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Conception

When's the best time to get pregnant? Use our interactive ovulation calculator to work out when you're most fertile and most likely to conceive.

Original poster

Initial fertility tests - what have people done, or considering? (TTC)

66 replies

CC81 · 23/07/2020 10:53

I find the 'not knowing' part of TTC really stressful - in terms of my fertility - which I think has an impact on my general wellbeing (and thus probably natural fertility). Aaaagh, the irony!

I'm wondering how useful it would be to get a private consultation and pay for an AMH test, to check egg quality/quantity. Is anyone else looking into the same thing, or has done it recently?

I know hormone tests are available via GP - but the NHS is obviously under pressure and it's tough to book blood tests on the right days (i.e. CD3-5 for FSH etc. and CD21 for progesterone). Especially as my cycle went randomly wonky last month, so predicting dates is unreliable. I had the same tests last summer and they were normal, but the results may be different a year later and I don't want to waste precious time (I'm 38).

One of our local clinics offers a 'Fertility MOT' where you pay about £400 for a couple to have all the tests (including AMH) and a consultation.

Alternatively, if I get a GP referral, I can get an AMH test at the clinic for about £170 - but I'm not sure how the results would be interpreted (the clinic said they'd fax them to my GP, but the GP sounded unsure and said she'd need to check with a senior partner at the practice).

It's all a bit confusing and frustrating. We've been TTC for about 6-7 months and I've got worried in the last month because I had the random long cycle. I literally don't have a clue what to expect, this cycle - I've started temping, using OPKs, etc., to try to get some idea.

If things don't settle down, I think we'll end up doing the initial MOT thing. But if they DO get back to 'normal' - i.e. cycle length, signs of ovulation - I'll be more inclined to see how the NHS process goes.

OP posts:
Original poster
CC81 · 18/08/2020 09:38

@sweetpea2000 - Cheers. Will keep fingers crossed. I've got tests on 2 September then the consultation on 22 September.

OP posts:
sweetpea2000 · 18/08/2020 09:17

@CC81 oh right... they didn't say. They just said to come back if we hadn't conceived naturally in 4-6 months. I actually liked that they didn't pressure us to sign up sooner.

But I don't imagine it would be long. From what I've read on here, most clinics will put a protocol together quickly.

Original poster
CC81 · 18/08/2020 09:10

@sweetpea2000 - Oh sorry, I meant to start IVF treatment (once you decide). Did they give you any idea?

OP posts:
sweetpea2000 · 18/08/2020 08:56

@CC81 it was two weeks for the appointment and one week following that for the consultation, so pretty quick.

Original poster
CC81 · 18/08/2020 08:26

@sweetpea2000 - Do you mind me asking how long the waiting times seem to be at Manchester Fertility?

@Moominmiss - Well it was actually three years ago now, but still feels very recent!

The thing is, for all I know, I may have already had a low egg reserve back then - but the right egg was released at the right time. It's impossible to know!

So sorry about your losses - it must have been such a difficult time.

OP posts:
Moominmiss · 17/08/2020 14:47

@CC81 really? Thank you. I was just confusing myself even more trying to google what normal levels are.

My main worry was that I might be perimenopausal due to my age.

As you say it really just seems to be a lottery. My thinking is that so far it’s likely been my ‘old’ eggs and the fact they just aren’t as good quality anymore.

My 3 children were conceived really easily but I had my last 6 years ago which is a long time in fertility terms.

After my first miscarriage in January I put it down to bad luck, but then after another 2 losses I started to wonder what’s going on.

I’ve been taking ubiquinol now for nearly 3 months so I’m hoping that might do something to help with egg quality.

It’s really positive though that you conceived with no issues only a couple of years ago! 🤞🏻 It will just be a matter of time before you’re pregnant again!

Original poster
CC81 · 17/08/2020 14:37

@Moominmiss - Yes, those results are really good - definitely encouraging from a fertility point of view (from what I've learned recently).

Hopefully you'll get to the bottom of whatever is going wrong - but at least you know it doesn't appear to be your hormones (or egg reserve).

It's rather a lottery, isn't it?

I'm finding it difficult to believe that my situation is SO different to just a couple of years ago. I wonder if maybe I was just super-lucky to conceive our first child immediately (it's the one and only time I've ever been pregnant).

OP posts:
Moominmiss · 17/08/2020 14:08

Hey, I’m in a similar boat to you all, I’m 38 and after several miscarriages was referred to a fertility specialist where I had bloods done on cd2 and my day 21.

