This comprehensive guide will serve as your go-to resource for female fertility tests, providing detailed information about different types of fertility testing, and everything you need to know to take control of your reproductive health, wherever you are in your fertility journey. Quick facts: Fertility testing in the UK If you’re planning a family, now or in the future, checking your fertility can offer you insights and peace of mind.  In this article, we’ll cover where you can get female fertility tests done and when you would be eligible, including fertility tests on the NHS, fertility tests at home, and fertility tests online. We’ll also explain how fertility tests are carried out, whether they’re painful, and information about blood tests. We’ll delve into the hormones and individual tests so you know exactly how the tests work, what exactly they’re testing for, and what your fertility test results mean for you. You can get answers to your fertility testing questions including: Understanding fertility in women Let’s start with the foundations of female fertility and the biological processes that govern your reproductive system. Your fertility is influenced by various factors, both physiological and environmental. Understanding what goes on inside, and how your fertility works, helps you gain a deeper understanding of fertility testing. The menstrual cycle The foundation of fertility lies in your menstrual cycle—a recurring roughly 28-day cycle that’s regulated by your hormones. A normal menstrual cycle can last between 25-31 days. The cycle consists of phases, including menstruation (when you get your period), the follicular phase, ovulation and the luteal phase. Within different phases of your menstrual cycle, different things are happening in your body, all orchestrated by your hormones. Each phase has its superpowers, but for fertility, the most important phase is ovulation. Ovulation Ovulation is when a mature egg is released from the ovary making it available for fertilisation (the first step of conception and pregnancy). Ovulation typically happens around the middle of the menstrual cycle (around day 14 of a 28-day cycle, but it might be later or earlier depending on your cycle length) and is an important moment in the fertility timeline. The egg travels down the fallopian tube where it awaits potential fertilisation by sperm. If you’re not ovulating, this could impact your fertility potential. Issues with ovulation accounts for 40% of female infertility. Fertilisation and implantation Fertilisation occurs when sperm successfully penetrates the egg. If it does fertilise it, the fertilised egg is called a zygote. The zygote travels down the fallopian tube towards the uterus where its goal is to successfully attach itself to the uterine wall lining (implantation). From there, it grows and develops into a baby. Hormone regulation Hormones play a crucial role in the menstrual cycle and fertility. Follicle-stimulating hormone (FSH) and luteinising hormone (LH) released from the pituitary gland in your brain, along with oestrogen and progesterone from the ovaries, regulate the various phases of the cycle. Each hormone has a specific role to play. A big part of female fertility testing is testing your hormones to offer insights into your fertility. Ovarian reserve Your ovarian reserve refers to the quantity of eggs you have remaining. It gradually declines with age, particularly after the age of 35. Assessing ovarian reserve provides insights into a woman’s fertility. Age, and therefore, declining ovarian reserve, is the most common reason for infertility. Cervical mucus and reproductive environment The consistency of cervical mucus changes throughout the menstrual cycle. Just before ovulation, and during ovulation, your cervical mucus becomes slippery and water like to help the sperm travel through the fallopian tube to meet the egg, for the egg to become fertilised. If fertilisation is successful, the next stage towards healthy pregnancy is implantation (when the fertilised egg successfully attaches to the uterus wall lining). For implantation to be successful, the uterine lining has to be thick enough. If implantation doesn’t occur, the uterine (womb) wall lining sheds resulting in a period (and no pregnancy). External factors Lifestyle factors such as nutrition, sleep and overall health can impact fertility. Maintaining a healthy lifestyle is essential for optimising reproductive function. Why and when to check your fertility There are various reasons why and optimal times you’d want to check your fertility from age-related concerns to family planning and if you’ve been trying to conceive without success. Family planning If you want to get pregnant or are planning a future pregnancy, checking your fertility from the get-go could be beneficial. Getting a fertility test at the start of your journey can help to start your journey from a place of knowledge and understanding. Some individuals and couples wait until the 3-month, 6-month, or 12-month mark trying to conceive without success before pursuing a fertility test. To get a fertility test on the NHS, you have to have been trying for a year without success. You can, however, check your fertility from the comfort of your own home at any point in your