Fertility MOT.

Again my ovaries have not played ball. These are the words from my consultant recently as I am once again prescribed norethisterone to induce a bleed after nearly 60 days without one. In fairness my last bleed was a chemical pregnancy followed by a hysteroscopy so I can understand the confusion from their (my ovaries) part.

There have been months previously, especially when we were trying naturally that my cycle was AWOL. That’s the major stumbling block with PCOS, anovulation. I had no idea I had PCOS until we started trying for a baby. I had only ever missed one period from the age of 13-32 and did not recognise any of the symptoms. It makes me wonder, if I had the foresight to have a fertility MOT in my 20’s and possibly have this diagnosis earlier? Would I have paid for one? The answer is abso-bloody-lutely!

The older, wiser me would not have taken her fertility for granted and maybe this highlights the lack of education within our schooling surrounding fertility health more than my own lack of judgment? I wonder if we spend so much time teaching our teenagers how not to get pregnant we are not covering fertility health alongside it? Of course we have to educate practicing safe sex, using contraception and the science of how babies are made. But we must also offer education around fertility health and how that declines with age. As females we are born with all of our eggs, so we need to understand the timeline and how our fertility declines.

I spent most of my 20’s on the contraceptive pill which would have masked my PCOS and therefore just assumed when I was ready I would come off the pill and voila! I would become pregnant. I honestly didn’t fully understand the changes surrounding female and male fertility or have any real knowledge about sperm counts or my own ovarian reserve? Should this be our responsibility as young adults? Should schools make this part of the curriculum?  We take control of many other aspects of our lives like education and our careers so why not our fertility health?

The advances in modern science have of course enabled many women like myself to conceive but I also worry women/couples are relying on freezing their eggs or the premise of IVF as a back up plan to motherhood, rather than actually investigating their own fertility health? It is wonderful we have that option, as for many through no choice of their own are not able to have children, whether that be because of  health reasons or lifestyle choices and it is amazing that the option is there. Without such intervention I wouldn’t be a mum. But I am not sure this should be the ideal when family planning. My decision to start a family at 32 was completely misguided on my behalf just assuming it would happen, had I known more about my personal fertility health I would have made very different decisions about when we planned a family. The ethos around freezing your eggs should also be considered carefully as that doesn’t always guarantee a baby. I have had 3 rounds of IVF and we have been extremely lucky that one of those embryos resulted with our son. Eggs do not always equate to babies. Egg quality, environment, hormones and most importantly AGE all play a part in a successful pregnancy.

So what does a fertility MOT entail? As an example below I have listed the main tests that most clinic’s will offer. They include a joint package for Males and Females:

  • Consultation with a fertility Specialist
  • Pelvic-ultrasound scan with Antral follicle count
  • Anti-Mullerian Hormone (AMH) Blood test
  • Semen Analysis
  • Counselling for Implications and support

The cost of a similar package like above can cost in the region of £450 (may vary on individual needs) and there are separate Female and Male packages offered by clinics which can be cheaper. A year after trying for a baby we were referred to our fertility clinic where our consultant performed the above MOT on both my husband and I, a pelvic scan showed cysts around my ovaries and I was diagnosed with PCOS.  My AMH levels came back very high so although the PCOS diagnosis was a shock, it was explained to me that with a good ovarian reserve should we need to move forward with IVF, the success rates in our favour. I was 33 and I did have to insight to know that if we needed IVF my age would increase our chances of a successful pregnancy, hence why we went private and didn’t rely on NHS waiting times and the postcode lottery. My husbands semen sample was also ok so we had options. All of that information offered a fantastic insight into both of our fertility health which really was invaluable.

I appreciate this cost isn’t affordable for all, most people in their mid twenties want to spend any disposable income on holidays or other care free activities, I know Mr M and I did. But trust me when I say the cost of a fertility MOT is nothing compared to IVF or other fertility treatment. Maybe it’s a scary thought knowing there could be potential fertility issues, but I would have happily paid that money whilst in my 20’s so I could have that insight, I just didn’t realise it was even an option?

It would be great to know we are educating girls and boys about fertility health, maybe some schools do cover these topics, it would be amazing to know they are? Girls need to know the facts about their own fertility and not assume when they are ready a baby will come. We also need to make sure that boys are aware too, that settling down later in life is great but don’t assume your partners fertility will still be healthy? The education lies with them aswell. Periods and learning about monthly cycles just isn’t enough. Of course, many couples conceive naturally later in life but if there was an issue with your fertility health (male or female) wouldn’t you want to know so you can make a more informed decision regarding your family planning. I guess it comes down to prioritising your future plans, even when they are far on the horizon.

I was very much of the thinking that I would have my career then start a family? Yet I didn’t invest in that plan, well not the family part anyway. Everyone has the right to plan the timing of their family, so we need a more comprehensive education in place so that as individuals we have the foresight to make more informed decisions. The awareness to check our fertility health should we want to, will hopefully become more mainstream. Armed with the information I now know, my planning would have been different. Would your twenty something self have invested in a fertility MOT? Mine certainly would!



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