Category: Reproductive Health Basics

A common symptom of endometriosis is fertility issues. Up to 50% of people with endometriosis will struggle to conceive, with the causes still relatively unknown. Here take a deep dive into what you need to know about your fertility if you have diagnosed or suspected endometriosis. Quick facts: What is endometriosis? Endometriosis is a reproductive health condition where tissue similar to the lining of the womb grows in other places. This is called endometrial tissue. This tissue can grow in the ovaries and fallopian tubes and can cause painful symptoms.  It’s one of the most common reproductive health conditions. 1 in 10 women and those assigned female-at-birth (AFAB) will develop endometriosis, yet its definitive cause is still unknown.  As a long-term condition, endometriosis can significantly impact some people’s lives. One of the most common concerns is how does endometriosis affect fertility? Will endometriosis affect my fertility? In short, it might. Fertility problems are common in those with endometriosis, with 30-50% experiencing fertility problems (1). But having endometriosis does not automatically mean you will have fertility problems—every case is different. It will depend on the severity of your symptoms and any structural or hormonal issues you may have.  Is it possible to get pregnant with endometriosis? Yes, it’s possible to get pregnant with endometriosis. However, you may experience difficulty getting pregnant. Those with endometriosis have a lower chance of getting pregnant with each monthly cycle (2). This can result in it taking longer for people with endometriosis to conceive (3).  Infertility is also common in those with endometriosis, and in subfertile (failure to conceive after one year of trying) women the prevalence seems to be considerably higher, ranging from 20% to 50%, but it varies with time and age (1). How does endometriosis affect fertility? Again, not necessarily. But those with endometriosis are at an increased risk of miscarriage, ectopic pregnancy and other obstetric complications compared to those without (4). How does endometriosis affect fertility? Exactly why and how endometriosis affects fertility is still unknown. But here are the latest theories of possible links and causes.  Structural issues One of the ways endometriosis is likely to affect fertility is by distorting the position of reproductive organs. Growth of endometrial tissue and adhesions around the uterus and Fallopian tubes can cause this distortion. In turn, this may block mature eggs from reaching the uterus to be fertilised. The risk of blocked Fallopian tubes, in particular, increases in the more advanced stages of endometriosis.  Endometriomas The presence of cysts on your ovaries, called endometriomas, could also affect fertility and ovulation. Endometriomas can damage ovarian tissue and the precious ovarian follicles which house immature eggs.  Immune reaction Another theory is an immune reaction to endometrial tissue growing outside the uterus. This is because this tissue is recognised as ‘foreign’ to these parts of the body. The immune system responds by attacking it, causing inflammation. Inflammation leads to harmful toxins which may affect Fallopian tube function, sperm function and egg quality (5). Womb reciprocity There is also debate about whether endometriosis affects the receptivity of the womb to a fertilised egg. However, there is currently no conclusive evidence to prove this theory.  Painful sex Painful sex is one of the symptoms associated with endometriosis. Pain during or after intercourse can negatively impact your sex life and make the trying-to-conceive process difficult. Can treating endometriosis improve fertility? Various treatments for endometriosis that aim to improve fertility. The right ones for you will depend on the location and severity of your endometriosis and what your symptoms are.  One treatment that aims to improve fertility is laparoscopic surgery. This is surgery to remove the endometrial tissue deposits and adhesions. It aims to free the pelvic organs of any structural issues or blockages and reduce inflammation.  For people with endometrioma, laparoscopic ovarian cystectomy can remove the endometriosis-related cysts on the ovaries (6). This has been shown to lower the recurrence rate of both cysts and pain symptoms.  However, there are risks associated with any surgery. For example, ovarian cystectomy can also negatively affect ovarian reserve by the removal of healthy tissue.  It’s important to discuss the potential for surgery with a specialist. And to explore the individual risks. How can I improve my chances of conceiving with endometriosis? If you’re trying to conceive with endometriosis, there are options to improve your chances. These include expectant management and assisted reproductive techniques (ARTs).  Expectant management  This is for heterosexual people who are trying to conceive naturally and:  To improve your chances of conceiving with every menstrual cycle, it is recommended to have sex every 2-3 days so there is a good chance of catching your fertile window.   Assisted reproductive techniques (ARTs) ART options include ovarian stimulation (COS), intrauterine insemination (IUI), and in-vitro fertilisation (IVF).  Depending on your age, ART is recommended if: IUI is usually offered to couples with minimal or mild endometriosis if their partner has normal semen quality and is typically not offered to those with moderate/severe endometriosis, because of a probable effect on the Fallopian tubes. IVF can be offered to those with moderate or severe endometriosis. It can also help those with a very low egg reserve. IVF has been found to be less successful in people with endometriosis compared to those without endometriosis. However, lots of factors influence IVF success, like age, whether you’ve been pregnant before, if you’ve had treatment before body mass index, underlying health conditions, lifestyle and your partner’s sperm quality.  Resources:  

On Wednesday, the 15th of February, we hosted our first community event to launch our Black Women’s Health Initiative. It was a privilege to have brought together so many people who were actively engaged in the topic.  The event provided us with such insightful information and has helped us not only hone our commitments to change but also acted as the first step in our journey as a company. We are still learning and growing as a young seed-stage start-up, but that doesn’t stop us from having big aspirations, and we hope to build on these year after year. We are so thankful to everyone who attended the event. We really appreciate the time, energy and support each person gave.  It was an incredibly proud moment to be able to share the findings from our recent research looking into the role that ethnicity played in access to fertility testing and reproductive healthcare. A roundtable discussion followed, moderated by Hertility’s CEO and founder Dr Helen O’Neill, where we heard from clinical gynaecology experts, community leaders, and patient advocates Dr Christine Ekechi, Dr Stephanie Kuku, Noni Martins and Sophia Ukor. In case you missed it, here’s a rundown of what was covered: The changes to Black women’s reproductive healthcare over the years All the panellists agreed that they are seeing a positive trend, with more conversations being had around women’s health in general, and increased awareness and advocacy from colleagues within the healthcare system and doctors for their patients. We heard about positive interactions with healthcare providers  or seeing positive changes in healthcare delivery in the last five years.  “I feel there is a change with the language, culture and even the way they listen to you. They listen and you feel understood. I felt seen, I did not feel alone. The language, the care and the attention is evident.” – Sophia Ufy Ukor, Founder & CEO of Violet Simon We heard from Dr Christine Ekechi that not only is there an increased awareness of conditions that are more prevalent in Black women, but they are more cognisant of their experiences.  We briefly touched on the current state of the healthcare system and what needs to be done to support healthcare professionals further to provide compassionate care. As the healthcare system becomes more stretched and there is continuous pressure to shorten GP appointments, there will be limitations on the capacity of doctors. It is no surprise that the average GP appointment in the UK lasts just 9.2 minutes, with an average of 2.5 health concerns being discussed (1), and there is not enough time to allow for a  comprehensive discussion about someone’s reproductive health or pregnancy history. Women whose first language is not English and/or who have had a negative experience with a healthcare practitioner are at more of a disadvantage.  “We all swear on the Hippocratic oath to do no harm, but if the system works such that the resources and the human capacity are lacking, there is a dearth of compassion. As a result, unfortunately, I think that, as with everything in life, some people are going to suffer more than others, and the human reflexes are that when you have no capacity, you are less likely to treat people the same” –  Dr Stephanie Kuku Advisor, Consultant and Health Technology Executive (MBCHB MRCOG MD) However, Dr Christine Ekechi also highlighted that the majority of UK-based doctors are willing to learn to improve the care of Black women and there is room for positive impact.  Looking to the future, we heard from both the event and post-event feedback about the importance of framing positive conversations around Black women’s reproductive health to stop the further victimisation of Black women and ethnic minority groups and to empower them so that we can help give women strength and power in healthcare situations, instead of reinforcing currently accepted narratives. The power of knowledge and tips on advocacy Throughout the discussion, a salient theme that shone through was the value and power of having the right information in a healthcare setting, especially when it comes to advocating for ourselves. Noni Martins emphasised the importance of going into GP appointments with symptom diaries and the knowledge about what is going on with your body, as no one knows your body better than you. Dr Christine Ekechi also highlighted that everyone deserves a right to a second opinion if they feel they do not understand or agree with the outcome of their appointment.   “One thing about doctors, particularly doctors now, is that we are cognisant about working in partnership with you…Of course, you’re not going to go into a consultation and understand everything about gynaecology, but you should leave with an understanding of what the concerns are and what the approach is going to be. For me the key is if you come away thinking I have no idea what they said, then you ask for a repeat explanation or ask for a second opinion” – Dr Christine Ekechi Consultant Obstetrician & Gynaecologist and Co-Chair, Race Equality Taskforce, Royal College of Obstetricians & Gynaecologists. We briefly spoke about the prevalence of myths in reproductive health, fertility and women’s health more generally. We know from the Women’s Health Strategy that many women get their information from the NHS website (2), so as Dr Christine Ekechi said, “it’s about going to the trusted sources and addressing those gaps by filling it in with the correct information”. “I think my biggest concern when we have these kinds of discussions is for people who don’t have that voice. I worry about the people who, in their homes and in their communities, cannot speak out about the fact that they have been trying to conceive and it is not working out. I’m always thinking about how we can get to those people, I don’t have the answers. I hope that by being someone who looks like them and talking about it, we can draw them out. Even if you are having a […]

Fertility testing is much more common than it used to be. But with the growth in the at-home fertility testing market, how do you know which one is best? In this article, we explain why Hertility is a cut above the other at-home tests available.   Quick facts: What at-home testing can tell you Whilst there is no way to 100% definitively determine how fertile you are, testing our hormones can give us key insights into the functioning of our reproductive health and ovarian reserve (egg count).   There are a whole range of different hormones that can work hard to regulate the menstrual cycle and ovulation. If just one becomes imbalanced, it can throw the whole system off.  At Hertility, we’ve spent years building the most accurate diagnostic tool in female health and our tests can give indicative diagnoses within just 10 days of testing.  We don’t believe in doing things in halves—so unlike a lot of other at-home tests on the market, we provide full end-to-end care. Here’s what to expect with each step of our test.  Online Health Assessment  Your test starts with an Online Health Assessment. It takes around 5 minutes to complete and is essentially everything you would cover in an initial private gynaecologist appointment before being referred for a hormone test.  Up to 60 questions cover your medical history, period and cycle, symptoms and individual biomarkers. Each question has been carefully selected to build a 360-degree view of your health and fertility.  Our proprietary algorithm will then determine your risk factors, using 835,000 data variables, for various conditions or hormone imbalances. You’ll then be recommended a personalised hormone panel for your test, based on the analysis of your Online Health Assessment results.  Some other at-home tests don’t include this crucial step and will simply test you for a generic hormone panel. Which hormones do Hertility test? Depending on the outcome of your recommended panel, your test could include the following hormones:  Some fertility tests will only look at E2, LH, FSH and testosterone. These are all very useful in determining how your menstrual cycle is working, but without looking at the full picture and the interplay between different hormones, you’ll only be able to get half the picture.  That’s why we take a comprehensive, whole-body approach when it comes to your hormones and fertility.  You’ll receive your at-home test kit with your personalised panel 3-5 days after you place your order. Our kits are easy-to-use with detailed instructions on each step with links to video instructions. Anti-Müllerian Hormone (AMH) A key part of any fertility test is measuring the levels of a hormone called Anti-Müllerian Hormone or AMH. Produced by the cells in your developing eggs, AMH can be used as a really powerful indicator of how many eggs you have left.  