What Are We Looking For? Understanding the POA Screening Process

Coral Tolisano

This information will be on your exams so I recommend you take notes. Demystifying the What’s My Fertility screening process can give you a little peace of mind about the hows and whys of what our doctors are looking for.

Participation counts, simply being engaged and informed about the risks of POA when planning ahead for a complete future is a huge part of getting started. Filling out a short survey designed to gather medical history helps establish connections to potential hereditary influences and autoimmune factors.

Autoimmune disorders have a huge range, from lupus to multiple sclerosis, and there is a 40% chance that you will carry some level of subclinical autoimmunity if you have relatives with any form of autoimmunity issues. That’s why it’s important to pay attention to autoimmune and other familial conditions when it comes to identifying risk levels for POA.

After collecting a little background about you and your family, blood work is the next step. Using either your primary care physician, one of the local providers in our network or simply at a LabCorp location closest to you, we ask for 3 indicators hidden in your veins that help our doctors paint a bigger picture for you and your ova:

  1. FSH, Follicle Stimulating Hormone. FSH is a hormone produced in your brain by your pituitary gland that tells your ovaries to wake up deep sleeping eggs at the beginning of each monthly cycle. Think of your ovaries as cozy little domes of primordial eggs wrapped up in follicle blankets while fast asleep. FSH is the alarm clock for the next batch of potential ovulation candidates. Having abnormally high levels of FSH is like having the sound turned way up on the alarm, something is wrong. Normally, the beeping of FSH alarm clock is dampened by another substance (called inhibin b) produced by growing follicles in a feedback loop. When there aren’t enough follicles growing and producing this substance, FSH beeps louder and louder, meaning that a high level of FSH is a sign that not enough eggs are maturing in the ovaries.
  2. AMH, Anti-Müllerian Hormone. AMH is a hormone produced in the cells of “sleeping” ovarian follicles. Think of it as being able to count the little ZZZ’s coming off the still undeveloped eggs as they wait to wake up for ovulation. Having low levels of AMH can indicate that there are fewer eggs sending up the sounds of healthy rest and your reservoir of options may be shrinking. In the last few years, AMH has really become the “hormone of choice” for fertility specialists interested in gauging the ovarian function of their patients because of its superior accuracy.
  3. Genetic Factors. Everyone has 2 sets of genetic information that come together to form the symbiotic mutations that produce them as an individual. In other words, we really are our parents on a molecular level. All of the material they shared to create your life is coded inside you. Within these mind boggling codes, scientists have discovered a series of mutations that appear to correspond directly to your body’s control over how rapidly you use up your eggs, specifically the repetitions of CGG on the FMR1 gene. To summarize the findings described in the article How the FMR1 Gene Became Relevant to Female Fertility and Reproductive Medicine, published in the journal Frontier, there is a normal range of CGG repeats for both alleles of the FMR1 gene and where you fall on the spectrum can say a lot about how likely you are to suffer from premature ovarian aging (POA).

After all this information is gathered and analyzed, our physicians will create a personalized profile of your fertility trajectory to help you decide what the next step is. Remember, for most women POA won’t be an issue. But for those it does effect, consider having more information as the chance to have more time to plan ahead.

Written by Coral Tolisano

Coral TolisanoHaving experienced fertility complications in her own family, Coral is now focused on helping young women stay healthy and better plan their reproductive options. Raised in New Mexico, Coral currently works as a writer in New York City, where she continues to investigate the role of science and nature in our everyday lives.

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