Movie Review: One More Shot

Netflix recently released a touching documentary about infertility One More Shot.  In this documentary you see a young couple Maya and Noah battle infertility.  They really badly want a family, but for medical reasons have trouble conceiving naturally and go through a series of fertility treatments with lots of trial and heartbreak along the way.

Their story is especially touching because it is clear that Maya and Noah really want to be parents.  They clearly love children and have a close relationship with their families, and so it is hard to watch as treatments fail and they bump up against financial and logistical hurdles.  There were more than a few tears in the office when we did a screening.

Being a women’s health company, we were also interested in the medical aspects of movie.  Maya had Diminished Ovarian Reserve (DOR), which means the number of eggs her ovaries produce is low, reducing her chance of conceiving naturally.

At Droplet, it’s our mission to help women learn about their own health, and it turns out that there are lab tests that you can take that can help diagnose DOR, the condition that Maya found herself having.  There are two hormone levels that are indicators of DOR and those are called Anti Müllerian Hormone (AMH) and Follicle Stimulating Hormone (FSH).  A person with low AMH and (typically) high FSH will have diminished reserves and can struggle to conceive.  Though these tests are not as highly predictive as (for example) A1c tests are for diabetes, they can serve as an important data for women interested in their ovarian function.

Unfortunately, these tests are uncommon, and many people are not tested until they already have symptoms.  Here is a post from 34 year-old female reddit user andPeggy1:

My AMH dropped from 2.69 in July 2016 to .51 in August 2017. F***! My FSH went from 5.69 to 10.1. I got this in an email message from my doctor in the middle of France on vacation and spiraled HARD. I might have drank an entire bottle of wine that night (it was delicious, the hangover not so much). We had already been planning to do IVF this fall, but my mindset went from “no guarantees but it will probably work for us” to “are we even going to be able to do IVF?”. The internet was not my friend, I had to stop myself from googling too much.

Though AMH and FSH testing is controversial, and some doctors think it is unwarranted for women not actively trying to conceive, it might be a good idea from a personal perspective for women to have AMH and FSH levels tested regularly.  A downward trend is expected due to natural aging, but it is certainly better to be aware of one’s level and status, versus surprised like Maya was when she got her diagnosis at a young age.