fertility journey. The earlier you know, the better, since fertility declines with age. Age-related concerns Concerns about age-related fertility decline might prompt you to check your fertility to assess your ovarian reserve and fertility potential, especially if you’re considering delaying conception until later in life. This might be the case if you’re in your 30s but don’t want a baby yet. Women are born with all the eggs they’ll ever have (the ovarian reserve), and as you age, you gradually lose eggs every menstrual cycle. Your naturally declining ovarian reserve is the leading cause of infertility. In your 20s and early 30s, you are considered at your most fertile age. After the age of 35, fertility can decrease significantly. This prompts many to take a fertility test whether it’s out of curiosity or wanting to plan for the future. Age is one of the most important factors when it comes to your fertility. If you plan on delaying having a baby until later in life, having a fertility test to check your ovarian […]

In this article, we explore how and why ageing affects fertility, offering insights into hormonal shifts, alterations in egg quality and quantity, and your reproductive health overall. Quick facts: Does age impact fertility? Age is one of the biggest factors affecting female fertility. Although ageing is inevitable, how it affects your fertility is complex, and varies between individuals. As women and those assigned female-at-birth (AFAB) age, their reproductive health undergoes various changes that impact conception, pregnancy, and childbirth. But how and why does fertility decrease with age, and what can we do about it? Some of the most common questions we get at Hertility are, ‘What is the best age to have a baby?’, ‘What age does a woman stop being fertile?’ and ‘What are the chances of getting pregnant over 35 naturally?’ We’ll cover everything you need to know about fertility in your 20s, 30s, 40s, 50s and beyond, so you’re equipped to make informed family planning decisions as you navigate ageing and fertility. Understanding female fertility and age To understand how ageing affects female fertility we need to understand the basics of female fertility.  Three factors—the quality and quantity of your eggs, your hormones, and your reproductive environment (uterus and fallopian tubes)—are what is needed to be in tip-top shape for a healthy pregnancy to occur.  If one or more are out of sync, conception and pregnancy become more difficult. Let’s take a look at each. Ovarian reserve Women and AFAB people’s fertility is closely tied to the menstrual cycle. The average menstrual cycle lasts about 28 days, but it can vary. The menstrual cycle involves the release of an egg (ovulation) and the build-up of the uterine wall lining in preparation for a potential pregnancy. We are born with all the eggs we’ll ever have. Our eggs are stored in our ovaries and this pool of immature eggs is known as your ovarian reserve.  Each month, a couple of eggs from this pool start to mature, but only one egg is eventually released during ovulation. But here’s the thing: as you age, the quantity and quality of your eggs decline—they age too! Cycle hormones Hormones, particularly oestrogen and progesterone, play a crucial role in regulating the menstrual cycle. Hormonal balance is therefore essential for the proper functioning of your reproductive system, but hormonal imbalances affect lots of people trying to conceive for reasons in and out of their control. You can support your hormones with lifestyle adjustments like eating a well-balanced diet, regular exercise, managing sleep and stress, and limiting alcohol and smoking. Reproductive environment Your uterus provides a safe space for a fertilised egg to implant and develop into a foetus. The fallopian tubes transport the egg from the ovary to the uterus where fertilisation can occur (the first step of pregnancy).  For a natural pregnancy to occur, your reproductive environment (like your uterus and fallopian tubes) must be in good condition too. How age affects fertility in women Our bodies are incredible, but unfortunately, as we age, there’s a time limit on our fertility. Wondering how fertility decreases with age? For most, in your 20s and 30s, your reproductive health is in full swing and your eggs are super healthy. As you age, your eggs do too, which means there’s less available, and the ones there aren’t necessarily the best quality. Your ovarian reserve can be estimated with an Anti-Müllerian Hormone (AMH) test, but it won’t tell you the quality of your eggs, only the number you have left. Good-quality eggs are associated with better rates of fertilisation, improved embryo quality, and a higher chance of successful implantation (when the fertilised egg attaches to the womb lining to develop into a foetus, then a baby). Infertility issues, frequent miscarriages and in rare cases, genetic disorders like Down syndrome, can be down to poor egg quality. As we age, our hormones change too. Your fertility hormone heroes, oestrogen and progesterone, can fluctuate and gradually decline over time, with the most significant dip at menopause. Reproductive health conditions like polycystic ovary syndrome (PCOS) which can make your periods and ovulation unpredictable, thereby