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

Frequently branded the 'Egg Timer' or 'Biological Clock' test, anti-Mullerian hormone (AMH) screening for women is becoming widely available in the United States. Blood levels of AMH are understood to reflect a woman's remaining ovarian reserve or egg supply; low values may index reduced fertility. This project explores the social, cultural, and individual dimensions involved in a woman's experience of undergoing AMH testing. Using immersive and experimental ethnography, the project brings together data from three deliberately selected contexts to document the role of early screening in women's life narratives in the urban United States. Methodologies drawn from critical medical anthropology and include participant observation in clinical contexts, semi-structured interviews, and a unique experimental ethnography in which women will be given the opportunity to access direct-to-consumer AMH screening and followed during the process. The aims of this research are: 1) to examine the current dialogue between providers and patients around the projected 'potential' of AMH testing/results and understand how AMH screening and interpretation of results fits into female patient's life course imaginaries 2) to understand the factors that modify a woman's decision to seek out AMH testing, particularly individual identities across race, class, sexual orientation, and socioeconomic status, and 3) to use experimental ethnography outside of a clinical context to assess the life narrative and social impacts of direct-toconsumer AMH testing in real-time. The research plan includes eight months of ethnographic fieldwork at the University of Pennsylvania Fertility Care Center, an academic research facility, and Fertility Centers of Illinois, a private clinic that serves a socioeconomically and racially diverse patient population and offers $90 out-of-pocket 'Fertility Awareness Check Ups' including AMH screening. In the last phase of this project, the co-PI will direct an experimental ethnography following women who elect to take the 'Fertility Age Test' through a diagnostic testing service that uses an outpatient laboratory to measure AMH and then connects patients to video-based follow-up consultations with a provider. Detailed semistructured interviews during this process will be part of a larger mixed-methods component including surveys exploring fertility knoweldge and the effect of testing fertility on women's quality of life.