03 September 2013
Would you get your fertility tested? These women did, with surprising results...
The Daily Mail's Health reporter, Julie-Anne Barnes speaks to three patients who have had their fertility tested.
As many hopeful mothers are acutely aware, they are born with a finite number of eggs in their ovaries. Women start with around one million eggs, but by the time they reach the age of 50 the figure has fallen to just 50,000.
The process is not reversible. Once the eggs have gone, you cannot get them back. As career women opt to delay having children, the biologiscal clock continues to tick down remoreslessley until many find they have left it too late.
Now, as new rules are ontroduced meaning women over 40 will be entitled to have IVF, many are entering the world of assisted conception by having their fertility tested.
Large numbers of women are opting to have an Ovarian Reserve Test, which meansures levels of a specific hormone in the blood.
This, combined with a scan, can indicate the quality of eggs available to a woman if she ever faces having to undergo IVF. It can also help her decide if she should go ahead with treatment, and at what age she should do so.
The £350 test is being carried out at private fertility clinics across the country. Dr Joo Thong, a consultant in reproductive medicine at IVF Scotland describes what is involved in the procedure: ‘This is a test which has been around for a few years. First, you do the blood test which measure AMH (anti-Mullerian hormone). This comes specifically from the specialised cells in the ovaries. We also carry out an internal vaginal scan. These results can give you a very accurate reflection of the egg reserve. When we do the scan, we can also visualise the ovaries and the little sacs of fluid known as antral follicles, which are counted. The higher the number of antral follicles, the better the ovarian reserve.’
Dr Thong emphasises that the results do not tell a woman exactly how many eggs she has left, although the test will indicate her potential fertility.
‘Every patient thinks they have a good egg reserve,’ say Dr Thong. ‘Provided there is no history of damage, for example following surgery, radiotherapy to the ovaries or chemotherapy, you expect a young woman will have a good egg reserve.
Smoking is bad for the ovaries, as is drinking too much alcohol. You do get a lower egg reserve in smokers. It also stands to reason, if you have a low egg reserve, that the menopause is going to arrive earlier.’
Dr Thong warns that, after ovarian reserve testing, some women with a low egg reserve will have to ‘adjust their expectations’ with regard to the potential success of IVF.
‘If you have a 33-year-old and you have a low egg reserve, you have to adjust expectation. Up to the age of 35, you may have a 50 per cent pregnancy rate with IVF in women with good prognosis. ‘The quality of the egg is the important thing. That is usually determined by age. Unless a woman wants a baby, there is no point doing the test. The ovarian reserve test should be considered by women who are thinking of starting a family.’
Good Health spoke to three women who have opted to have their fertility tested. The surprising results have made some reconsider their options in light of the findings. One young woman was told she has low fertility, while two others were told it was likely they had polycystic ovarian syndrome.
Deputy charge nurse Kelly Davis, 29, from Airdrie, Lanarkshire, is living with her partner and their nine-year-old son. She said, ‘We are getting married next year and soon after we would hope to have a child. I was 50/50 as to whether I could ever have children. My menstrual cycle was completely abnormal. I didn’t know if it was a hormonal thing. ‘I heard about the test and I felt it was a good opportunity but I was scared there would be something wrong.’
She was told she had polycystic ovary syndrome (PCOS), leading to an imbalance of female sex hormones. She said: ‘It explains why my cycle was so erratic. But I do have a healthy egg reserve. Hopefully, within two years there will be the pitter patter of tiny feet. ‘I don’t find it strange to have the test done. I think its good there are lots of options for women.’
Animation graduate Katie charter, 23, lives with her partner in Edinburgh. Having a family is a priority for her and she wants to have as many children as she can. Although her career is important to her, she is also looking towards starting a family soon: ‘At the back of my mind I thought: ‘What if I can’t?’ I felt I’d rather know now.
‘Although I’m quite young, I’d like to think I could start a family in the next five years. I wanted to know if I had to look at other options and come to terms with whatever I found out.
‘I have thought; “What if I’m not fertile?” I would rather know now. There is nothing that means I will become miraculously fertile later. It is an expensive procedure, but I think all girls would like to know.’
Katie’s results revealed she has low fertility. She says: ‘I was expecting it to come back quite positive, but it came back as low fertility. I was advised to have children sooner rather than later. It seems my ovaries are older than me.
‘I’m definitely happy I had it done. To start with, it was a shock. Now I feel happy I have that knowledge. I’m not as happy as I should have been, obviously. I have had time to come around to the result. I am not going to take any direct action. ‘I’m definitely pleased I did it. Maybe I would have been too nervous if I was older.’
Art teacher Fiona McWilliam, 34, is also living with her partner in Edinburgh. She decided to take the test as she struggled to get pregnant. She says: ‘I saw the test become available. We were struggling for a year to get pregnant and I felt it was a good opportunity to see if there was something wrong.’
Fiona says that she had visited the doctor for years with irregular periods and hormone-related issues. She adds: ‘I was quite excited to have a bit more clarity on why things weren’t happening for us. I felt it was time to get proactive. I was going in full of hope.’
Her results showed that she had undiagnosed polycystic ovary syndrome. She says: ‘It is disappointing that no one had suggested to me that PCOS might be the problem. ‘I felt I was doing all the right things. I did feel relieved that they confirmed there was something going on. Thankfully it seems I have a good egg reserve. I feel at least I know I should be able to get pregnant. Now I have been to the GP and I’ve had lots of hormone tests done so they can decide whether I need fertility medication.’