Attitudes, knowledge and practice regarding the anti-müllerian hormone test among general practitioners and reproductive specialists: A cross-sectional study

Tessa Copp; Rachel Thompson; Karin Hammarberg; Sarah Lensen; Lidiya Augustine; Jenny Doust; Michelle Peate; Erin Cvejic; Ben W Mol; Devora Lieberman; Kirsten J McCaffery

doi:10.1111/1471-0528.17741

Attitudes, knowledge and practice regarding the anti-müllerian hormone test among general practitioners and reproductive specialists: A cross-sectional study

Tessa Copp^* (Corresponding Author), Rachel Thompson, Karin Hammarberg, Sarah Lensen, Lidiya Augustine, Jenny Doust, Michelle Peate, Erin Cvejic, Ben W Mol, Devora Lieberman, Kirsten J McCaffery

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVE: To describe clinicians' attitudes, knowledge and practice relating to the anti-müllerian hormone (AMH) test.

DESIGN: Cross-sectional nationwide survey.

SETTING: Australia.

POPULATION OR SAMPLE: A total of 362 general practitioners (GPs), gynaecologists and reproductive specialists.

METHODS: Clinicians were recruited through relevant professional organisations, with data collected from May 2021 to April 2022.

MAIN OUTCOME MEASURES: Clinicians' attitudes, knowledge and practice relating to the AMH test, measured using multiple choice, Likert scales and open-ended items.

RESULTS: Fifteen percent of GPs (n = 27) and 40% of gynaecologists and other specialists (n = 73) order at least one AMH test per month. Specialists reported raising the idea of testing most of the time, whereas GPs reported that patient request was more common. Half of clinicians lacked confidence interpreting (n = 182, 51%) and explaining (n = 173, 48%) an AMH result to their patients. Five percent (n = 19) believed the test was moderately/very useful in predicting natural conception/birth and 22% (n = 82) believed the same for predicting premature menopause, despite evidence that the test cannot reliably predict either. Forty percent (n = 144) had previously ordered the test to help with reproductive planning and 21% (n = 75) to provide reassurance about fertility.

CONCLUSIONS: Clinicians reported use of AMH testing in clinical circumstances not supported by the evidence. With the proliferation of direct-to-consumer testing, efforts to support clinicians in the judicious use of testing and effectively navigating patient requests are needed.

Original language	English
Journal	BJOG : an international journal of obstetrics and gynaecology
Early online date	9 Jan 2024
DOIs	https://doi.org/10.1111/1471-0528.17741
Publication status	E-pub ahead of print - 9 Jan 2024

Bibliographical note

The authors would like to thank the clinicians who participated in this study. Open access publishing facilitated by The University of Sydney, as part of the Wiley - The University of Sydney agreement via the Council of Australian University Librarians.

FUNDING INFORMATION
This project was supported by a National Health and Medical Research Council (NHMRC) Centre for Research Excellence grant (1104136), Program grant (1113532), and Emerging Leader Research Fellowship (2009419). These awarded grants included external peer review for scientific quality. The funder had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

Access to Document

10.1111/1471-0528.17741Licence: CC BY

Cite this

Copp, T., Thompson, R., Hammarberg, K., Lensen, S., Augustine, L., Doust, J., Peate, M., Cvejic, E., Mol, B. W., Lieberman, D., & McCaffery, K. J. (2024). Attitudes, knowledge and practice regarding the anti-müllerian hormone test among general practitioners and reproductive specialists: A cross-sectional study. BJOG : an international journal of obstetrics and gynaecology. Advance online publication. https://doi.org/10.1111/1471-0528.17741

Attitudes, knowledge and practice regarding the anti-müllerian hormone test among general practitioners and reproductive specialists: A cross-sectional study. / Copp, Tessa (Corresponding Author); Thompson, Rachel; Hammarberg, Karin et al.
In: BJOG : an international journal of obstetrics and gynaecology, 09.01.2024.

Research output: Contribution to journal › Article › peer-review

Copp, T, Thompson, R, Hammarberg, K, Lensen, S, Augustine, L, Doust, J, Peate, M, Cvejic, E, Mol, BW, Lieberman, D & McCaffery, KJ 2024, 'Attitudes, knowledge and practice regarding the anti-müllerian hormone test among general practitioners and reproductive specialists: A cross-sectional study', BJOG : an international journal of obstetrics and gynaecology. https://doi.org/10.1111/1471-0528.17741

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title = "Attitudes, knowledge and practice regarding the anti-m{\"u}llerian hormone test among general practitioners and reproductive specialists: A cross-sectional study",

abstract = "OBJECTIVE: To describe clinicians' attitudes, knowledge and practice relating to the anti-m{\"u}llerian hormone (AMH) test.DESIGN: Cross-sectional nationwide survey.SETTING: Australia.POPULATION OR SAMPLE: A total of 362 general practitioners (GPs), gynaecologists and reproductive specialists.METHODS: Clinicians were recruited through relevant professional organisations, with data collected from May 2021 to April 2022.MAIN OUTCOME MEASURES: Clinicians' attitudes, knowledge and practice relating to the AMH test, measured using multiple choice, Likert scales and open-ended items.RESULTS: Fifteen percent of GPs (n = 27) and 40% of gynaecologists and other specialists (n = 73) order at least one AMH test per month. Specialists reported raising the idea of testing most of the time, whereas GPs reported that patient request was more common. Half of clinicians lacked confidence interpreting (n = 182, 51%) and explaining (n = 173, 48%) an AMH result to their patients. Five percent (n = 19) believed the test was moderately/very useful in predicting natural conception/birth and 22% (n = 82) believed the same for predicting premature menopause, despite evidence that the test cannot reliably predict either. Forty percent (n = 144) had previously ordered the test to help with reproductive planning and 21% (n = 75) to provide reassurance about fertility.CONCLUSIONS: Clinicians reported use of AMH testing in clinical circumstances not supported by the evidence. With the proliferation of direct-to-consumer testing, efforts to support clinicians in the judicious use of testing and effectively navigating patient requests are needed.",