Studies comparing the levels of AMH with the number of eggs seen on a pelvic ultrasound scan (when done on the same day of your cycle) have shown AMH to be a reliable way to gauge egg count.  After peaking in your 20’s, AMH levels decline, dropping more rapidly after your mid-30s. However, this rate of decline differs from person to person so it’s important to test regularly to understand what this rate of decline looks like for you.  Based on over 10 years of clinical research, AMH is established as the single most important marker of ovarian reserve and forms a core part of our advanced hormone and fertility test. AMH will always feature in your hormone panel, however, it’s important to know that if you’re currently taking hormonal contraception this can temporarily suppress your AMH. Although you can still test AMH while on contraception and get valuable insights, we recommend waiting three months after coming off contraception to give the most accurate results.  Furthermore, research has found that AMH has the potential to be used as an indicator of when someone will go through menopause, a predictor of fertility treatment success and can be used when diagnosing reproductive health conditions such as PCOS & POI.   A fertility test isn’t all about AMH. AMH alone cannot give you the entire picture, it’s just one piece of the puzzle. So, when looking at your fertility, and overall reproductive health, it’s crucial to take a whole-body approach.  Results and follow-up doctor-written report Just 10 days after sending your test kit back to us, you’ll be able to access your hormone results in your online health hub. Each hormone result comes with an explanation, so you can easily understand what your result means.  Along with your results, you’ll receive a doctor-written report that will consider your Online Health Assessment results alongside your blood work. Your dedicated doctor will outline a care plan based on any symptoms you might be experiencing and will recommend any onward care or treatments should you need them. The takeaway At Hertility, we care deeply about your health and well-being. Our mission is to arm women with the answers they need about their reproductive health so that they can make informed decisions about their futures. Our Online Health Assessment and at-home test kits have been rigorously quality tested and are CQC-approved, MHRA-regulated and CE-marked. Start your Health Assessment here.

Hertility partners with Pearl & Dean for the launch of #MeToo film, ‘She Said’, to rally women in the UK for the next women’s rights movement, the Reproductive Revolution.   Women’s health company Hertility’s award-winning film, ‘Ooh Someone’s Hormonal,’ spotlighted the lack of research on women’s bodies and called out society for using women’s hormones against them. Now, they’re teaming up with Pearl & Dean, the UK’s best-known cinema advertising contractor, to take the “Mother of all movements” to the next level in a bid to urge millions of women across the UK to get to know their bodies. For 5 weeks from November 25th, ‘Ooh Someone’s Hormonal,’ created by female-founded creative content agency Be The Fox, will be shown before every screening of ‘She Said’ in Pearl and Dean cinemas nationwide, the film starring Carey Mulligan and directed by Maria Schrader telling the story of the #MeToo movement.  Founded by women and powered by an (all female) research team, Hertility is setting a new standard of scientific rigour in female health by empowering women with information about exactly what’s going on under their skin using at-home diagnostic testing, telemedicine and treatment. By joining forces with cinema ad sales firm Pearl & Dean, the partnership aims to fuse science and art in the fight for equality. ‘The #MeToo movement was such a huge step forwards in women’s rights but from a reproductive perspective, women are still second-class citizens. We want to inspire women watching ‘She Said’ to join us in our fight in the next revolution – the Reproductive Revolution – by getting to know their bodies and taking control of their life choices. For themselves and for all women worldwide.’ – Dr Helen O’Neill, CEO and Founder of Hertility Carey Mulligan, has spoken openly about the lack of support for women in the film industry but as a middle finger to the male-dominated Harvey Weinstein era, ‘Ooh Someone’s Hormonal’, produced by female-led production company, Be The Fox, shows Hollywood how it’s done. Echoing the equality seen in the production of ‘She Said’, the female-powered cast and crew of ‘Ooh Someone’s Hormonal’ worked to the soundtrack of female artist Rebecca Taylor of Self-Esteem, complete with childcare on set, changing the outdated landscape and showing what’s possible when women, fully supported, come together. Diana Ellis Hill, Co-Founder, Be The Fox comments: “Empowering women and having true representation is an important cause that’s close to our hearts. We gathered an 80% female team to make the film from DOP and Director to Editor and Colourist as we wanted it to be real and authentic. We are immensely proud of what’s been produced and to see our film on screens at cinemas nationwide ahead of She Said.” Kathryn Jacob OBE, CEO at Pearl & Dean, said: “Cinema is a unique advertising medium in the sense that it is both a personal and shared experience. Cinema has the power to truly reach an individual, and to speak to them one on one, as well as spark a conversation. We are honoured to be working with Hertility to launch its first ever cinema campaign and to be a part of helping to better articulate an important issue that is often hidden or ignored by wider society.” Watch the cinema advert ‘Ooh Someone’s Hormonal’ More information on ‘She Said’

If you’re looking to conceive soon, nutrition can have a big impact on your fertility and reproductive health—both positive and negative. Get to know which foods are natural fertility boosters and valuable lifestyle changes that can improve your journey to conception. Quick facts: Why are diet and nutrition important for fertility? As the saying goes, we really are what we eat. Our diets and nutrition impact almost all of our body’s processes—all the way from our metabolism to our mental health. But one often overlooked area is how food can impact our fertility. When trying to conceive, you’ll need a high-nutritional diet. This can increase your chances of conceiving and help to create a healthy home for your baby during their vital first 9 months. Even making small changes to your lifestyle and nutrition choices can go a long way. Here are 16 evidence-backed tips from our Registered Nurse and Associate Nutritionist, Emily Moreton to help prepare your body for pregnancy. You can also book an appointment with a Hertility Nutritionist for a personalised plan. 1. Follow a Mediterranean-style diet Whilst there are no specific guidelines for a recommended fertility diet, the Mediterranean diet, is associated with improved fertility in both women and men. Known for its abundance of fruits, vegetables, nuts, whole grains, fish and healthy fats, the Mediterranean diet is rich in antioxidants. These have been shown to protect sperm and eggs from DNA damage and oxidative stress. A study involving 15,396 participants, which looked at how different diets affect fertility, showed that sticking to the Mediterranean diet improved birth and pregnancy rates significantly, with a 91% higher chance of success. This diet is also high in fibre and rich in vitamins and minerals that support fertility and pregnancy. Think lots of veg, whole grains, nuts, seeds, beans, pulses, olive oils, avocados and oily fish. 2. Eats foods high in antioxidants Eating a diet rich in a variety of colourful fruits and vegetables can provide a wide range of antioxidants that support fertility and overall health. Think making a rainbow on your plate. Foods high in antioxidants include fruits (such as berries, apples, and citrus fruits), vegetables (such as broccoli, spinach, kale, and carrots), nuts, seeds, and whole grains. 