making getting pregnant difficult, is also the result of a hormone imbalance, especially androgens like testosterone. Plus, as you age, you might experience health issues. Medical diagnoses, chronic health conditions, and autoimmune disorders can crop up as you get older. These can all prevent your hormones and the reproductive environment from working as they should. At what age does fertility decline? Female fertility typically peaks during the 20s and early 30s. During this time, the likelihood of conception is higher and the risk of miscarriage is relatively low. One study by the Norwegian Institute of Public Health found that miscarriage was lowest among women aged 25-29 at 10%. This rose rapidly after age 30, reaching 53% for women aged 45 and over. Female fertility starts to decline in the late 20s and more significantly after the age of 35. The quantity and quality of eggs diminish more rapidly, making it more challenging to conceive. As we age, especially from our mid-30s, the decline in the ovarian reserve both in terms of quality and quantity happens very rapidly and the odds for conception and pregnancy become harder. Menopause marks the end of your reproductive years, usually occurring between ages 45-55. During menopause—an inevitable part of ageing—your ovaries stop working, your hormones gradually decline, your menstrual cycle ends and you can no longer get pregnant naturally. Females stop being fertile at menopause (not having a period for 12 months), however, fertility declines gradually with age, and after age 35, it becomes much more difficult to conceive and have a healthy pregnancy. However, it is important to note that this decline is unique to each person. Fertility milestones by age group You are most fertile in your 20s. Fertility gradually declines in the 30s, particularly after age 35. The chances of getting pregnant each month during your 30s are about 20%.  That means that for every 100 […]

Age is a big factor when it comes to fertility, but on the whole, people are having children much later than previous generations—some well into their 30s. If you’re looking for advice on how to boost your fertility naturally in your 30s, there are several things you can do. Read on to find out.  Quick facts: Fertility in your 30s Age is a big factor when it comes to fertility and we’ve all heard of the infamous biological clock. In other (more scientific) words, your biological clock refers to your ovarian reserve.  This is the number of eggs you have left and equally as importantly, the quality of your remaining eggs. Both of these factors unfortunately decline over time, significantly so after your mid-30s.  That’s not to say that you can’t have a very healthy and even easy pregnancy in your 30s, it’s just worth bearing in mind that as you get older, it becomes more difficult to get pregnant and to keep the pregnancy. Luckily there are many different types of fertility treatments, like egg freezing and IVF, which can help those who have more difficulty conceiving naturally.  When you’re trying to conceive in your 30s, whether you’re using fertility treatments or trying to get pregnant naturally, every little helps. Your lifestyle choices, nutrition, menstrual cycle awareness and mental health can play a crucial role in your fertility journey in your 30s, and at any age. Let’s take a look at some of the key lifestyle factors and medical factors that can help you on your journey. Medical considerations and check-ups Boosting fertility naturally in your 30s begins with a proactive understanding of your reproductive health. Regular medical check-ups, including hormone and fertility testing, can help you to understand if any underlying conditions may be affecting your reproductive health and help you address any potential hurdles to pregnancy. Lots of healthcare providers recommend only visiting a fertility specialist if you’ve been trying to get pregnant for a year without success, but you don’t need to wait that long.  While some couples have no trouble conceiving, 1 in 6 heterosexual couples face fertility struggles. Knowing your body from the inside out means you can seek support and advice faster with all the facts, should you need it. When it comes to getting pregnant in your 30s, timing is everything. By taking charge of your reproductive health through regular check-ups and fertility screenings, you equip yourself with the knowledge needed to optimise your chances of a successful pregnancy.  You may also want to consider getting a pelvic ultrasound scan to give you your definitive Antral Follicle Count (AFC). This gives you a clear and accurate picture of your remaining ovarian reserve Lifestyle changes to boost fertility Despite common misconceptions, you can implement lots of lifestyle changes to help support your fertility and reproductive health. While some aspects of fertility are out of our control, there are actions you can take to improve your chances of getting pregnant in your 30s, with and without fertility treatments. Lifestyle changes can help to boost your fertility naturally. Choosing a well-balanced and nutritionally rich diet, doing regular physical exercise, managing your stress and getting enough sleep can all support your fertility. Physical exercise to boost fertility Getting at least 150 minutes of physical exercise a week is important for supporting overall health—physical and mental.  