Private fertility MOT. Good idea? What to expect?

[peskyfeelings]

New to this board, so hello all waves

Just wondering if any other posters here have undergone a fertility MOT, and what it was like if so?

A bit of background. I'm 37, no children and never had so much as a pregnancy scare! I'm not actively TTC atm, but very aware that time is not on my side.

I've decided to book a private MOT for a few months time as I'm currently really concerned about my fertility (or possible lack of it) I stopped taking the mini pill on 12/04/16 and I had a 3 day bleed three and a half weeks afterwards.

I'm really scared of going. I just have a terrible feeling they are going to give me bad news. Any reassurance would be gratefully received at this point. It's eating up my day with worry.

It's a good idea and a positive step. Just because you're 37 doesn't necessarily mean there will be a problem. They are usually really detailed and give you results straight away. Good luck!

Thank you mellowyellow1 :) I appreciate your good wishes.

Apparently you go for blood test first and then back for the scan. You get the results on the second visit. Does that sound right? There are so many clinics out there. It's hard to know what to choose. Not least because some are terrifyingly expensive!

Hello pesky I am interested in the responses to this as I'm also considering this. I'm 29, have been off contraception for 5 years (after I got married), started really ttc in November, on cycle 6 at present. Starting to worry.

Rather than spend your money -could you book into your GP's Well Women clinic and see if they can help ?

I did one aged 28 and was a terrific idea

The NHS doesn't offer the AMH test, which combined with FSH and antral follicle count are the most reliable measures of ovarian reserve

A well woman won't cover this - you want AMH and antral follicle count to let you know how your ovarian reserve is for your age

I should add that this won't address the specific issue about the bleed - and fertility is made up of more than ovarian reserve.

Ovarian reserve is however very very important when it comes to the biological clock - it's just a measure of quantity, not quality - as egg quality is primarily determined by age, and that steadily declines after age 35, with a sharper decline after age 38

However ovarian reserve tests will help identify how fast the clock is ticking relative to what you'd expect for your age

Fertility mot is basically the bigger picture of your biological clock

It won't necessarily address the more fundamental building blocks of fertility & TTC

• day 3 bloods (FSH, LH, oestrodial, testosterone, thyroid and prolactin) - are your hormone levels OK?

• day 21 progesterone - are you ovulating?

• HSG / HyCoSy - tubal patency test - are your fallopian tubes open or blocked

• pelvic ultrasound - are there any obvious ovarian or uterine abnormalities (eg polycystic ovaries, cysts, septum)

• semen analysis - what is your partner's sperm like?

There's no reason to do any of these tests at the outset - these are more diagnostic if you're having issues, whereas a fertility mot is predictive of your ovarian reserve

Where would one go to find these tests? My Gp refuses to give me any blood tests and gynaes only looked at physical things so not my bloods/hormones then discharged me. That said my oh and I did have a bit of a giggle at the home sperm count tests in boots. We didn't even know these things existed. He wouldn't let me spend £30 "for a laugh"

Why would you do this unless actively trying to conceive? How will the outcome of this test affect that?

I think it's pretty pointless. A third of infertility cases are female, a third male and a third unexplained. So a fertility mot would give you less than 1/3 of the picture (because it can't even cover all possible female issues).

We were unexplained - all tests on both sides were normal but it took four rounds of IVF to get a pregnancy that stuck. A fertility mot would have given me false optimism.

I wanted to find out if I had any ovarian reserve issues that meant we needed to think about TTC sooner than we might have otherwise planned - I didn't want to think 'if only I'd known'

I found out I had severely diminished ovarian reserve and am so glad we found out earlier rather than later

They should really call them ovarian reserve tests or biological clock MOT - as pp have said it doesn't tell you anything about your overall fertility, just one aspect

That's mainly why I want it bananafish81. I really want to find out where my ovarian reserve is. Can I be very nosey and ask your age, and if you did manage to conceive?

I do want to start trying for a baby sooner rather than later, but I want to try and get an idea of where I stand iyswim? I don't want to try for 6 months first and then realise there is a problem. It's all time ticking away...