3. Increase intake of plant-based proteins In general, you should focus on lowering your intake of red and processed animal meats and focus on adding plant-based protein sources into your diet.  This can include fertility-friendly and micronutrient-rich beans, lentils, peas, soya beans, and chickpeas. Plant-based protein sources help to support healthy ovulation and are high in antioxidants and nutrients, such as iron and fibre, which are really important during pregnancy.  Low iron levels can add to your tiredness or even could cause iron deficiency anaemia. Iron deficiency during pregnancy can increase the risk of pregnancy complications. It is also important to keep your iron uptake up postpartum too, to replace any iron lost at birth.  You’ll also find some protein in whole grains such as quinoa. If you are opting for plant-based meat alternatives (‘fake meats’), choose a brand that is not ultra-processed and low in additives. 4. Cut down on sugar Cutting down on sugar can be beneficial for fertility. This is because too much sugar can lead to insulin sensitivity, disrupting certain reproductive hormones and causing inflammation. Insulin spikes have been associated with poor egg quality and sperm production and could affect implantation. A study published in the American Journal of Clinical Nutrition in 2018 found that women who consumed two or more servings of sugary drinks per day had a 50% higher risk of ovulatory infertility compared to those who consumed less than one serving per month. Reducing sugar intake and opting for a balanced, low-glycemic index diet can help improve insulin sensitivity and overall reproductive health. Limit sugary foods and high glycemic index foods such as cakes, biscuits, fizzy drinks, energy drinks, sweets, white rice and white bread. Check the labels for high sugar content. 5. Take pregnancy supplements Folic acid Folic acid is an important supplement during pregnancy because it decreases a risk called neural tube defects. This is a defect that can occur during the development of the baby’s brain and spine.  If you are currently trying to become pregnant, it is advised to take at least 400 mcg of folic acid supplement every day for 12 weeks before conception and for at least three months after conceiving. Some people are at an increased risk of their baby having a neural tube defect and so it is advisable to speak with your doctor as they may recommend and prescribe you a higher dose.  Prenatal vitamins Prenatal vitamins typically contain a combination of various vitamins and minerals that are important for both maternal and foetal health. While folic acid is a main component of prenatal vitamins, these vitamins usually contain a range of other nutrients as well.  These include iron, calcium, vitamin D and other essential vitamins and minerals needed to support maternal health and the baby’s development during pregnancy. Tip: More often than not, doctors will suggest taking prenatal vitamins instead of just folic acid supplements because they cover a wider range of needs for both mum and baby’s health. However, it’s essential to consult with your doctor to determine the most appropriate approach for your unique needs.  6. Take Vitamin D for pregnancy  A previous study has shown that both men’s and women’s vitamin D levels impact fertility and IVF results. It showed that Vitamin D supplements reduce risks for mums and babies, might prevent bone problems, and play a role in foetal development.  How much Vitamin D should I take? It’s recommended that all adults at all stages of life should supplement with 10 micrograms a day of Vitamin D, in the UK. This is particularly true if you are trying to conceive, or you are pregnant—so be sure to supplement right through from the preconception period to breastfeeding.  Prenatal vitamins often contain vitamin D, but the amount can vary […]

Testosterone is an important androgen hormone in people of all sexes. In this article, we’ll cover exactly what it does in the body, what the symptoms and causes of high or low testosterone are and how you can ensure your levels are balanced and healthy.  Quick facts: What is testosterone? Testosterone is an important hormone for regulating sex drive (libido), bone and muscle mass and fat distribution. It’s part of a group of hormones called androgens.  There are a lot of misconceptions about testosterone being just a “male” hormone. Whilst testosterone plays an important role in the development of the male sex organs and male secondary sex characteristics, people of all sexes have testosterone.  Everyone produces and requires a certain amount of androgen hormones for reproductive development. The difference is just how much testosterone we have based on our sex-at-birth. How is testosterone made? In women and people assigned female-at-birth, testosterone is produced by the ovaries and adrenal glands. It’s then converted to hormone–oestrogen. Testosterone production is age-dependent and it gradually declines with age. Most of the testosterone in the body is inactive. It remains bound to a protein called, sex hormone-binding globulin (SHBG). The small amount of testosterone that’s unbound and therefore active, is called freely circulating testosterone (free T).  Free T can enter cells to bring about its effects. Our free T levels are affected by the levels of SHBG. Low levels of SHBG result in higher free testosterone, whereas high levels of SHBG result in lower free testosterone. What does testosterone do in the body? Some of the functions of testosterone are: What are the symptoms of high testosterone? Excess levels of testosterone in the body is called hyperandrogenism. This can bring about symptoms like:  Some studies suggest that high testosterone levels may increase the risk of developing high cholesterol, heart disease and type 2 diabetes. What causes high testosterone levels? The most common causes of high testosterone levels are underlying health conditions. It can also be caused by certain medications and lifestyle factors. Let’s look at the main ones… PMOS (formerly PCOS) Polyendocrine Metabolic Ovary Syndrome (PMOS, formerly known as PCOS) is a hormonal and metabolic condition affecting 1 in 10. The exact cause is still being researched, however, the proposed causes include an excess of androgens and insulin, genetic and environmental factors. If you suspect you might have PMOS, our at-home tests can give you a better insight into your hormones.  