Broken down, that could look like five 30-minute workouts, a week. This can be anything from a brisk walk to a gym session, yoga, swimming—or any kind of movement that’s right for you.  30-60 minutes of physical exercise per day was shown to reduce the risk of anovulatory infertility (infertility due to an ovulation disorder). Exercise not only balances your hormones, but it can boost your mood, help you manage stress and support your energy. However, being underweight, or doing vigorous physical exercise (more than 60 minutes a day) combined with eating in a calorie deficit, can negatively impact your fertility. This can have a knock-on effect on your hormones, which can lead to irregular periods and ovulation. Your menstrual cycle relies on a delicate hormone balance, and if your weight is too low or too high can throw them out of sync affecting your chance of conceiving. Stress management strategies for fertility Stress can also throw your hormones off balance, causing irregular periods and ovulation. It might also affect your desire to get intimate and reduce your sex drive.   Manage stress to boost fertility in your 30s by identifying coping strategies that work for you. You could try relaxation techniques like breathwork, yoga, meditation and mindfulness to help you relax.  If you find that self-help measures are not helping out, you can always consider seeking professional help.  The connection between sleep and fertility It’s recommended to get between 7-10 hours of sleep every night regardless of your health concerns. Sleep is associated with better health outcomes all round, including reproductive health.  So, how does sleep affect our fertility? A lack of sleep can cause your circadian rhythm (responsible for your sleep-wake cycle) to become dysregulated. This can cause knock on affects for your hormones and in turn your menstrual cycle and fertility.  One study revealed that in a survey of nurses of reproductive age, 53% reported menstrual cycle changes while engaging in shift work. To get a healthy sleep routine, try switching all screens off two hours before bedtime, and have a wind-down routine which could include a hot bath, calming tea, stretching or bedtime yoga. Try to stick to a schedule by going to bed and waking up around the same time each day, so your sleep-wake cycle is regulated. It’s usually easier to fall asleep when it’s quiet, dark and cool, but test different sleep environments to see which works best for you. Morning sunlight is proven to improve your ability to sleep too. Exposure to sunlight in the first hour of waking for 10-30 minutes a day, and in the afternoon as the sun is setting, […]

In this article, we’ll delve into the five main lifestyle factors that play a pivotal role in female fertility, and how you can shape and optimise your lifestyle to support your reproductive health. Quick facts: Understanding female fertility When embarking on your fertility journey, whether it’s trying to conceive for your first or your fifth—planning is everything.  Understanding the various lifestyle factors that can affect your fertility is crucial for both individuals and couples looking to begin their conception journey.   Lots of couples conceive without any issues, but 1 in 6 heterosexual couples face fertility struggles, so if it’s taking longer than you’d hoped, know that you’re not alone.  The earlier you know what’s going on inside your body, the earlier you can take action to support your future fertility goals.  There are lots of different factors that can impact female fertility—including age, lifestyle factors, hormones, reproductive health conditions and environment.  To get pregnant and have a baby, lots of these biological and environmental factors come into play. When one or more of these factors fall out of sync, that’s when you might face difficulties with fertility. Let’s take a look at some of these factors and how you can prepare for your fertility journey. Age and fertility First, let’s explore what fertility is from a biological perspective. Ovulation plays a critical role, marking the release of an egg from the ovary. For a pregnancy to occur, a healthy egg must meet healthy sperm (usually in the fallopian tube) where the egg gets fertilised. Plus, the uterus (womb) must be in optimal condition so the fertilised egg can implant and grow into a healthy baby. But unfortunately, biology often has other plans for us. We hear a lot about the ‘biological clock’ when it comes to women and those assigned female-at-birth (AFAB). This references the deterioration of both the quality and quantity of your eggs over time—known as your ovarian reserve.  Women and those AFAB are born with all the eggs they’ll ever have. Each menstrual cycle, you lose eggs. Once you hit your mid-thirties, this decline increases even more rapidly. Add in hormonal changes as a result and collectively, it reduces your ability to become, and often stay, pregnant. For a pregnancy to occur, you need healthy eggs. So from a biological standpoint, the younger you are, the healthier your eggs will be.  