Doctoral Dissertation Research: Cultural and Social Dimensions of Anti-Mullerian Hormone Screening Technologies

Northwestern University, Evanston IL

Investigators

Abstract

Demographic shifts in the United States, including a later average age of first birth have significantly changed how women and couples navigate family planning. For women, age is one of the best predictors of fertility: that is, whether a woman will be able to conceive. Younger women are typically more fertile, and ability to conceive declines until a woman reaches menopause. However, the age at which an individual woman becomes less fertile varies depending on many factors unique to her individual body, including genetic makeup, diet, lifestyle, and environment. Over the past decade, medical providers have increased the use of a simple blood test to measure a woman's anti-Mullerian hormone (AMH) level, a hormone secreted by a woman's remaining pool of eggs. AMH level has been used in some medical settings as an indicator of fertility, with lower values suggesting reduced fertility. AMH screening is a low-cost fertility test and is becoming more widely available in the United States. As AMH testing is becoming more widespread, it is important to understand how women are using test results as a tool in family planning and to navigate their biological parenthood options. In addition to providing funding for the training of a graduate student in anthropology in methods of empirical, scientific data collection and analysis, the project would enhance scientific understanding by broadly disseminating its findings to organizations invested in discovering more effective means of improving public health. Moira Kyweluk, under the supervision of Dr. Thomas McDade of Northwestern University, will explore the cultural and social dimensions of AMH testing. The research will take place at two locations where AMH testing is common: first, at a network of private clinics that offer fertility testing for low out-of-pocket costs directly to consumers and second, at a large research hospital fertility clinic where testing is often a part of family planning using reproductive technologies like egg freezing and in vitro fertilization. The project uses anthropology methods including careful observation and recording of conversations in both clinics, as well as interviews with patients and providers who deliver test results. Qualitative data will help the research team understand why and when women seek AMH testing, as well as the role of romantic partners, family and social networks on accessing fertility testing and taking action using test results. Importantly, this project will gather data on experiences with low-cost fertility testing from women from diverse socioeconomic statuses, races, ethnicities and sexual orientations, deliberately including women often overlooked in research on reproductive technologies, since most patients who have access to fertility medical care in the United States and thus comprise the majority of research participants are white and affluent. Ultimately, data from this project will be important in helping women and providers make decisions about when, whether, and how to take this sort of fertility test since it can have impacts on family planning decisions, emotional health, and social life. Early fertility screening and ongoing screening throughout a woman's life could soon become a standard of care. Information from these interviews will be available to the public to give women more information about others' experiences with elective AMH testing. This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.