A so-called egg timer test — which gives an indication of how many eggs a woman has left — told Anneline Padayachee she was sterile at 35.
The test, often used in IVF treatment, measures the level of anti-Müllerian hormone (AMH) in a woman's blood to estimate her ovarian reserve.
Increasingly it's being spruiked as a way for women to decide when to have a baby, even if they aren't thinking of having one any time soon.
Anneline's AMH level was low, which she said her GP told her meant she was infertile.
"She's like, basically, you can't have kids. I felt like I was punched in my stomach," Anneline, who is a nutrition scientist in Brisbane, said.
"I don't think I functioned for a good three days straight."
She said clinicians told her she was headed for early menopause, was barren and should consider freezing her eggs.
But experts say the test does not measure fertility.
According to multiple studies, there is no link between your AMH level and your chance of becoming pregnant.
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists says AMH "should not be considered a single marker for fertility".
And the American College of Obstetricians and Gynaecologists says the test "should not be ordered or used to counsel women about their reproductive status or future fertility", nor is it suitable as a predictor of menopause at this time.
Anneline wasn't having IVF, and she wasn't trying to get pregnant.
There was no indication she would be unable to have a baby.
Then she got the test, and was told she never would.
"My value as a woman — I think I challenged it myself. I cried so much, and I'm not even clucky, so imagine if you were," she said.
"Things that you take for granted, all your dreams, all your hopes, your expectations are suddenly gone. How do I navigate a future that I never planned for?"
Anneline took her specialist's advice, and began to plan to freeze her eggs.
'There is a biology we can't ignore'
Clinicians and researchers warn the test, which is now available to buy online, is leading women to make choices about their bodies based on a false premise.
Monash University's Karin Hammarberg has been a clinical coordinator for IVF programs for 20 years.
A woman with high AMH could put off pregnancy, or a woman whose result is low may have a baby sooner than planned, wrongly believing she is infertile, or go through with an unnecessary procedure, like egg freezing — all because of a test which promises an answer it can't give, Dr Hammarberg said.
"If you ask for information that a test can't provide, and then make decisions based on a response that this test gives you, your decision-making is influenced by false information.
"There is a biology here that we can't ignore, and it's not dictated by AMH, it's dictated by age."
Zara* took the egg timer test at 24, and was told she had as many eggs as a 39-year-old woman.
She wasn't trying to get pregnant either. She just wanted to know about her fertility.
She spent days in bed and for months grieved the family she thought she may never have.
Then she and her husband started trying to conceive.
"First month we tried, I fell pregnant," said Zara, whose son is now 11.
"Had I not got the test, I'm sure I wouldn't have gotten pregnant that young.
"I probably had kids two or three years sooner than I might have."
Zara "wouldn't trade him for the world", and is glad she had her son when she did.
But the 35-year-old, who works in healthcare, thinks her AMH result was misleading.
And she is worried for other women who take the test.
"Every time I have ever had unprotected sex I have fallen pregnant," she said.
"I just made a decision to fall pregnant, and within a couple of weeks I was and so clearly, there's nothing wrong with my fertility."
How do you get the test?
You can be referred for the egg timer test by your GP, and a pathologist will carry it out for about $90. Or you can have it done at a private clinic, or buy a test online, potentially for hundreds of dollars.
Dr Eva Kretowicz, a fertility specialist in Brisbane, said the AMH test — which is used by clinicians treating women who experience infertility — needed to be taken with other tests, and interpreted by a specialist, to give useful information.
Women with low AMH could be "very fertile", and women with high AMH could be unable to conceive, she said.
Fertility is complex, it's not just the egg count which matters, it's also the quality of a woman's eggs, and the quality of a man's sperm, Dr Kretowicz said.
"If they concentrate on a single number then they miss a whole lot of other factors which are far more important than an egg count," she said.
"An egg count is essentially a number, and it is not predictive of fertility or the capacity to carry a pregnancy."