I had texts from my surgery to say results were ‘normal’ but wasn’t until today I could actually view the figures for myself.

I have no clue what the numbers mean and although they call them normal, I don’t know if that means they’re any good for ttc.

I have 3 children already and because I now seem to struggle to remain pregnant I figure it’s clearly to do with my age etc.

These are my results if anyone is a bit more clues up than I am.

Day 2 - serum prolactin - 144miu/L
- serum testosterone 0.7nmol/L
- serum TSH - 0.9miu/L
- serum LH - 2iu/L
- serum FSH - 5iu/L

Day 21 - serum progesterone - 67nmol/L

Original poster
CC81 · 17/08/2020 13:53

@sweetpea2000 - Good to know you're going to the same place! Thanks for that.

There are so many things to weigh up. I guess now that I've booked the appointment(s), in the meantime the best thing I can do is focus on improving my wellbeing - and hope that I keep ovulating!

Good luck for your next cycles :)

OP posts:
sweetpea2000 · 17/08/2020 12:16

@CC81 From what I understand (and perhaps someone more knowledgable will come on to correct me!) I don't think IVF will deplete the reserve. IVF stimulation will still only generate tens of eggs. And I think at an older age the risk is not literally running out, we still have thousands left, but it's just that fewer of them are chromosomally normal, plus there is a higher risk of annovulatory cycles. So there is a lower likelihood of successful conception.

I think the risk with IVF is that we miss out on valuable 'trying time' for natural conception whilst the process is taking place. Sometimes the likelihood of conception is just as high naturally as with IVF, we just need more months to 'roll the dice' IYSWIM. I'm not sure how long a cycle takes and how long it takes for you cycle to reset afterwards.

I'm sure they'll talk you through it all and have stats. I found Manchester Fertility really helpful for our assessment (Dr Munjeera) and if we aren't successful by the end of the year we'll be going back.

Original poster
CC81 · 17/08/2020 11:48

@sweetpea2000 - That's a really good way of looking at it (thank you). Yes, I think you are right.

I've seen lots of people say similar things - and I've also read the same about scientific studies - but sometimes it takes a while for the penny to fully drop! I think you've hit the nail on the head with the way you've described it (or at least, I hope you have).

If trying to conceive naturally and ovulating monthly, then the key is for timings, conditions and a good-quality egg to all work in harmony.

But for IVF, from my limited knowledge, it's all about quantity (to raise the chances) - so the overall reserve carries more importance.

From that point of view, I wonder if IVF can actually cause problems too, as surely it depletes the reserve more quickly, not to mention all the stress! But I can understand the desire to move quickly and get some sort of answer (we may opt for that).

We'll be having our 'MOT' tests at Manchester Fertility, as it's our nearest and only £395 for a couple. We'll be asking tons of questions.

Congrats on your results - they sound really encouraging so far :)

OP posts:
sweetpea2000 · 17/08/2020 11:37

@CC81. My results were quite good - just over 30 for AMH and AFC.

I will also request the hormone tests from my GP next. Like AMH and AFC, I'm not sure how much FSH indicates the likelihood of conceiving naturally. Does a low ovarian reserve matter so much for natural conception, when you only need one egg, rather then IVF where you want to maximise the number of eggs?

I thought egg quality is the main issue at older ages, and there is no measure of that, it's just a case of taking longer to try until you get a good egg. Am I right?

The frustration at older ages is that we don't have as long to wait to try, before seeking assisted treatment, as the likelihood of the treatment working is reducing all the while. It's so hard to know how long to keep trying for, or when to get help.

Have you selected a clinic yet?

I'd be interested to hear how you get on with the acupuncture too - I've been really struggling with sleep and stress levels, and know this doesn't help!

Original poster
CC81 · 17/08/2020 10:01

@sweetpea2000 - Thanks for the message. How were your results?

Unfortunately, after my good 'day 21' results, I had my 'day 3' hormone tests at my GP practice and my FSH was higher than ideal, at 15.9 - which indicates a low ovarian reserve. It should ideally be below 10. But it's good that it's lower than 20. Apparently people DO get pregnant with similar levels. But there's a lower probability - especially at my age (38).

We'll continue trying naturally - but we're going to pursue private treatment and see where that leads. I've been reading about natural/mild IVF (instead of conventional IVF), which seems to be focused on quality over quantity and is aimed at those with a low reserve. But we need to do a lot more research.

I've booked initial private tests for September (AMH, AFC, etc.) and started taking ubiquinol about a month ago, so hopefully that should help.

