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

[CC81]

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.

@claireb707 - I think there's a lot of bad communication around NHS tests. Very frustrating. Hope you manage to get it sorted (and good luck for the SA results).

I did a private AMH test probably back in January now and the result completely confused me.

I don't have pcos as far as I am aware. I'm fairly sure I ovulate every month (temp rises confirming opk tests) and have 28 ish day cycles.

Partners just rang, he's got the results from his SA and they aren't good 😢 good motility but very low count. He's been told to book in for testosterone bloods and we'll see what we can do after that. But it's very very unlikely we'll conceive naturally 😢😢

Hi @claireb707 - I just replied to you on another thread. xxx

My Husband and I had a Full fertility assessment done a few weeks back, it including the egg count, blood tests, and a hicosy for me, and a sperm check for the hubby, and then a phone consultation with a specialist. this cost around £550.

The doctor we had the consultation with then advised on further blood tests on certain days of my cycle, to check for LH, FSH, Progesterone, Prolactin and Oestradiol which cost a further £50 per thing tested for so £250 in total, another semen analysis to double check, as the levels were low first time round - £120, and another consultation to discuss these extra results due in the middle of September - £190.

Although they have been amazing and we have finally had some answers as to why we aren't falling pregnant, just be prepared for additional costs.

Hope this helps in some way!

@FranklinOo86 - Thanks for sharing. Do you mind me asking what the results showed? What are the next steps for you?

Since my original post I've had standard hormone tests with the GP (progesterone, FSH, LH, etc.), which revealed that everything is normal except FSH - which is on the high side.

So next week we're having AMH/AFC/SA tests at a private clinic.

I'm really scared of what the results will show, but at least we'll know what we're dealing with.

On the bright side, my cycle seems to be regular again (after the single weird one) and we already have one child (conceived with no problems three years ago), so various factors are in our favour.

We'll see!

@CC81of course not. So far all of my results have come back absolutely fine, although I have not had the official results of the hicosy yet, he didn't say there was anything to be concerned about at the time.

My husbands sperm count has come back as low in all areas, motility, morphology and the amount per ml. This is why he is having to have a second one.

When the lady called to give him his results first time, she said that she would recommend us having ICSI, but I thought that was a bit strange for the lab technician to say that, rather than wait for our meeting with the consultant. But nonetheless I hit google and have now totally overwhelmed myself with it all.
IVF just hadn't crossed my mind really, and now I feel freaked out.

We have our next consultation appointment mid September, so will see what he says then and what the next steps for us are.

I hope everything goes well for you, its such a nerve-racking time, but like you say, getting some answers is better than the not knowing x

@FranklinOo86 - Glad to hear your results were all good. Fingers crossed for your husband's second test.

Yep, totally with you on the freaked out thing - I've gone from knowing nothing about all this stuff, to feeling really overwhelmed!

I knew I was ageing, of course (being 38); and that can cause issues. But I was complacent because we had no problems with our first child (only three years ago). I never really knew how egg reserve can be measured, medically, and which options are available.

What scared me is discovering that high FSH can mean that IVF doesn't work too well... which I'd always viewed as a last resort! The idea that it might not be possible at all hadn't really crossed my mind until recent weeks.

So I've been really stressed about that. I've started to accept that we may not have a second child, which is painful, but somehow lessens the stress and pressure.

BUT I've also read things that have encouraged me (and may help others in the same situation):

It only takes one good egg - so if I'm ovulating monthly, there's a chance
Plenty of women with high FSH have had successful pregnancies, both with IVF and without (it's just that the stats aren't great)

Like you, we need to see how our consultation goes in September (with private test results) and take it from there... x

@CC81 This is the danger of the internet isn't it, sometimes its great for research, but mostly it just scares the living bejeezus out of you and causes unnecessary worry.

I really feel for you and the concerns you have, I wish I had something helpful to say, but I, (probably like you) am sick to death of people telling me not to stress, or if you relax it will happen naturally blah blah fricking blah... so I will not insult you lol!