'Perfect eggs'
Anneline is now 40.
COVID delayed her plan to freeze her eggs. And in those two years alone, she was told her fertility would have dropped so much the number of cycles she would need to undergo to retrieve her eggs went from two, to six — taking 12 months and costing $60,000.
Eventually, she got a new specialist, got her eggs frozen — and found out they were the quality of a woman nearly 10 years younger.
Or, as the lab manager described them, "perfect eggs".
It was nearly five years since she was first told she was barren.
"I felt like I beat them. It's a weird way to say that. But previously, I felt like such a giant-sized failure. I felt like there's nothing I could do and I was a failure as a woman," she said.
"Then they showed me the pictures of my eggs, and they showed me pictures of eggs for women who are in their late 20s, 30s and 40, and my eggs look like a 30-year-old's eggs," she said.
Anneline said this debunks what she was first told.
"I was told that my eggs are poor quality, because I was in my mid-30s, and there isn't anything left and I'm barren and I'm about to go through menopause.
"It's been a good four and a bit years later and I'm still getting my period like normal, on time, every single month. I clearly haven't gone through menopause.
"So the fact that I was told that, 'You're pretty much falling off the edge of the cliff or you are over the edge of the cliff'. That's not true."
Tessa Copp, from the University of Sydney School of Public Health said women are being misled.
Her research found some clinic websites and test providers made statements which were not supported by evidence, or glossed over the test's limitations — like how the result can be affected by a woman being on the contraceptive pill, and can vary over time.
"All they see are these persuasive statements, telling them to be proactive about their fertility and that they'll get personalised insights about their reproductive timeline and menopause timing, which is not correct and it's the opposite of empowering, it's impeding informed decision making," Dr Copp said.
The ABC spoke to three companies selling the egg timer test direct to consumers online. Two have since changed the way they describe it.
A third, Kin Fertility, has defended its claims as evidence-based.
The company describes its "fertility test", which costs $299 and tests several hormones including AMH, as "the most powerful step you can make to understand your fertility" — even if you are not planning to get pregnant any time soon — as well as a way to find out when you may enter menopause.
There are caveats if you read further — the test is described as "not perfect", and "cannot tell you your chances of getting pregnant".
Its founder, Nicole Liu, told the ABC that "the fertility test protocols and messaging" were developed with a Royal Australian and New Zealand College of Obstetricians and Gynaecologists fellow.
"Similarly, all of the discussions and counselling around how to interpret the test results, counselling on the limitations of the test and the appropriate discussion of next steps and consideration for the patient, are all undertaken by fellows of the Royal Australian College of General Practitioners," she said in a statement.
The ABC is not suggesting Kin Fertility engaged in misconduct.
'Bad news you can't forget'
Egg freezing is one of Michelle Peate's research specialties.
The University of Melbourne and Royal Women's Hospital principal research fellow is studying what's driving women to take AMH tests.
Dr Peate said a "bad result" — a low AMH, if it's believed to mean low or zero fertility, can't be forgotten, even if it's later explained away by a professional.
And taken on its own this test could do "emotional harm".
"Even if someone else says 'No, you're fine', that fear still sits there.
"No matter what you do, you've got that in your head and you're not going to let it go because, 'What if I just accept this and then I can't have my babies later, I will not forgive myself for not having done something right now', which is actually why I think a lot of women freeze eggs," she said.
Zara, even though she got pregnant twice so easily, still worries she may go into early menopause.
"It does just give you this feeling in the back of your mind that there's something wrong and I think that that's really unfounded. There's no evidence to say that," she said.
She wants to see better information out there so women know what they're in for before they get the test.
"My health anxiety drove me to get this [test] and this was more than 10 years ago, and nothing has been done about this," she said.
"Everybody needs to have good information when they're making medical decisions if you are going to do something that gives you information that you can't un-know."
*Name has been changed to protect privacy.