Congenital andreal hyperplasia Congenital adrenal hyperplasia (CAH) is an inherited condition that affects the adrenal glands. These are small glands located on top of the kidney. They produce hormones like cortisol (stress hormone), dehydroepiandrosterone (DHEA) and testosterone. People with CAH are unable to produce an enzyme necessary to regulate the production of these hormones, which can result in an overproduction of testosterone. It’s been found to be more common in some ethnic groups such as people of Hispanic, Mediterranean, Yugoslavian and Ashkenazi Jewish descent. Cushing’s syndrome is another hormonal condition impacting the adrenal glands. It results in excessive cortisol and androgen production. Medications Testosterone levels can rise due to certain medications, such as: Alcohol Excessive alcohol consumption may increase levels of testosterone in premenopausal women, however, research is conflicting.  How to lower my testosterone levels? Treatment for high testosterone depends on the cause, but generally, it is a combination of lifestyle changes and medications. Achieving a healthy weight by including a healthy balanced diet and exercise routine may help with the symptoms of a hormonal balance.  Medications used to treat high testosterone, and associated symptoms include: What are the symptoms of low testosterone? If you’re experiencing low testosterone, you may experience some of the following symptoms:  Low testosterone over a long period may also contribute to long-term health conditions such as heart disease, memory issues and loss of bone density. Often, the symptoms of low testosterone in women are undiagnosed or misdiagnosed. Some of the conditions that low testosterone may be mistaken for include stress, depression and the side effects of menopausal changes in women. What could cause low testosterone levels? The most common causes of low testosterone levels are often age, underlying conditions and problems with certain glands. Age Testosterone levels naturally decrease as we age. As it’s produced in the ovaries, the natural decrease in ovarian function with age means that some may experience low testosterone levels as they transition from the perimenopausal phase into menopause.  Underlying health conditions Premature ovarian insufficiency (POI) can increase your risk of low testosterone. Additionally, surgery, such as the removal of the ovaries, can cause lowered testosterone levels.  Problems with the hypothalamus or pituitary gland Underlying health conditions impacting the pituitary, hypothalamus, or adrenal glands can also cause lowered testosterone levels. This is because these parts of the brain are responsible for the secretion of hormones which control the proper functioning of the ovaries.  A disruption in the pituitary gland can also impact the adrenal gland. Addison’s disease or adrenal insufficiency is a hormonal condition that occurs due to underactive adrenal glands and can cause a low level of its hormones. What can I do to increase my testosterone levels? Low testosterone levels effects and treatments in women are still being researched and treatment is usually recommended only if symptoms are significantly impacting health and quality of life.  Testosterone replacement therapy is a form of hormone replacement therapy (HRT) based on the replacement of testosterone. It may be prescribed orally, as injections, gels or skin patches. DHEA is a precursor to testosterone, and it is believed that taking DHEA supplements could increase the amount of testosterone. It is always recommended to speak with a doctor before starting any medication or supplements. How to test testosterone levels? If you’re experiencing any of the symptoms mentioned above, our Advanced At-Home Hormone and Fertility Test can determine your testosterone levels. Hormone testing is the only way to know what your testosterone levels are for definite.  Our Doctors can recommend a care plan for you, based on your symptoms, hormone […]

For many, the journey to parenthood can be a challenging process, both physically and emotionally. We’re here to help you understand the different causes of infertility, and the options available for those who need support. Quick facts: What is infertility? Infertility is defined as not being able to conceive after one year (or longer) of trying. This could be despite having regular unprotected sex with a partner, or trying using methods like artificial insemination (IUI).  There are 2 types of infertility: In the UK, as many as 1 in 7 heterosexual couples experience infertility, yet the causes are sometimes preventative, or treatable.  Causes of infertility  There can be many different reasons why you might struggle to conceive. This can include structural fertility issues, ovulation problems, underlying health conditions and hormonal imbalances. Let’s take a look at each. Ovulation issues  Anovulation, also known as the inability to ovulate, is the most common cause of infertility. Ovulation is when a mature egg is released from one of your ovaries, each month, during your menstrual cycle. The egg travels into the Fallopian tube, where it prepares to be fertilised by a sperm, before then travelling down the tube to the uterus.  When trying to conceive, ovulation is a crucial event, with the 5 days before ovulation and ovulation day itself often referred to as your ‘fertile window’.This is the time of the month when you’ll be most likely to get pregnant.  Research suggests that as many as 25% of infertility cases are caused by anovulation. Anovulation can be caused by: Another possible explanation is a problem with the egg maturation process. This means that an “immature” egg may be released from your ovaries when it is not quite ready and unable to fertilise. Underlying health conditions Polyendocrine Metabolic Ovary Syndrome (PMOS, formerly known as PCOS) PMOS is the most common underlying condition affecting fertility. PMOS affects as many as 1 in 10 people with ovaries.  People with PMOS produce higher levels of androgen hormones, like testosterone. This can disrupt your menstrual cycle, ovulation, and balance of cycling hormones—like oestrogen, follicle-stimulating hormone and luteinising hormone (LH). As PMOS is still under-researched and misunderstood, many people are left undiagnosed and are unaware they have it until they are actively trying to conceive. This is why it’s a good idea to check in on your hormones before you start your conception journey.  Primary ovarian insufficiency (POI)  POI is when the ovaries stop working properly before the age of 40. POI is far less common than PMOS, affecting only 1 in 100 women younger than 40. Your ovaries produce oestrogen and progesterone—two cycling hormones responsible for the regulation of your menstrual cycle. When their function is disrupted, ovulation can also become disrupted or stop completely.  