Which Tests? Is AMH/AFC The Best Thing to Start With?

[Wanderdust]

I'm 39, been TTC our second child for a year now (but heading into cycle 15).

After being referred by my GP for further testing (which I know is a very long wait), I decided to go private and book some tests for peace of mind. But I'm regretting my decision already and wondering whether to cancel!

The clinic's first step is to offer a package, which I was aware of when I called, but I'm now unsure if the exact tests they offer are right for me. No consultation was given first - just seems to be a standard package offered to everyone.

I'll get an AMH blood test and AFC scan but what if I have something like a cyst or a blocked tube? Or maybe my progesterone levels are low? My GP didn't go into detail about my results, just said all was fine... It was a 21 day blood test I had, and I have now asked to see a copy of the actual results (will pick up today).

Now after doing some more research, I'm not sure what these new tests will achieve apart from worry me. I am older so not expecting fantastic results. They also seem to be a precursor for IVF (so it's understandable why these places do these tests) but I do not want to go down this road, nor do I think I'm a great candidate.

Is there any benefit to these tests other than telling you how many eggs and follicles you have? I understand they tell you nothing about quality...

It's a lot of money to pay so would rather do some other, more appropriate tests first...

Any advice, and ideas of what tests would be helpful for my first investigations, would be greatly appreciated!

So I’d say you still need your day 2-5 blood tests at GP (to test what your hormones are like). Those will help identify any hormonal issues which the doctor can either refer you for treatment or prescribe drugs. The AFC and AMH you need to have pre-IVF and give a good indicator of how your body will respond. If you don’t want to go this route you can see a gynaecologist privately to check your tubes etc, but at my scan to check AFC they did check my tubes and blood flow etc, so I did find it helpful, and it helped managed my expectations for IVF response. There aren’t any tests for egg quality unfortunately (you can take a good supplement and CoQ10). Alternatively if you don’t want to go down the IVF route you can get more tests including AMH done at a place like window to the womb, or see a gynaecologist privately who can do HyCosy etc if you need it.

AMH and AFC will give you some idea of what your fertility is like. How long did it take you to conceive your first child and what age were you at the time? You could also get your partner to get a sperm analysis if you wanted. A HyCoSy would help you understand if you have any polyps / issues with tubes etc.

Its worth asking your GP to do a thyroid function test, as that can impact fertility as well.

Otherwise just eat healthy and keep trying x

Thanks both - feeling very impatient at the moment but I did end up cancelling at the private clinic as felt it was the right thing to do RE: researching my options. Not to say I won't ever look into AMH/AFC but not for now. As @HopefulllHolly said, there's probably some basic checks like the 2-5 day blood test to do first! I was sort of thinking the same thing, finding a private gynaecologist or endocrinologist to talk things through with first. My GP won't do anymore bloods sadly! I have had thyroid checked before as was having issues when breastfeeding my son but that was a while ago so something to think about.

@2mumlife It only took about 5 months to conceive our first so this has been a bit of a shock! I was 36 when I had my son (conceived at 35). Was such a easy straightforward pregnancy and birth but no such luck this time.

Part of the private package included SA too but my GP agreed just today that my husband can get this done at our local surgery so seemed daft to pay when we can some of it free. Trying not to get ahead of myself until that is done but hard not to Google!! There are so many testing options now.

Thanks for taking the time to read and reply, feel like a bit of a fraud on this board as very lucky to have my son :( Just hard going when there's no obvious reason things aren't going well this time x

@Wanderdust to be honest I wouldn't be surprised if its just a case of taking longer because of your age, rather than anything that needs treatment / intervention. Fertility does decline quite rapidly after 35. Hopefully it happens for you soon :)