While an Anti-Müllerian Hormone (AMH) test can help you to understand how many eggs you have left, it can’t tell us the quality of the eggs we have. Additionally, after the age of 35, there’s a higher risk of pregnancy-related complications and negative health outcomes for the baby. There’s also a higher risk of miscarriage, high blood pressure, and gestational diabetes. Plus, chromosomal conditions like Down’s syndrome are more common. Despite misconceptions, ageing affects male fertility too. From age 40 onwards, sperm quality and sperm function decrease with significant implications to pregnancies and births including increased time to conception and increased risk of miscarriage. Lifestyle choices and fertility The idea that our fertility is out of our control is somewhat of a myth. Whilst biological and genetic factors play a big role—there’s a lot we can do to support our reproductive health.  Through lifestyle choices, we can impact the quality of our eggs and contribute to a healthier reproductive environment. Eating a well-balanced, nutritionally rich diet, getting regular physical exercise, managing stress, getting enough sleep and stopping or reducing smoking and excess alcohol can contribute to improving your fertility. This is because your lifestyle choices directly impact your hormones, and hormonal balance (involved in regulating your menstrual cycle) is crucial to a successful conception, pregnancy and healthy baby. Let’s take a look at some lifestyle tips that can help take care of your fertility Eat a fertility-friendly diet One of the best things you can do to support your fertility is to focus on your nutrition. Eating a Mediterranean diet—one that’s based on plant foods like fruit, vegetables, nuts, beans and whole grains with a moderate amount of dairy, fish, meat and eggs—can be really beneficial.  Check out our fertility-friendly meal plan, and fertility nutrition shopping list to support your healthy diet.If you’re trying for a baby and in the first 12 weeks of pregnancy, taking prenatal supplements like folic acid is important as it can help prevent major birth defects by supporting neural tube development. Get regular physical exercise Getting regular physical exercise is healthy no matter where you are in your fertility journey, but be wary of overexercise. Too much vigorous physical activity can stop ovulation, cause irregular periods or stop them altogether, known as hypothalamic amenorrhea. An absent period is often a sign that something’s not quite right, so it’s worth speaking with a healthcare professional if you’re worried. Limit smoking and alcohol Smoking, alcohol and recreational drug use are associated with an increased risk of miscarriage and complications during conception and pregnancy. Cigarette smoke contains chemicals that can disrupt your hormones and impact your fertility. It’s also been linked with early onset menopause. There’s limited evidence to know how vaping affects fertility (although early studies suggest it could affect the ability to implant and result in lower birth weights) but if you’re trying to get pregnant, not vaping is safer than vaping.  The lack of information doesn’t mean it’s safe, but by stopping, you’re being exposed to fewer chemicals. Get help to quit smoking in the UK with the NHS. Excess alcohol consumption is not only associated with hormone imbalances, there is no safe level of alcohol that can be consumed during pregnancy as it can lead to adverse health effects for the baby.  In women and those assigned-female-at-birth, disrupting your hormones can affect your menstrual cycle causing irregular periods which can affect ovulation, reducing your chances of conceiving. As well as its impact on our hormones, drinking and smoking negatively impact our general health which can lead to knock-on impacts on our fertility making it harder to become and stay pregnant, […]

For women or those assigned female-at-birth, society ensures that as we age, we’re hyper-aware of our declining fertility. Jokes about our ticking ‘biological clocks’, extended family constantly asking when we’re going to ‘settle down’ and even trying to navigate company maternity policies—it can feel really overwhelming. There are many different pathways to parenthood and for a lot of people, either for medical or social reasons, their fertility timeline just doesn’t line up with where they are at in their personal or professional lives. Luckily, advances in reproductive science are enabling many people to access fertility treatments, like egg freezing, to preserve their fertility.  We spoke to five people, all with different circumstances, who have undergone egg freezing. We hope these accounts can help you to understand a little bit more about the egg freezing experience. Recap: What is egg freezing? The egg freezing process (known medically as ‘oocyte cryopreservation’) is a fertility preservation method and medical procedure that involves having your unfertilised eggs surgically removed from your ovaries, frozen and stored in a lab until you’re ready to use them.  