People with POI also have a lower ovarian reserve, meaning fewer eggs for their age. Without a sufficient amount of eggs and the correct level of hormones needed to regulate your cycle, the possibility of conceiving is reduced considerably. According to the National Infertility Association, POI can be caused by genetics, autoimmune factors, induced by chemo or radiotherapy, or it can have an unknown cause. Uterine fibroids Uterine fibroids are noncancerous tumours that affect as many as 25% of people with a uterus. They can cause symptoms such as heavy periods, intermenstrual bleeding, and pelvic pain. In some cases, depending on the location in which they grow, and whether they affect the shape of the uterus or cervix, fibroids can also cause infertility.  This is because they can block the fallopian tubes, stopping eggs from meeting sperm, or reaching the uterus for implantation. They can also get in the way of implantation if they are near the inner lining of the womb.  Despite being less common than other causes of infertility, around 5-10% of infertile women and those assigned female-at-birth are found to have uterine fibroids, with their instance being much more common in Black women.  Endometriosis Endometriosis is a common reproductive health condition that affects around 1 in 10 women and people assigned female-at-birth. With endometriosis, tissue similar to the tissue that makes up the lining of the womb starts to grow in other places, such as the ovaries and the fallopian tubes, causing lesions and scarring.   This can cause several life-altering symptoms, such as painful and heavy periods, pain during or after intercourse and pelvic pain. It is also another common cause of infertility, with research suggesting it is present in around 20-50% of infertility cases. The exact link between endometriosis and infertility is unknown. However, some theories suggest that lesions and scarring can cause structural problems with the reproductive organs and chemical changes in the lining of the uterus. Structural infertility  Structural infertility is a problem with the anatomical structure of the reproductive organs. This can include blockages, structural damage or abnormal growth in the fallopian tubes, uterus or ovaries.  Structural issues with the ovaries or fallopian tubes can prevent eggs from being released from the ovaries or stop them from moving through the fallopian tubes to reach a sperm for fertilisation.   Additionally, if the structure of your uterus is abnormal or damaged, it may prevent eggs from implanting into the endometrium (uterus lining). This is needed to create a healthy embryo and pregnancy.  Structural infertility problems can also be caused by scarring from surgery, infections, injuries, or endometriosis.  Also, the growth of noncancerous tissues such as uterine polyps on the lining of the uterus, can cause blockages. Polyps occur when additional tissue grows on your uterus. However, sometimes tissue grows elsewhere in your reproductive system potentially blocking your fallopian tubes and preventing pregnancy.  Implantation failure Other possible explanations of implantation failure are: Infections and auto-immune disorders  Untreated sexually transmitted infections (STIs) may have serious consequences for your fertility. STIs like chlamydia or gonorrhoea can cause scarring and blocking of your Fallopian tubes.  Additionally, if syphilis is left to develop, it can cause stillbirth. There are also other forms of infections of the cervix with human papillomavirus (HPV) […]

Exercise can greatly improve your overall health, including your reproductive health. In this article, we’ll break down different types of exercise, their impact on fertility and how to find movement that’s right for you.  Quick facts: Finding the right exercise for you We all have different feelings towards exercise. Some of us can’t go a day without it and some of us simply can’t bear it.  Whichever team you’re on, there’s no denying that exercise comes with some serious health benefits—some of which extend to your fertility and reproductive health.  But getting the balance right, with the right amount of exercise, supplemented with good quality nutrition that covers your personal energy and calorie requirements is essential.  We know that finding the right balance for you and your body can be difficult, especially if you’re just getting started with your movement journey. Here we’ll break down some different types of exercise and intensity that you can consider.  Remember, movement will look different for everyone. If your movement is restricted, you may want to speak to a physio or occupational therapist who can help you find the best way to meet your movement goals. Is exercise good for fertility? The health benefits of exercise are too many to mention. It affects every system in your body from your cardiac system to your digestion and even your bone health.  It would be unfair if your reproductive system didn’t get a share of the health kick you get from your chosen exercise regime but thankfully, it does.  There is more and more evidence emerging that physical activity and exercise can improve reproductive health and pregnancy rates (1). Some fertility benefits to exercise might be indirect but they are helpful nonetheless. Insulin regulation People with a high BMI and elevated blood sugars are known to be at greater risk of fertility challenges. Insulin resistance can affect the maturation of your eggs and inhibit ovulation.  Fortunately, regular exercise decreases abdominal fat, blood sugar, and insulin resistance (3).  Hormone balance  Regular exercise also increases sex-hormone binding globulin (SHBG), a protein that regulates the amount of testosterone in your tissues (4). Menstrual cycle benefits Many studies report that exercise improves menstrual cycle abnormalities including premenstrual syndrome (PMS) and dysmenorrhoea, or period pain (5), as well as reducing the risk of anovulation (failure to ovulate) (6).  Stress reduction Exercise is also known to reduce stress, improve self-esteem and greatly improve symptoms of poor mental health and low mood. Reducing chronic stress on the body can do wonders not only for your hormones and reproductive health but your overall health too. What exercise is good for fertility? There are different types of exercise, all of which can have benefits for fertility and your reproductive health for different reasons. Let’s take a look at each. Cardiovascular or aerobic exercise This is generally any exercise that gets your heart beating faster and increases blood flow to your muscles. Cardio is most beneficial for your heart health and blood vessels. It lowers blood pressure, regulates weight, blood sugars, and sleep, boosts mood, and strengthens your immune system.  All of these benefits will have knock-on benefits to your reproductive health. Brisk walking, running, swimming and cycling all fall into the cardiovascular or aerobic exercise category.Cardiovascular exercises are important but try to get at least two strength training sessions in a week too. Strength training  Strength or resistance training will better protect your bone and muscle health. It will make you stronger and help you to develop better body mechanics.  Strength training isn’t all about bulking up, using weights and going to the gym. You can start strength training using just your body weight at home or outside. Things like yoga, pilates and tai chi all count as strength training, as well as swimming which is a combination of strength and cardio. Flexibility and balance Working on your flexibility and mobility will help avoid injury and, if you’re older, lower your risk of falling. Both can be practised with stretching, yoga, pilates or a dedicated mobility routine.  