Ask the Expert with Hertility | Fertility & Hormone Health FAQs

Whether you’re trying to conceive, living with PMOS ( formerly known as PCOS), considering egg freezing, navigating perimenopause, or simply trying to understand what your hormones are doing, you are not alone.

Reproductive health can feel confusing, especially when symptoms are dismissed, cycles become unpredictable, or you’re told to “just wait and see” without clear answers. But your questions deserve more than vague reassurance. They deserve clinical context, personalised support and practical next steps.

Welcome to Ask the Expert with Hertility,  our expert-led series answering the reproductive health, hormone and fertility questions you really want answered.

I’m Zoya Ali, Hertility’s Senior Scientific Research Associate, and in this series I’ll be helping to break down complex fertility and hormone topics in a way that feels clear, clinically grounded and easy to understand. From irregular periods and PMOS to egg freezing, perimenopause and trying to conceive, my goal is to give you evidence-based information without shame, confusion or medical jargon.

In this edition, we’re answering some of the most common questions we hear from the Hertility community, including what to do if you feel dismissed by your GP, whether egg freezing in your early thirties is worth it, why a PMOS diagnosis matters, and whether pregnancy is still possible during perimenopause.

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Q: We’ve been trying to conceive for over a year. My GP told me to lose weight and said ovulation can happen at any time. I only get a period once every three months. I feel pushed aside. What can I do?

First, I’m really sorry you’ve been made to feel like this, your concerns are completely valid. After 12 months of trying to conceive, you are entitled to a comprehensive fertility assessment. Being told to lose weight and come back later, with no investigations or plan is not adequate care and you deserve more than that.

Now, let’s talk about what’s actually going on with your body, because irregular periods every three months are telling us something important. That pattern is known as oligomenorrhoea and it is a sign that your body may not be ovulating regularly. Ovulation is the event that makes conception possible, and if it’s only happening sporadically, or not at all, trying to conceive can become significantly harder.

Weight can be one piece of this picture, and it’s worth being honest about that. Weight can affect how the body manages insulin and inflammation, both of which influence reproductive hormones and ovulation. But weight is one factor in a much larger story, and it should never be used as a reason to withhold investigations. The most common cause of irregular, infrequent periods is PMOS ( previously known as PCOS ) which is a hormonal and metabolic condition affecting how the ovaries function. But thyroid imbalance, raised prolactin, insulin resistance and stress can all produce a very similar picture. You cannot know which of these is driving your symptoms without testing.

If you feel your GP is still not listening, you are entitled to ask for a referral to a gynaecologist or fertility specialist, or to seek a second opinion. At Hertility, our Advanced At-home Hormone and Fertility Test can give you clinical-grade results, insight into your egg count and screening for up to 18 reproductive health conditions, alongside a doctor-written report, personalised Care Plan and a Clinical Result Review Call.

We also offer Fertility Nutrition Consultations that can support ovulation, hormone and metabolic health without shame, blame or crash dieting. You don’t have to wait to be taken seriously.

Q: What is the success rate for egg freezing if you freeze your eggs in your early thirties?

This is one of the most common questions I hear from people considering egg freezing, and I understand why, you want a number, something reassuring and concrete. The honest answer is that there isn’t one single success rate, let me explain why, and what the picture actually looks like.

Age is genuinely one of the most important factors in egg freezing. Freezing in your late twenties to early thirties is the most recommended, because egg quality and quantity are typically the best. But age alone doesn’t determine your outcome, two women who are both 31 can have very different responses to fertility treatment depending on factors like their AMH levels and antral follicle count.

When we talk about success rates, we’re really talking about a chain of events, and at each link in that chain, some eggs are naturally lost. First, your frozen eggs need to survive the thawing process, thaw survival rates are typically around 80 to 90%. Then, not every thawed egg will fertilise successfully. Not every fertilised egg will develop into a good-quality embryo. And not every embryo will implant and lead to a pregnancy. Sperm quality and uterine health both play a role at that final stage too.