You may choose to freeze your eggs if you want to have children in the future, but aren’t ready to yet. As you age, the quantity and quality of your eggs decline, which means your chance of getting pregnant does too. Freezing your eggs will preserve their quality, as they are now, for if and when you become ready to use them. There are two types of egg freezing: The egg freezing process An egg-freezing cycle involves several different stages including preliminary tests, ovarian stimulation, egg retrieval, storage and then subsequently thawing once you’re ready to use them. Egg-freezing can be incredibly empowering—allowing you to control your family planning timeline and focus on your personal and professional life, or any medical treatment, without having to worry about your fertility decline.  However, it can be an intensely emotional journey full of ups and downs, with financial strain, daily injections, and hormonal changes that can affect your mental and physical health.  Remember—if you’re going through this process, Hertility’s fertility counsellors can support you through these challenges. While the procedure is generally safe, there is a small risk of Ovarian Hyperstimulation Syndrome (OHSS), which is a condition that can happen in response to fertility medication. For more information, read our egg-freezing guide. Natalie Getreu’s egg freezing journey Ovarian biologist and one of our very own co-founders, Dr Natalie, had a unique egg freezing experience after having been both a fertility practitioner and patient.  “I thought I knew everything about egg freezing, at least from a scientific standpoint. I’d supervised procedures, sat in on consultations, educated women and delivered lectures on treatments.  But when it came to undergoing the process myself, as a patient, it was a completely different experience.  I definitely didn’t fully appreciate the physical toll it would take, how draining it would be emotionally, or how much I would have to relinquish control to the process and just let my body do what it needed to do in response to the treatment.  Probably the biggest thing I came to appreciate was how much I needed to slow down. As a founder, there is an enormous pressure to be available 24/7, and as a woman, for everything to be done perfectly. There often doesn’t feel like we are afforded the space to slow down, but I realise now how important that is. The whole process made me have a much deeper appreciation of the lack of education and awareness out there about alternative routes to parenthood. If you’re thinking about undergoing treatment, get as much info as possible. Support is out there no matter what your circumstance is’.” Asher’s egg freezing journey “I discovered the importance of [egg freezing] the same day that I was diagnosed with gender dysphoria and recommended for Testosterone HRT. Luckily, this is when I was introduced to Hertility – finally some humane guidance, clarity and crucially being seen and understood as a trans person. The whole process became much clearer and felt more manageable, and honestly I started to feel inspired by the gift of being able to do this. The actual process wasn’t nearly as bad as I imagined, especially in relation to triggering my dysphoria.“ Georgia Habboo’s egg freezing journey “The reason I did this was that I had not had a period since coming off the pill (it had been 3.5 years) and I literally was getting no answers from doctors after 10,000 tests. I did the hormone testing kit which I’m SO grateful for. My AMH, which is an indicator of your egg reserve (ovarian reserve), was really low – within the range of a 55-65-year-old, so they recommended that I freeze my eggs straight away”. Daniella Abraham’s egg freezing journey “At age 30, I wasn’t anywhere near ready to have a baby. Although I wanted the option to have kids in the future, I didn’t want to feel pressured into trying sooner than I might have done just because of my ‘biological clock’. Honestly, the hardest part was deciding if the process was right for me, but in the end, I’m so glad I chose to do it. “Freezing my eggs has given me reassurance that I didn’t need to rush into making any major life decisions and given me peace of mind that I will have the option to start a family in the future when I’m ready to.” Mish’s egg freezing journey “As I approached 35, I knew I wanted to freeze my eggs. I didn’t want to feel pressured to have a baby just because of my biology. But I had no idea if I would be able to  – I knew you can only get screened on the NHS if you’re trying, so I assumed I would just have to wait until then. “That’s when I found Hertility. I took a Hertility test which allowed me to see if I had any issues in advance of starting […]

If you’re trying to conceive, understanding when you’re ovulating can greatly improve your chance of getting pregnant. Read to find out what ovulation is and how to track it.  