produced in the ovaries and "acts like an egg timer giving an indication of the reserve of eggs in the ovary".

It may also indicate the early onset of menopause.

Professor Norman, a speaker at the Royal College of Pathologists of Australasia's annual conference in Sydney last month, said the test had to be interpreted correctly so patients did not panic if they received a bad result.

"Once a patient has the test done, it's important to get some good advice on what to do next," he said. "This may be waiting, and assessing again at a later date, or deciding to move ahead with a pregnancy sooner. With increased controversy regarding egg freezing for young women, this test may offer a suitable alternative."

Professor Norman said the cost of the test, which is not covered by Medicare could be an issue for some women: "This is something that people may baulk at because it's pretty expensive. Yet if it gives information about fertility one would think that's a reasonable test to be paid for by the government."

Without the test, Ms McIntyre said she would have waited a couple of years before starting a family.

She also doubts whether she would have been properly diagnosed and treated for endometriosis – a condition where the tissue grows on the outside of a woman's uterus, rather than the inside, and causes debilitating pain.

"If I waited until I was in my 30s, like my friends did, I don't think I'd have my two children," she said. "I think time would have run out and I'd be lucky to have one."