Most clinics recommend aiming for around 15 mature eggs to give yourself a reasonable chance of a future live birth, with some recommending closer to 20 if you’re hoping for more than one child. Depending on how your ovaries respond to stimulation, some people collect enough eggs in one cycle; others need two or more. This is why egg freezing planning really is personal, it’s not a one-size approach.

An AMH blood test and pelvic ultrasound to check our Antral Follicle Count (AFC) are the best starting points for understanding your ovarian reserve. They can’t tell us about egg quality directly, that remains something we can only assess once eggs are fertilised, but they give us a meaningful picture of quantity and potential response to fertility medications. At Hertility, our Advanced At-home Hormone and Fertility Test includes insight into your egg count alongside a full hormone profile. We can also arrange a Pelvic Ultrasound Scan to assess your antral follicle count and pelvic structures, and we work with HFEA-accredited partner clinics to support a smooth referral process for egg freezing.

Q: If you know you have PCOS, do you need a formal diagnosis? There’s no medicine for it anyway.

A PMOS ( previously known as PCOS) diagnosis isn’t just about giving your symptoms a name. The first thing it does is rule out other conditions. The symptoms that look like PMOS, irregular or absent periods, acne, excess facial or body hair, hair thinning, weight changes, difficulty conceiving, can also be caused by thyroid imbalance, raised prolactin levels, or other hormonal conditions. Without testing, you genuinely cannot be certain which of these is driving your symptoms, even if PMOS seems like the obvious answer. Getting a diagnosis means nothing gets missed.

The second thing a diagnosis does is open the door to targeted treatment, and there’s actually quite a lot available, even if none of it is a single cure. If PMOS is disrupting your menstrual cycle, there are options to support more regular periods. If it’s causing androgen hormone related symptoms like acne or unwanted hair growth, there are specific treatments for that. If insulin resistance is part of your picture. and for many people with PMOS it is — nutrition, lifestyle support and in some cases medication can make a meaningful difference to both how you feel day-to-day and your longer-term metabolic health. And if you’re trying to conceive, a diagnosis is particularly important, because irregular ovulation is one of PMOS’s most significant effects on fertility, and there are evidence-based interventions that can help.

The third reason a formal diagnosis matters is long-term health. PMOS is associated with a higher risk of insulin resistance, type 2 diabetes, cardiovascular disease, mental health issues and increased risk of endometrial cancer. A diagnosis means those risks are on your medical record and can be monitored appropriately. Without it, important health checks can fall through the cracks simply because no one is looking for them.

At Hertility, our Advanced At-home Hormone and Fertility Test screens for up to 18 reproductive health conditions and gives you clinical-grade results with a doctor-written report and tailored Care Plan. We can support next steps including a Pelvic Ultrasound Scan, referrals for GP or gynaecology care, and Nutrition Consultations with Registered Nutritionists and Dietitians who specialise in hormonal and metabolic health. You don’t have to navigate this alone, and a diagnosis is genuinely worth having, even when it feels like you already know the answer.

Q: I have PMOS and want children in the future. I’ve done hormone blood tests, I’m eating healthily and I’ve started tracking ovulation. What else can I do?

What you’re already doing is genuinely impressive, and I want to start by saying that. Getting your hormone tested, paying attention to your nutrition and beginning to track your cycle are all meaningful, proactive steps, exactly the kind of thing that can make a real difference when you’re ready to start trying. Let me build on that foundation and give you a more complete picture.

The most important thing to understand about PMOS and fertility is that the condition mainly disrupts your ability to conceive through its effect on ovulation. Without regular ovulation, there’s no egg available to be fertilised, and conception can’t happen. The reassuring truth is that PMOS does not mean you can’t get pregnant, many people with PMOS conceive naturally, and many more do so with relatively straightforward support. But understanding whether you’re ovulating, and when, becomes much more central to your journey than it might be for someone with regular cycles.