Also planning to look into acupuncture, to help my stress/anxiety/sleep (and thus improve my general wellbeing)!

OP posts:
sweetpea2000 · 13/08/2020 13:50

Hi @CC81.
I just recently had a couples MOT which was helpful in terms of the semen analysis and anatomy scan, but the other indicators they test are AMH and AFC which, as a previous poster said, are really only relevant indicators of how you would respond to IVF.
There is no test for egg quality unfortunately, and the best predictor of this is age. The % of chromosomally normal eggs declines with age and reduces the chance of conception each month. I wish this stuff was taught in school!
I read 'It starts with the egg' on how to improve egg quality, and found it overwhelming but have started taking ubiquinol.

Original poster
CC81 · 10/08/2020 19:13

Just an update: I managed to get an urgent appointment for my 'day 21' progesterone test (except it was actually day 26, as that's what I estimated to be 7 days after ovulation - I had an LH surge on days 17 and 18, so probably ovulated on day 18 or 19).

It's come back "normal" and "indicates ovulation", which is a huge relief. It's a box ticked, at least. The rest of the blood screen was also normal (they tested for tons of stuff).

So... I'm encouraged. But I still need to make a decision about the private 'fertility MOT' (which includes scans and all sorts, to check egg quality/quantity, potential physical barriers, etc. - I had a c-section in 2017).

We've been trying for about 6 months, but I feel like I've only been fully informed about how everything works in the last few weeks, to be honest - and it's been such a weird year (which I think has affected my cycles).

So... hmmm. Maybe I should wait until my period starts (assuming no BFP) and then take the plunge.

How is everyone else getting on?

OP posts:
Original poster
CC81 · 29/07/2020 15:24

@Tink2019 - Ah, yes, that makes sense! Thanks :)

OP posts:
Tink2019 · 27/07/2020 17:18

@CC81

PS - *@Tink2019* - What's 'SA'?
@CC81 Oh sorry 🙈 - semen analysis 😊

@bb077 TTC is shitty, but hang in there. As others have said only progesterone should be tested on day 21, the rest should be around day 3. I found this blog useful for results and if they're 'normal' theduff.co.uk/category/hormones-and-eggs/ Definitely push for tests to be redone x

bb077 · 27/07/2020 15:48

[quote bb077]@FlorenceFlounce thanks for your reply I will ask my doc for day 3 I did do a urine fsh at day 3 which was positive and day 10 and 21

My LH and fsh has been constantly high this cycle

I'm just finding this distressing as I desperately want to replace the child I lost [/quote]
Top CB monitor cartridge the machine has said low all cycle
Middle wondfo LH
Bottom FSH

Initial fertility tests - what have people done, or considering? (TTC)
bb077 · 27/07/2020 15:46

@FlorenceFlounce thanks for your reply I will ask my doc for day 3 I did do a urine fsh at day 3 which was positive and day 10 and 21

My LH and fsh has been constantly high this cycle

I'm just finding this distressing as I desperately want to replace the child I lost

FlorenceFlounce · 27/07/2020 15:39

[quote bb077]@Juno231The progesterone was day 21 and they did the other tests from the same vile[/quote]
You can’t test FSH, LH or Estrogen on day 21 and use the results to draw any kind of conclusions about your fertility, it’s the wrong part of the cycle and not valid 💐

If those had been your day 3 results I’d have said you were in perimenopause! Xx

bb077 · 27/07/2020 15:23

@Juno231The progesterone was day 21 and they did the other tests from the same vile

Juno231 · 27/07/2020 15:20

@bb077 are these your day 3 results? I thought day 21 tests only checked for progesterone.

bb077 · 27/07/2020 15:11

Thanks cc81 it's patient access it has my records on so I can take a peek at test results and notes ect

Original poster
CC81 · 27/07/2020 15:09

@bb077 - Good luck for Thursday. Which app is it? One that your GP uses?

Wish I could help but I have no medical knowledge! As you can probably tell from my posts, I'm pretty new to TTC issues.

OP posts:
bb077 · 27/07/2020 15:06

Just started a new thread did see this one !
Been ttc after MMC in January so asked doctor for some tests and she did thyroid which was normal and 21 day and fsh and LH she's not calling me till Thursday but my results are on my app what do you guys make if this ? I'm 43
Can anyone help ?

Serum LH = 41.3 IU/ml
Serum FSH = 64.7 IU/ml
Serum Progesterone =0.6 nmol/L
Serum Oestradiol = 92 pmol/L