Quick facts: What is ovulation? Ovulation refers to the phase around halfway through your menstrual cycle when your body releases an egg (ovum). It travels through the fallopian tube where sperm can fertilise it and you can become pregnant. The fertile window Pinpointing the day you ovulate can improve your chance of conception since you can ensure you have sex within your fertile window. Your fertile window is a six-day window during each menstrual cycle, it includes the five days leading up to the day of ovulation, and the day after ovulation. If the sperm fertilises the egg and implantation (the attachment of the fertilised egg to the wall of the uterus) occurs, it can develop into a pregnancy. But if it doesn’t implant, around 14 days later, you’ll have a period. Your period (or menstruation) bleed is the uterus wall lining (endometrium) shedding. An egg can only survive for 12–24 hours, which might seem like a brief window of opportunity for the egg and sperm to meet and fertilise, but sperm’s lifespan is much longer. Sperm can survive for up to five days in the female reproductive tract, so if you have sex five days before ovulation, it’s still possible to become pregnant. When does ovulation occur? Ovulation will usually happen during the middle of your cycle (anytime from 11-16 days after your period starts) if you have a regular period.  The day of ovulation is dependent on the length of your cycle and can also sometimes vary from cycle to cycle, particularly if you don’t have regular periods. You may hear that ovulation happens on day 14—but this assumes everyone has a 28-day cycle which isn’t always the case.  Cycles can vary in length from person to person and even from one cycle to another. Anything from a 21-day cycle to a 35-day cycle is considered regular. If you’re taking birth control or hormonal contraception exactly as prescribed, you shouldn’t ovulate. The hormones in hormonal contraception work by stopping ovulation and thickening cervical mucus, which makes it harder for sperm to reach and fertilise an egg. Tracking ovulation: signs and symptoms There are a few different methods you can use to track ovulation, such as using a predictive period tracker app, monitoring signs like basal body temperature and discharge changes, or using an ovulation test kit. Let’s take a look at each.  Ovulation test kits Ovulation test kits can determine whether you’re ovulating. They work similarly to a pregnancy test. They test your urine to detect the levels of luteinising hormone (LH) – the hormone released by the pituitary gland in the brain to trigger ovulation. Although LH is always present at low levels, it surges 24-36 hours before you ovulate. Ovulation prediction kits may not be suitable for someone with PCOS, because they often have high LH levels which can cause falsely positive results. Our at-home hormone and fertility test can help you get clarity on what’s going on inside your body including your egg count and highlight any red flags to do with fertility. It’s personalised to include a comprehensive Online Health Assessment, personalised hormone panel, at-home blood collection kit, and a gynaecologist to analyse your results and help you create an actionable plan for the future. Calendar method Tracking your menstrual cycle is an effective way to determine when you’re ovulating. You can use a traditional pen and paper, digital calendar or even period tracking apps that you mark when you’re bleeding. You can also track different symptoms throughout the month to notice patterns that can indicate which menstrual cycle phase you’re in. Mobile application-based fertile window predictions may not always take into account current cycle variations or factors that might impact your cycle. They are also reliant on the accuracy of the information you input, which is why you should be careful with relying on them for predicted fertile windows because it could put you at risk of an unintended pregnancy.  Cervical mucus changes Cervical mucus changes throughout your menstrual cycle and plays a key role in conception. Before ovulation, it’s often pasty and creamy. During ovulation, it becomes clear, slippery and stretchy resembling raw egg whites. This consistency makes it easier for sperm to swim up the vagina and into the uterus to meet and fertilise an egg. Cervical mucus can be affected by many other factors, such as infections, sex and medications, and may naturally alter within each cycle, which is why relying only on this method alone might not be accurate. Basal body temperature changes You may be able to detect ovulation by checking your basal body temperature with a digital basal body thermometer. Your body temperature increases slightly during ovulation by 0.5 to 1 degree. This method works more effectively if you track your basal body temperature for several months first thing in the morning before you eat, drink and go to the toilet to get an idea of your baseline temperature. That way, you’ll notice when it increases. Although, it is important to remember that basal body temperature can be affected by many things such as alcohol consumption, a change in sleep schedule or if you are feeling unwell.  Physical ovulation symptoms Some people who menstruate often feel physical symptoms when ovulating too. It’s common to have tender breasts, an increased sex drive, minor pelvic or abdominal pain (ovulation pain or mittelschmerz), light bleeding or spotting, bloating, a heightened sense of smell, taste or sight, mood changes and appetite changes. However, these symptoms aren’t an effective way to predict ovulation. Whether you’ve just started trying to get pregnant or are considering your future family options, knowing when you’re ovulating and understanding your body puts you in the driver’s seat of your reproductive journey to give you peace of mind and improve the chance of conceiving. Problems with ovulation If […]

