WHILE it’s widely believed that younger women have a higher egg count and are more fertile, one Jamaican fertility expert says recent egg donor drives are revealing a different trend.

Dr Sharifa Frederick, clinical director of the Caribbean Fertility Centre, shared that a recent egg donor drive saw hundreds of women ages 20 to 30 offering to donate their eggs to help other women conceive. However, she said only about 10 women were successful after completing the medical and psychological examinations to determine if they were fit donors.

She told the Jamaica Observer that after medical examinations and blood tests, only about 20 per cent of applicants are typically left, because the majority do not meet the criteria of having a normal body mass index (BMI), not having seizures, sickle cell, or any other medical conditions. However, it is their egg count that she said she often finds most concerning.

“We find that a lot of young people don’t pass the [fertility] test because you have to have an anti-mullerian hormone (AMH) level of about three and over nanograms per millilitre to be able to qualify, so about another five per cent don’t qualify from that 20 per cent,” said Dr Frederick.

Anti-mullerian hormone is produced by the follicles in a woman’s ovaries that helps to estimate her ovarian reserve or the number of eggs remaining. AMH levels are commonly measured through a blood test and can provide insights into a woman’s fertility potential. AMH levels between 1.0 and 4.0 ng/mL are considered within the normal range for women of reproductive age.

“Then now you have to do another blood test where your sickle status has to be normal, your steroid, your hormonal testing has to be normal, and so forth. You have to do an ultrasound, and your ovaries have to be normal, so another five per cent are snipped out there. Then we do a psychological evaluation and sometimes you get a report: ‘We don’t think this person is psychologically or socially ready,’ so it is a very rigorous process that you go through,” she told the Sunday Observer.

“That’s why we have to do these large [donor drives]; that’s why we have to get a large number coming in, because there’s so much that they have to be sieved out through,” she explained.

Dr Frederick stated that a low AMH level can be caused by many factors, and in some cases is hereditary.

“[Some women], they’re just built that way, and they’re going to have premature ovarian ageing. Some of it is environmental and sometimes they have a condition called endometriosis that may deplete your eggs, destroy your ovaries, and deplete your ovarian function over time.

“Endometriosis can have no symptoms as well, so there are a lot of things like environmental causes or it could be [their] lifestyle. They may have other conditions [too]. It could be the medications that they’re on, because some people have autoimmune diseases and the medication may be a bit cytotoxic, so there’s a lot of reasons why your egg function can be declining,” she said.

The clinical director said that while many donors might not be chosen, their medical evaluation gives them insight into their fertility levels. She urged women who are thinking about conceiving to do the necessary tests so they are informed.

“I’m a big advocate for all young people doing their AMH levels, even if you’re not interested in having children,” she told the
Sunday Observer.

“There’s a lot of times where I have to speak with a donor and say to her, ‘Well, your fertility window is very narrow and so you should probably either freeze eggs or you should, if you’re in a position, you should think about building your family from now, because in another 10 years — if you’re 22 years old and you’re having such low AMH levels — in another 10 years, you’re going to have problems getting pregnant.’

“You may not have problems now because it’s okay now. It can be low and it’s satisfactory to have kids now, but in another 10 years it’s going to fall, because you’re born with the amount of eggs that you will ever have in your lifetime and all they do is they become depleted over time,” said Dr Frederick.

She noted that even women with a normal AMH will have their levels reduced over the years and urged all women to get their levels checked so they can plan accordingly.