I'm pretty sure my DP hasn't got any issues. He got a woman pregnant a few years ago (she terminated. Sorry if tmi) Plus he's only in his twenties, so hopefully has plenty of good swimmers left.

Just bought a copy of "Taking charge of your fertility" so going to start reading that. :)

foofoobum. It's a clinic in London. It's called City Fertility, but there are loads of others about. I just googled "Female Fertility Test" and loads came up. Hope that helps.

I think it's a good idea even if it doesn't give you the whole picture. I would recommend paying privately rather than going through Nhs as they don't do amh tests on the Nhs. I had Nhs first which showed my fsh was borderline high suggesting diminished ovarian reserve which I was very upset about. Ended up going privately for more tests including amh and antral follicle count and they were both excellent. I was unexplained in the end and ended up having IVF to conceive my first but I produced a good amount of eggs showing the amh and antral follicle count was more accurate for me.,

pesky I'm a bit (lot!) of an odd one as my ovarian reserve changed a lot in a short space of time

I had one at 28 which showed I had spectacular ovarian reserve, but was the means by which my PCOS was diagnosed - so I was aware before TTC that I would have a fertility issue of some sort - I just didn't rush to start TTC earlier because the tests showed my biological clock was looking good

Aged 33 we decide to start TTC - anticipating that we are likely to need some treatment because of the issue identified 5 years previously. I ovulate my first month off the pill - which would have been great news for anyone else, but for me was a warning sign something seemed to have changed (given I was expecting to still be PCOS)

Went for another fertility mot straight away and discovered my ovarian reserve had absolutely plummeted beyond all belief

Now, low ovarian reserve doesn't mean you can't conceive naturally IF all the other bits of the building blocks are in place. It's just a measure of quantity, and in a natural cycle you're just ovulating one egg a month - which is where quality, not quantity, counts . But it does mean the clock is ticking much much faster

A couple of monitoring cycles and more tests with a private gynae showed that yes, my ovarian reserve situation looked pretty dire, and also that I had persistent thin lining issues that meant although I was ovulating, had patent tubes, DH swimmers were fine, as nothing could implant, I'd need monitoring cycles with lining support if we decided to TTC naturally

We didn't want to take the risk of getting a year down the line having not conceived and our chances of IVF having been significantly less then they would have been a year prior - given how fast my ovarian reserve was depleting

The tests for me showed two things

1. it can lull you into a false sense of security
2. but the second one when we decided we were ready to start TTC meant we found out earlier rather than even later that things had changed so drastically

We didn't have quantity on my side, but we did have quality - which is primarily determined by age. My consultant said even if we didn't get many eggs, the fact I had age on my side meant we had a better chance of there being a good one in there. He said if I'd been 5 years older with the same ovarian reserve - ie aged 38 rather than 33 - the picture would likely have been very different

We conceived on our second IVF cycle, aged 34. Sadly I miscarried at 10w, however the tissue testing showed the miscarriage wasn't due to chromosomal abnormalities - ie it wasn't due to embryo quality, and I did indeed have some good eggs left

We're going again, and hopeful that if I had one good egg, I'll hopefully have another

Very long-winded story, and mine is NOT a representative example - ovarian reserve doesn't normally decline so drastically between 28 and 33! But being proactive did identify a number of issues earlier on.

If you can afford it and it will help you relax I think it's a good idea. GP won't be able to request bloods if you are not trying and have no other reason to think there is a problem. Different clinics do more or less, I was thinking about going to our local clinic which does bloods, semen analysis and then ultrasound /tubal patentcy. We have been trying for a while and NHS bloods have been fine. Cannot get ivf referral due to my weight so trying to sort that while thinking about options.

I've had one, was all great, but still needed three rounds of ivf.

Just want to reiterate banana's message that you don't want it to give you the idea that you have loads of time if it's good. Your best bet, if you want a baby, and you're in your late 30s, is to start trying to conceive. Don't think you can wait if you've got good ovarian reserve.

HI @bananafish81, I'd love to hear more about this. Would you be up for chatting about your experience? I'm writing a piece about getting a fertility MOT. I am on [email protected]. Thank you!