Menstrual pad could give women insights into their changing fertility

An at-home test built into a menstrual pad could help women track their fertility using their menstrual blood, providing a non-invasive way to monitor changes over time, without the need for repeat blood tests or clinic visits.

For many women, their fertility remains a mystery until they try to conceive. If they encounter difficulties, clinical tests can provide clarification.

These tests can measure levels of anti-Müllerian hormone (AMH), a common marker of “ovarian reserve” – a rough indication of the number of eggs remaining. In adults, AMH levels decline with age, so high levels indicate a plentiful supply of eggs. A level below average may signal a decrease in egg reserve or early menopause.

Traditionally, AMH is measured using an in-clinic blood test or a finger prick at home. In either case, the sample must be sent to a laboratory for processing before the results are returned.

Now, Lucas Dosnon of ETH Zurich in Switzerland and colleagues have developed an easy-to-use test that provides immediate results using menstrual blood.

The test is a lateral flow test (similar to a covid-19 test) that uses tiny gold-coated particles coated with antibodies that bind specifically to AMH. When the test is dipped into menstrual blood, the interaction of the hormone and particles creates a visible line on the test strip. The darker the line, the higher the AMH.

Although results can be estimated by eye, the researchers trained a smartphone app to analyze a photograph of the test strip to provide a more accurate reading. When they used their approach to test menstrual blood containing known concentrations of AMH, the results closely matched those obtained from laboratory tests.

The team also integrated the test into a menstrual pad, which would allow AMH levels to be measured passively over a period. This could provide significant information about ovarian reserve over time, potentially revealing trends that might go unnoticed with a single test.

“We think this work could be transformative for women’s health,” says Dosnon, who suggests the test could enable frequent screening of ovarian health for many purposes, including during IVF or for detection of fertility conditions other than declining ovarian reserve. High levels of AMH, for example, are associated with polycystic ovary syndrome and, in rare cases, granulosa cell tumors, which affect the ovaries. “Menstrual blood is an underutilized resource that actually holds a lot of promise for overall health monitoring,” says Dosnon.

Richard Anderson of the University of Edinburgh, UK, points out that clinical interpretation is a challenge for any type of at-home medical test, because analyzing the results is not always straightforward and no AMH test can tell you about egg quality. He also questions whether women would choose this test over established tests. “Is getting a reliable blood test such a burden?” » he asks.

In response, Dosnon says the test is not intended to replace clinical laboratory testing, but rather to offer an alternative that addresses some of the challenges faced in women’s health monitoring and research, thanks to its non-invasiveness, ease of use and low cost.