I will just keep my fingers crossed that your consultation gives you some proper answers and reassurance :) x

@FranklinOo86 - Late reply, sorry! Just a note to say thanks very much for your kind words :)

I've now had the private tests. Won't get my AMH result until our consultation on 22 Sep, but they also did an internal ultrasound.

The antral follicle count was in line with my FSH, as it showed a low number (5 total) - which probably means a low egg supply. Not entirely unexpected at my age, but still a little disappointing. It may mean that I'm not an ideal candidate for IVF, if we decide to pursue treatment. The natural modified IVF may be a better route (we'll see what the doctor says).

On the bright side, as long as I'm still ovulating each month, it's possible to conceive naturally. And the scan showed that everything else is normal - womb fine, no cysts, no fibroids, no polyps, a 'very neat' c-section scar (!); and two functioning ovaries (it showed recent ovulation).

So if nothing else, it's reassuring to know that my physical health seems generally good.

I guess it depends on your area but given your age you should be fast tracked. I was 38 and had been TTC for 6 months when I went to the GP in January and they ordered all the hormone blood tests asap so we would have the results for our consultation which we had at the end of February. I then had more tests and partner had his SA booked in for April but unfortunately covid happened which delayed everything. Push your GP for a referral and you hopefully won't have to wait too long. If it wasn't for covid we would have known where we stood by early May and could have started treatment asap but as it stands we're starting IVF in Oct/Nov.

[quote CC81]@FranklinOo86 - Late reply, sorry! Just a note to say thanks very much for your kind words :)

I've now had the private tests. Won't get my AMH result until our consultation on 22 Sep, but they also did an internal ultrasound.

The antral follicle count was in line with my FSH, as it showed a low number (5 total) - which probably means a low egg supply. Not entirely unexpected at my age, but still a little disappointing. It may mean that I'm not an ideal candidate for IVF, if we decide to pursue treatment. The natural modified IVF may be a better route (we'll see what the doctor says).

On the bright side, as long as I'm still ovulating each month, it's possible to conceive naturally. And the scan showed that everything else is normal - womb fine, no cysts, no fibroids, no polyps, a 'very neat' c-section scar (!); and two functioning ovaries (it showed recent ovulation).

So if nothing else, it's reassuring to know that my physical health seems generally good.[/quote]
Was replying as you were typing this I think!

I've just finished reading the full thread. I find this all really interesting because in my mid 20s I had a few private fertility tests, there were family issues at the time and I was trying to work out if I should try and a baby soon or not due to these family issues. At the time I was told my fertility was subpar for my age (all the tests had terrible results) and unless I tried soon, I might never conceive naturally. However a million things happened and I didn't try. Many years later, my now DH and I decided to start trying for a baby, we went in prepared for the long haul. With IVF doctors pre screened etc, and we conceived on the very first try. I'm not the only friend I know with similar story. Though this is only a personal anecdote.

I realise the thread has moved on from the OP wondering about having the tests etc but I now wonder massively about the utility of these tests as a guide to future fertility, not saying they are not useful for those that are preparing for IVF or anything else, I can see they are useful for the doctors. But as a indication to us women on future success, I'm no longer sure and I've cautioned friends against having them prematurely.

Thanks @MF1981 - fingers crossed for you!

We're not eligible for NHS IVF, as we've already got a child (conceived naturally three years ago).

So for us the decision will be whether to pay for private IVF - and if so, which type! If so, it should be pretty quick. But it's a tough decision!

@icantevenexplain - Thanks - I've had similar thoughts, which is partly what makes the decision about treatment so difficult.

I may have had sup-par results for years, but we never got tested because we conceived our first child so quickly.

There are several studies suggesting that these tests are only really good for predicting IVF success, and even then they're only an indication.

I guess we just want to feel like we've tried every option, before we decide to stop. If we do a few rounds of treatment and also try naturally either side, at least we can't regret it.

Quick update to this thread - I actually went on to conceive naturally, to my surprise!

Story here: www.mumsnet.com/Talk/infertility/4290062-Update-Low-AMH-success-story-hope-it-helps