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Comment by shouldifakeit | Hacker News Reader

I love what you're doing, but a piece of advice - please don't oversell and mislead women by suggesting you can tell them 'how many eggs they have' (text taken from your home page).

You know well that this is not possible at all. 'High/medium/low' is about the best you can say. Please don't mislead people in this way and diminish what is otherwise a really good product.

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Thanks for digging in! We share exactly where the science is and what these tests can and cannot tell you. We can't count the exact number of eggs, and we do report in buckets which are impactful and have clinical utility. One of the hormones we measure is AMH which is a well validated proxy of ovarian reserve. There is a lot of literature on AMH but Hansen et.al.2011 is one of my favorites- they counted the number of eggs (primordial follicles to be specific) in the ovaries of women who were already having their ovaries removed for other medical reasons and found the their AMH levels strongly correlated with follicle count.

I repeat: you’re misleading women by telling them you can tell them ‘how many eggs they have.’ (These are the words you use on your website)

There is no way to count the number of eggs exactly but your statements seem to suggest you do this. This is just wrong - the best you can do is give a very wide range.

Also you say AMH levels are well validated as a proxy for ovarian reserve - the science on this is far from what I’d describe as ‘well validated’. Please speak to 5 gynaecologists and let me know if all 5 agree with your assertion. (That it is the best measure available is not the same as saying it’s wdlk validated, please be clear on this).

Thanks for the feedback on the AMH language. We are always trying to find the best way to simplify the science. In regards to AMH, great question! AMH is known by the clinical community as the best marker for ovarian reserve. I know everyone doesn't have access to peer reviewed journals so here are a few quotes: Podfigurna et al 2017: "AMH level is recognized to be the one of the most reliable markers of ovarian reserve [60–65]. AMH is mainly produced by granulosa cells of the pre-antral and small antral follicles and AMH levels decline with age. AMH level, especially in comparison with FSH level, was considered to be very stable across the menstrual cycle, but more recent studies have shown a slight decrease in AMH concentrations in the luteal phase [56,57]. Moreover, unlike other tests of ovarian reserve, such as AFC and FSH, it has sufficient specificity and sensitivity [58]. AMH concentration correlates with age and AFC" // Leader and Baker 2014:"Hundreds of clinical studies confirm that adding serum AMH testing to a complete ovarian assessment provides a powerful tool to help provide better healthcare for women. The benefits of this testing can optimize fertility treatments; help lead to earlier diagnoses of PCOS, POI, POF, and certain autoimmune conditions; provide the opportunity for better planning for procreation and menopause; and allow for better medical decision-making by monitoring ovarian damage from exposures to medical or surgical therapies. Although challenges with variability in AMH results make the provided practical steps a prerequisite for appropriate interpretation of the testing, the clinical benefits of testing more than justify this additional effort." We have a great post on the science behind ovarian reserve testing here: https://modernfertility.com/blog/ovarianreserve/

> We are always trying to find the best way to simplify the science.

Please don't.

Just be honest and try to actually solve the problem of explaining science in layman terms rather than doing away with the explanations and complexity altogether.

Our OBGYN also told me AMH level is a good indicator of ovarian reserve. I did dig in deeper and found quite a bit of official resources backing this claim. Is there any supporting evidence on why it's not "well-validated?"

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