The 101 on Fertility and Fertility Tests
Fertility (noun) - the quality of being fertile; productiveness. (In other words, your body’s natural ability to produce children).
Let’s talk about fertility. Whether you’re already a parent, thinking about having a baby or are just curious we’re here to break it all down. Waiting until the time is right and hoping for the best isn’t the only option. Even before you start thinking about having children, there are many options available for you to check-up on your fertility (sounds great, right?). Before we get into the details, let’s start with the basics.
The Menstrual Cycle and Pregnancy
Our menstrual cycle is what regulates our monthly cycle. In women, this is all affected by two key hormones Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH). LH and FSH are basically chemical signals which help regulate our menstrual cycle.
LH starts the ovulation process by signalling to our ovarian follicle to release an egg into the fallopian tube.
FSH helps to produce ovarian follicles (temporary housing for your eggs) which eventually grows into one follicle and egg ready for ovulation for your menstrual cycle.
Roughly every month, one egg is released from our ovaries. If the egg isn’t fertilised by the sperm then our lining in the uterus sheds through our vagina causing us to have a period.
So, what happens if our eggs are fertilised by sperm? Simple! The fertilised egg implants itself into the uterus which is also known as conception.
A good way to think about the chances of having a healthy pregnancy is like a line of dominos. If one block wobbles, this has a knock-on effect for the blocks in-front:
Are the sperm and egg healthy?
Do regular periods occur?
Are the reproductive organs working properly?
Are both involved healthy and within a good age window?
Fun fact: We are born with all of our eggs (this is called our ovarian reserve). The quality and amount we are born with decreases with age and some external factors. The rate at which our ovarian reserve reduces is different between people this is why it’s important to regularly monitor these hormones.
Now back to those fertility hormones (our old friends LH and FSH). What happens if these are out of range?
If your LH levels are too high, this can increase the amount of testosterone in the body (high LH is commonly related to Polycystic Ovary Syndrome or PCOS). If your LH levels are too low, the eggs are less likely to be released so less chance of becoming fertilised. Both scenarios can make it harder to become pregnant.
If your FSH is too high this could signal that your body is working overtime to mature the follicle ready for the egg to be released. This could possibly mean that the number of eggs left (ovarian reserve) is low. If too low, follicles struggle to develop which may cause the egg to not be released. Again, both scenarios affecting fertility.
There’s also another hormone which can help to predict ovarian reserve - Anti-Mullerian Hormone (AMH). This is produced by the follicles in the ovaries (remember, that temporary housing for your eggs). AMH can be a better indicator of your egg supply as AMH levels don’t change during the menstrual cycle like FSH. A high AMH level signals a high ovarian reserve.
Getting your LH, FSH, and AMH tested in combination helps us to create a good picture of your fertility profile. To take this one step further, it’s also possible to count the total number of eggs left by getting an ultrasound examination at your fertility clinic.
Whether you’re actively trying to conceive or not, keeping an eye on these hormones to ensure that they are within optimal range is important to make sure your ovaries are working correctly as part of your menstrual cycle. We recommend monitoring these levels at least once a year. As you age, your body changes and your fertility reduces overtime. The same way you take your car for a regular MOT, keeping a check on your fertility can help you plan for your future, even if you are nowhere near thinking about having a family yet. Fertility testing is the first step on this road to becoming empowered about your fertility and reproductive health.
As much as we like fortune cookies in our takeaways, we can’t predict our future, however, there are a few things which we can measure to help us understand our fertility past our suggested fertile window. Blood tests, ultrasounds and x-rays can all help us out. Don’t worry. We’ll go into what each of these means.
Sound’s scarier than it is but a simple swab or finger prick test, blood tests can help us measure key fertility hormones. Alongside LH, FSH, and AMH, at Syrona Women we test for other hormones such as Progesterone which helps us understand your menstrual cycle and how to plan for conception. We also look at Free thyroxine (FT4) and Thyroid-stimulating hormone (TSH) which gives us a picture of your thyroid function, essential as it links to your fertility. Fertility doctors (Reproductive Endocrinologists) have a few more ways to assess fertility.
Fertility doctors may also take an x-ray (hysterosalpingogram) of your uterus and fallopian tubes. This allows them to see whether there's any blockages which could prevent your eggs from being released.
Transvaginal ultrasounds help fertility doctors to count the follicles in your ovaries. Note: this is not the same type of ultrasound that we have when you’re pregnant! The doctor inserts the ultrasound wand into your vagina and this allows them to view your follicles to give a picture as to whether the number of follicles for someone of your age and health profile.
So, where do I start?
You’re probably thinking, so where do I start? Many of us have already taken the first step by monitoring our menstrual cycle, may be manually or through an app and know when our fertile window is. The next step is to really understand what’s going on in our bodies through monitoring our hormones through a blood test.
At Syrona Women, we can help you do so through our at-home fertility kits. We’ll send you an at-home kit where you take a sample and you simply pop it back to us in the post and we’ll send you the results within a few days. Don’t worry, we’ll give you the low-down as to what is all means and we’ll support you throughout your female healthcare journey. Think of it something similar to your credit score, by knowing where you currently are helps you make decisions on what to do next. Welcome to the Syrona Women community!
If you have any questions, let us know! firstname.lastname@example.org