author = "Tessa Copp and Rachel Thompson and Karin Hammarberg and Sarah Lensen and Lidiya Augustine and Jenny Doust and Michelle Peate and Erin Cvejic and Mol, {Ben W} and Devora Lieberman and McCaffery, {Kirsten J}",

note = "The authors would like to thank the clinicians who participated in this study. Open access publishing facilitated by The University of Sydney, as part of the Wiley - The University of Sydney agreement via the Council of Australian University Librarians. FUNDING INFORMATION This project was supported by a National Health and Medical Research Council (NHMRC) Centre for Research Excellence grant (1104136), Program grant (1113532), and Emerging Leader Research Fellowship (2009419). These awarded grants included external peer review for scientific quality. The funder had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.",

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T1 - Attitudes, knowledge and practice regarding the anti-müllerian hormone test among general practitioners and reproductive specialists

T2 - A cross-sectional study

AU - Copp, Tessa

AU - Thompson, Rachel

AU - Hammarberg, Karin

AU - Lensen, Sarah

AU - Augustine, Lidiya

AU - Doust, Jenny

AU - Peate, Michelle

AU - Cvejic, Erin

AU - Mol, Ben W

AU - Lieberman, Devora

AU - McCaffery, Kirsten J

N1 - The authors would like to thank the clinicians who participated in this study. Open access publishing facilitated by The University of Sydney, as part of the Wiley - The University of Sydney agreement via the Council of Australian University Librarians. FUNDING INFORMATION This project was supported by a National Health and Medical Research Council (NHMRC) Centre for Research Excellence grant (1104136), Program grant (1113532), and Emerging Leader Research Fellowship (2009419). These awarded grants included external peer review for scientific quality. The funder had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.

PY - 2024/1/9

Y1 - 2024/1/9

N2 - OBJECTIVE: To describe clinicians' attitudes, knowledge and practice relating to the anti-müllerian hormone (AMH) test.DESIGN: Cross-sectional nationwide survey.SETTING: Australia.POPULATION OR SAMPLE: A total of 362 general practitioners (GPs), gynaecologists and reproductive specialists.METHODS: Clinicians were recruited through relevant professional organisations, with data collected from May 2021 to April 2022.MAIN OUTCOME MEASURES: Clinicians' attitudes, knowledge and practice relating to the AMH test, measured using multiple choice, Likert scales and open-ended items.RESULTS: Fifteen percent of GPs (n = 27) and 40% of gynaecologists and other specialists (n = 73) order at least one AMH test per month. Specialists reported raising the idea of testing most of the time, whereas GPs reported that patient request was more common. Half of clinicians lacked confidence interpreting (n = 182, 51%) and explaining (n = 173, 48%) an AMH result to their patients. Five percent (n = 19) believed the test was moderately/very useful in predicting natural conception/birth and 22% (n = 82) believed the same for predicting premature menopause, despite evidence that the test cannot reliably predict either. Forty percent (n = 144) had previously ordered the test to help with reproductive planning and 21% (n = 75) to provide reassurance about fertility.CONCLUSIONS: Clinicians reported use of AMH testing in clinical circumstances not supported by the evidence. With the proliferation of direct-to-consumer testing, efforts to support clinicians in the judicious use of testing and effectively navigating patient requests are needed.

AB - OBJECTIVE: To describe clinicians' attitudes, knowledge and practice relating to the anti-müllerian hormone (AMH) test.DESIGN: Cross-sectional nationwide survey.SETTING: Australia.POPULATION OR SAMPLE: A total of 362 general practitioners (GPs), gynaecologists and reproductive specialists.METHODS: Clinicians were recruited through relevant professional organisations, with data collected from May 2021 to April 2022.MAIN OUTCOME MEASURES: Clinicians' attitudes, knowledge and practice relating to the AMH test, measured using multiple choice, Likert scales and open-ended items.RESULTS: Fifteen percent of GPs (n = 27) and 40% of gynaecologists and other specialists (n = 73) order at least one AMH test per month. Specialists reported raising the idea of testing most of the time, whereas GPs reported that patient request was more common. Half of clinicians lacked confidence interpreting (n = 182, 51%) and explaining (n = 173, 48%) an AMH result to their patients. Five percent (n = 19) believed the test was moderately/very useful in predicting natural conception/birth and 22% (n = 82) believed the same for predicting premature menopause, despite evidence that the test cannot reliably predict either. Forty percent (n = 144) had previously ordered the test to help with reproductive planning and 21% (n = 75) to provide reassurance about fertility.CONCLUSIONS: Clinicians reported use of AMH testing in clinical circumstances not supported by the evidence. With the proliferation of direct-to-consumer testing, efforts to support clinicians in the judicious use of testing and effectively navigating patient requests are needed.

U2 - 10.1111/1471-0528.17741

DO - 10.1111/1471-0528.17741

M3 - Article

C2 - 38196321

SN - 1470-0328

JO - BJOG : an international journal of obstetrics and gynaecology

JF - BJOG : an international journal of obstetrics and gynaecology

ER -

Attitudes, knowledge and practice regarding the anti-müllerian hormone test among general practitioners and reproductive specialists: A cross-sectional study

Abstract

Bibliographical note

Data Availability Statement

Access to Document

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Cite this