On the ovulation tracking you’ve started, this is great, but I want to give you a heads up about some of the limitations that are particularly relevant for PMOS. Ovulation predictor kits work by detecting a surge in LH, the hormone that triggers ovulation. In PMOS, LH levels can be elevated at baseline, meaning you might get a positive result on an OPK without ovulation actually happening. This doesn’t mean tracking kits aren’t useful; it means you should treat them as one signal among several rather than the definitive answer. Similarly, cycle tracking apps rely on your period arriving at predictable intervals to estimate when ovulation occurred, which is less reliable when your cycles are long or irregular.

A more complete picture comes from combining several methods. Tracking changes in your cervical mucus, monitoring your basal body temperature each morning before getting up, and noting cycle length patterns together give you a much richer dataset than any single method alone. Where possible, a day 21 progesterone blood test, timed to around seven days after suspected ovulation can confirm whether ovulation actually occurred. This is something your GP can arrange..

On the nutrition side, you’re already eating well, which is a strong foundation. If insulin resistance is part of your PMOS picture, and it’s worth checking whether it is, there are specific nutritional strategies that can support your hormonal health and ovulation more directly. Prioritising protein and fibre to support stable blood sugar, reducing refined carbohydrates and ultra-processed foods, and eating regular meals are all things that can make a meaningful difference. Strength training and regular movement also help with insulin sensitivity in ways that are distinct from general cardio. Good sleep is often underestimated in this context too, chronic sleep disruption raises cortisol and disrupts the hormonal signals that regulate your cycle.

One of the most useful things you can do at this stage is book a consultation with one of Hertility’s Private Gynaecologists or GPs, who can review your hormone test results, help you interpret your cycle data and discuss whether ovulation is consistently happening. They can create a personalised care plan with clear next steps so that when you are ready to start trying, you’re not starting from scratch.

You might also find our guide, Trying to Conceive with PCOS: What You Need to Know, a helpful companion alongside these conversations.

Q: Can periods be delayed by 46 days in perimenopause?

Yes, absolutely, and if you’re in perimenopause, a delay of that length is not unusual. But I’d also like to give you some context around when that’s most likely to be perimenopause, and when it might be worth looking a little further.

Perimenopause is the hormonal transition that precedes menopause, and it most commonly begins sometime in your 40s, with the average age of menopause in the UK being 51, though for some it can start earlier. During this phase, oestrogen and progesterone levels stop following their predictable monthly pattern and begin to fluctuate, sometimes dramatically. This has a direct effect on your cycle because your period is triggered by a specific sequence of hormonal events, and if those events are disrupted or delayed, your period follows suit. Ovulation in particular becomes less consistent during perimenopause, and since your period typically arrives around 10 to 16 days after ovulation, a cycle without ovulation or with very late ovulation can easily add weeks onto your expected date.

A 46-day delay is within the range of what perimenopause can produce, especially when it comes alongside other symptoms you might be noticing: hot flushes, night sweats, changes to your sleep, mood shifts, brain fog, changes in sex drive, vaginal dryness, or differences in how heavy or light your periods are when they do arrive. If several of these resonate, the picture does point toward perimenopause.

That said, a late or missing period should never be automatically attributed to perimenopause without considering other possibilities. Pregnancy is still possible during perimenopause and this catches many people off guard. If there is any chance you could be pregnant, it’s always worth taking a test. Beyond pregnancy, thyroid issues, significant stress, weight changes, PMOS and certain medication changes can all produce a very similar picture of cycle disruption. This is why testing is valuable even when perimenopause seems like the most likely explanation.

I’d also encourage you to see a doctor if this pattern is new and concerning to you, if you’re experiencing very heavy bleeding, bleeding between periods or after sex, pelvic pain, or  importantly, if you have had no period for 12 months and then start bleeding again. That last scenario, known as postmenopausal bleeding, always warrants prompt investigation.