If you plan on getting pregnant, strength and flexibility will help your body to adjust to the changes that come with pregnancy. Types of exercise intensity Exercise is categorised into three different intensity levels: low, moderate, and vigorous. We all do some bit of low-intensity exercise, whether that’s doing the housework, doing the shopping or strolling to the bus. Other examples are beginners yoga, tai chi or a casual walk.  You can make any of these moderate exercises by upping the pace. Moderate exercise can be thought of as anything that raises your heart rate and makes you breathe faster, but not so much that you’re unable to speak without taking a breather.  Any activity that makes your breathing harder and faster would fall into the vigorous exercise category. Examples include running, rowing, high-intensity interval training and spinning. The NHS recommends 150 minutes of moderate activity or 75 minutes of vigorous activity a week. As a general rule, try and aim for 30 minutes of moderate physical activity a day. If you’ve always been active you can continue your usual training regime at the same level to maintain your health. If you’re new to exercise or you’ve taken a long break from fitness, start to build up your level of activity, starting with low to moderate-intensity exercises. If you just don’t feel like doing a high-intensity workout today, then don’t do one. Start with some slow exercises, or try some yoga to help calm your mind. Finding time for exercise Our lives today have hectic schedules and exercise isn’t at the top of everyone’s priority list. If you can’t squeeze in a training session, remember that some exercise is better than none. Ask a colleague to join you for a 10-minute brisk walk at lunchtime, take the stairs instead of the lift or consider getting off a stop early on your work commute. NHS-approved apps for managing and mapping your progress will help you with time management […]

Ovulation tracking can be a great way of either avoiding or planning sex during your fertile window. There are lots of ovulation detection methods, each with varying degrees of reliability. Read on to find out which could be right for you. Quick facts: What is the fertile window? The fertile window is 6 days around the midpoint of your cycle when you ovulate. It includes the 5 days before ovulation and the day after.  Ovulation is when you release an egg from one of your ovaries, and it travels down the fallopian tube to the uterus where it hopes to reach a sperm and be fertilised.  If you have regular periods, it is a good sign that you are ovulating (releasing eggs), every month. Your egg is capable of being fertilised 12 to 24 hours after ovulation but sperm can survive in the female genital tract for up to five days. So it’s possible to get pregnant if you have sex in the days leading up to ovulation. Ovulation tracking methods Lots of people choose to track ovulation, either to avoid or to plan to have sex during their fertile window. There are a few different methods available to predict your fertile window each month, but not every method will work for everyone—so it’s useful to try a few to find your fit.  Cycle tracking Tracking your periods is a helpful starting point for finding your fertile window. If your cycle is like clockwork and lasts 28 days, the chances are you’ll ovulate halfway through your cycle on day 14. Everyone’s cycle is unique and often not 28 days. It’s important to keep track of how long your cycles last, how long your periods are and any symptoms along the way. Ovulation generally occurs 11 to 16 days before your next period but this can also vary from cycle to cycle. You can use cycle tracking apps, some of which will predict your fertile window based on your previous cycle data—but these are not always 100% accurate.  Ovulation detection kits Ovulation detection kits involve a pee stick, which you use when you’re around the time in your cycle when you’re approaching ovulation. Ovulation sticks are considered the best way to identify if you are ovulating  From the start of your cycle, your oestrogen levels will increase to thicken the lining of your womb in preparation for pregnancy. When oestrogen levels reach a certain point, it signals the release of luteinizing hormone (LH), which triggers ovulation. Although LH is always present at a low level, it significantly increases 24-36 hours before you ovulate, known as the LH surge, which is what the kits detect. Changes in cervical mucus  The consistency of your cervical mucus (discharge) changes throughout your menstrual cycle. Just before ovulation, your discharge becomes clear and stretchy, a bit like egg whites. This is to help the sperm swim through the cervix and towards the egg.  Although this can be a good indicator of when you’re nearing ovulation, remember the appearance of discharge can also be affected by many other factors. This includes infections, sex and medications, and can also naturally alter within each cycle. Basal body temperate tracking After you ovulate, your basal body temperature (BBT) increases by 0.4-1°C. It is unlikely you’ll be able to feel this change, but it can be monitored with an accurate thermometer.  To use this method effectively, you must take your BBT first thing every morning before getting up, to get an accurate reading.  Again, there are lots of things that can cause your resting temperature to vary, such as sleep changes, alcohol consumption and fighting off a cold. This means using temperature changes alone may not be the most reliable. It is also important to consider that this method will only tell you that you have ovulated and won’t be able to predict your fertile window ahead of time.  Changes in saliva Your saliva can also vary throughout your cycle. High levels of oestrogen just before ovulation can cause there to be more salt in your saliva, which can be tracked using a testing kit. A specific pattern is seen in the saliva at ovulation which is called “ferning”, but this can be quite difficult to identify.  Similar to BBT tracking, saliva testing is not always reliable, as it can be easily influenced by the things you eat and drink, so shouldn’t be used alone.  Ovulation pain  Ovarian pain, also known as Mittelschmerz, is a fairly common symptom experienced by around one in five people who menstruate. Ovulation pain can be caused by stretching of the sac of fluid which contains the egg (the follicle) during its development, or by ovulation itself (when the egg is released from the follicle).  This isn’t a reliable method of fertility tracking and isn’t usually recommended as it can also vary from cycle to cycle. If you’re experiencing pain that’s disrupting your daily activities, speak to a specialist about treatment or pain relief options. Understand your cycle As ovulation is controlled by your menstrual cycle hormones, testing your hormones can give you insights into whether you’re ovulating regularly or not.  If you’re experiencing any symptoms like irregular periods, long or short cycles, it’s a good idea to get your hormones tested to understand what’s going on with your cycle hormones.  Check out our at-home Hormone & Fertility tests to find out more. 