At Hertility, our Advanced At-home Hormone and Fertility Test can help check key hormones including FSH, LH and oestradiol alongside thyroid function and AMH, giving you a clearer picture of where you are in your reproductive journey. You’ll receive clinical-grade results, a comprehensive doctor-written report, a personalised Care Plan and a Clinical Result Review Call to talk through what your results mean and what your next steps could be.

Q: Can you still get pregnant during perimenopause?

Yes, you can still get pregnant during perimenopause. This surprises many people. But irregular periods do not mean ovulation has stopped completely.

Menopause is defined as 12 consecutive months without a period. Until then, ovulation can still happen. If ovulation happens, pregnancy is possible.

During perimenopause, ovulation becomes less predictable. You may ovulate some months and not others. Your periods may come every few weeks, every few months or at unpredictable times. This makes it harder to know when you are fertile. It also means unintended pregnancy can still happen.

If pregnancy is not your goal, contraception still matters during perimenopause. Our doctor can help you choose the best option for your symptoms, health history and preferences.

Pregnancy during perimenopause is possible. But fertility does decline with age, especially from the late thirties onwards. This happens because both egg quantity and egg quality decline over time.

As egg quality declines, the chance of chromosomal abnormalities rises. This can increase the risk of miscarriage and some pregnancy complications. Conception may also take longer.

If you are in perimenopause and want to get pregnant, seek specialist advice sooner rather than later, because waiting has a real cost in this context. Understanding your current hormone levels, ovarian reserve and cycle pattern gives you a much clearer sense of what’s realistic and what support might help. 

At Hertility, our Advanced At-Home Hormone and Fertility Test gives you clinical-grade insight into your hormones, ovarian reserve and cycle patterns. You’ll receive a doctor-written report, personalised Care Plan and Clinical Result Review Call.

Whether you are trying to conceive, planning ahead or trying to understand your body, you deserve clarity.

Your body deserves better answers.

Reproductive health is complex, deeply personal, and for too long has been under-investigated, under-discussed and under-resourced. The questions in this column are ones that thousands of people are sitting with right now, often feeling like they’re alone in them. You’re not. And whether you’re navigating a difficult GP appointment, considering fertility preservation, trying to understand a PMOS diagnosis or working out what perimenopause actually means for your body, there is support available, and you deserve care that treats you as a whole person.

At Hertility, that is exactly what we’re here for.

This content is for informational purposes only and does not constitute medical advice. Please speak with a qualified healthcare professional about your individual circumstances.

Frequently Asked Questions:

Can irregular periods make it harder to get pregnant?

Yes. Irregular periods can be a sign that ovulation is not happening regularly. Since ovulation is needed for conception, irregular ovulation can make it harder to predict your fertile window and may reduce your chances of getting pregnant each cycle.

Can you have PMOS and still get pregnant naturally?

Yes. Many people with PMOS conceive naturally. PMOS can affect fertility mainly by disrupting ovulation, but this does not mean pregnancy is impossible. Some people conceive without treatment, while others may benefit from ovulation support or fertility care.

Is egg freezing worth it in your early thirties?

Egg freezing in your early thirties can be a good time to consider fertility preservation because egg quality and quantity are generally better than later in reproductive life. However, whether it is right for you depends on your ovarian reserve, personal goals, medical history and how many eggs you are likely to freeze.

Can perimenopause cause a very late period?

Yes. Perimenopause can cause late, missed or irregular periods because ovulation becomes less predictable. However, pregnancy, thyroid issues, stress, PMOS and other hormone changes can also delay periods, so it is worth investigating if the pattern is new or concerning.

Can you get pregnant during perimenopause?

Yes. Pregnancy is still possible during perimenopause because ovulation can still happen, even if periods are irregular. Menopause is only confirmed after 12 consecutive months without a period.