IVF can be a highly effective fertility treatment for some people, but it doesn’t guarantee a successful pregnancy. Here we cover what the IVF process entails, who could benefit from it and things to consider if you’re thinking about undergoing a cycle.  Quick facts: What is IVF? In-vitro fertilisation (IVF) is a fertility treatment for those who can’t or don’t wish to conceive naturally. It’s one of the most common fertility treatments in the UK, with as many as 50,000 people undergoing IVF in the UK each year.  IVF involves removing eggs from the ovaries, attempting to fertilise them with sperm in a lab and then transplanting any successfully fertilised eggs (embryos) into the uterus. This is called an IVF cycle. It’s an invasive procedure and doesn’t guarantee a successful pregnancy.  Whether or not it’s right for you will depend on a range of personal and medical factors, as well as carefully considering the IVF cycle process. Fresh cycle vs frozen cycle IVF cycles can be fresh or frozen. Once an egg has been successfully fertilised by a sperm in the lab, it creates an embryo. This embryo is then typically incubated in the lab for 3-5 days.  In a fresh cycle, it will then be transferred to the uterus. In a frozen cycle, the embryo will be frozen at this point and transferred to the uterus at another time. This might be done if your uterus isn’t prepared to receive an embryo, or if you had several embryos that were successfully fertilised, they will be frozen, rather than transferring more than 1 at time, which is associated with multiple pregnancies (expecting two or more babies from a pregnancy). Who is IVF for? IVF can benefit lots of different types of people. Some instances where IVF may be explored could be: What happens in an IVF cycle? There are four key stages involved in an IVF cycle—ovulation stimulation, egg retrieval, egg fertilisation and embryo transfer. The entire process may take between 4 to 6 weeks but will vary and depend on you. Ovulation stimulation Firstly, you’ll take a course of fertility medication to stimulate your ovaries to mature multiple eggs. Usually in one menstrual cycle, you’ll only release one egg for ovulation. But this medication stimulates many eggs to mature.  During this time you’ll need to go to the clinic regularly for ultrasounds and blood tests to analyse your progress. The simulation period generally lasts for around 10 days.  Egg retrieval and sperm collection Once your eggs are mature, you’ll undergo a retrieval procedure. Egg retrieval is carried out under ultrasound guidance, where a small transvaginal needle is used to suck follicular fluid  that contains your mature eggs, out of your ovaries. You’ll have the option to have the procedure done under general anaesthetic or mild sedation. Whilst your eggs are being retrieved, your partner or sperm donor will be required to go into the clinic and produce sperm cells which will be used to fertilise your eggs, unless your partner or donor sperm has previously been frozen. Egg fertilisation During the fertilisation step, your eggs and the sperm will be combined in a lab. The goal is for the sperm cells to break into and enter your egg cells where an embryo will be formed.  There are multiple techniques in which your eggs can be fertilised. One technique is called conventional IVF which involves placing the mature eggs in a petri dish full of sperm. Another technique is called intracytoplasmic sperm injection (ICSI), where one sperm cell is selected based on morphology and injected directly into your egg cell. The technique used depends on the sperm, clinic and whether or not you have attempted conventional IVF successfully or not before.   Embryo transfer If you undergo a fresh cycle, any successful embryos will be transferred 2-5 days later. If you have a frozen cycle, you will be given medication to prepare the uterus lining and depending on your progress, your doctor will determine a transfer date.  However, this doesn’t guarantee a pregnancy. The embryo will still need to successfully implant to your uterus. You will be given a pregnancy test roughly 2 weeks later, which can confirm whether or not the IVF process has been successful.  The process for an embryo to grow into a healthy baby and undergo live birth is a very complicated and precise journey. A certain number of chromosomes, which is our genetic information in the form of our DNA, is required for an embryo to develop into a baby.  The test that is used to understand and analyse the number of chromosomes in the embryo before implantation is called Pre-implantation Genetic Screening. However, many other screening techniques can be used too depending on your clinic. Is only one embryo transferred? If more than one egg is fertilised, your doctor will choose one to transfer, based on trying to assure the maximum possibility of a pregnancy. There are multiple criteria that the clinics use to determine this, including:  Sometimes you will be given the option to transfer more than one embryo. This may increase your chances of developing multiple pregnancies but again, doesn’t guarantee a pregnancy. Can you get IVF on the NHS? The NHS provides full funding for IVF for those who: Whether or not you are eligible for IVF under the NHS also depends on where you live as different trusts have different requirements and funding availability. You must discuss thoroughly with your gynaecologist or GP and if you are not eligible, there are many private clinics available for IVF treatments.  The cost for 1 cycle of treatment is roughly £5,000. This depends on the clinic you choose and the treatment protocol you follow.  How effective is IVF? Yes, IVF can be an effective fertility treatment and many women can successfully become pregnant and give birth to healthy babies via IVF. The success rate depends on a range of factors, including age, medical history, sperm quality and success rates of your clinic.  As younger women […]