Anti-Müllerian Hormone (AMH) is a really important hormone for your fertility because of how closely it is linked to your eggs, AMH testing can help you understand your fertility and give you insights into your overall reproductive health. Here’s what testing can and can’t tell you. Quick facts: What is AMH and why is it so important? Anti-müllerian hormone (AMH) is a super important hormone for fertility. AMH is made by the small sacs, called follicles, in your ovaries. These follicles house your eggs.  Because of its close relationship to your eggs, testing your AMH levels can help indicate how many eggs you have left at the time of testing.  There are a few myths out there about what exactly AMH testing can tell us. So in this article, we cover the main things an AMH test can and can’t tell you. Let’s get into it… What can AMH testing tell me? Whether your ovarian reserve is a normal for your age AMH testing will give you insights into whether your ovarian reserve is in line with other healthy people in your age group. If you are not using any hormonal contraception, testing other hormones, like follicle-stimulating hormone (FSH) and oestradiol alongside AMH can also help to build a full picture of egg reserve. Generally, people with low egg reserves are known to have higher levels of FSH and lower levels of oestradiol. Whether you have polycystic ovaries or polycystic ovary syndrome AMH testing can also indicate whether you could have polycystic ovaries (PCO). PCO is a common reproductive health condition affecting around 30% of reproductive-aged people assigned female-at-birth. PCO is benign and does not affect fertility, but it can cause other unwanted symptoms.  People with PCO have a higher-than-expected number of immature follicles in their ovaries. More follicles mean a higher level of AMH in the blood.  Some people with PCO also have the syndrome that can be associated with it—polycystic ovary syndrome (PCOS), which often presents as symptoms like irregular periods and high testosterone levels.  According to updated guidelines, AMH testing can be used as a marker for polycystic ovaries, which is one of the criteria for a  PCOS diagnosis. However, we would always recommend getting a scan of your ovaries) to confirm the diagnosis. Whether IVF or egg freezing could be right for you AMH testing and understanding your ovarian reserve can also help to determine if certain fertility treatments like IVF or egg freezing could be suitable for you. During these fertility treatments, AMH levels are often tested to help determine the doses of medication needed and used to predict the outcomes of the egg collection process. People with lower AMH levels are known to have less successful IVF treatment cycles, whereas someone with high AMH might be at increased risk of developing a rare but potentially life threatening condition called OHSS (ovarian hyperstimulation syndrome).  Many NHS-funded and private IVF clinics therefore require a minimum AMH level for you to be eligible for a free IVF treatment cycle. The minimum level on the NHS will depend on where in the UK you are currently residing. Whether you may be perimenopausal or menopausal or have POI Menopause refers to the period of your life, usually post 45-50, where you no longer have menstrual cycles and are therefore no longer able to conceive naturally. Menopause is associated with having an extremely low, or completely diminished, ovarian reserve.  It is usually diagnosed retrospectively—when women are over 45 years old and have not had a period in 12 months (and are not using hormonal contraception).  For people who are younger, FSH levels are useful for diagnosing menopause, as FSH levels are known to increase for people with low egg reserves. Although AMH levels are not recommended to help diagnose menopause, it is known that AMH levels reduce to very low levels at the time of menopause. There is also evidence that people with very low AMH levels (who are not going through menopause) will undergo menopause much sooner than those with AMH levels that are within range. When the ovaries stop working before the age of 40, this is known as premature ovarian insufficiency (POI), which AMH levels have also been shown to provide a good indicator of. If you have a higher risk of miscarriage or recurrent pregnancy loss It is estimated that approximately 1 in 5 pregnancies end in miscarriage. Miscarriages occur most frequently in the first 12 weeks of pregnancy and can be associated with lots of different risk factors. Some of the most common are your and your partner or sperm donors’ age, pre-existing conditions and ethnicity. Recent evidence has shown that people with diminished ovarian reserve, and therefore very low AMH levels, are more likely to have a miscarriage or recurrent miscarriage (two or three consecutive pregnancy losses).  However, more research needs to be done to understand the links between AMH levels and miscarriage, including its risk factors. What can’t AMH testing tell me? Unfortunately, AMH testing and ovarian reserve forms only one part of the fertility picture and there are some things that AMH testing may not be able to tell you. Let’s take a look… It can’t determine your egg quality Although AMH levels can give insight into your egg quantity, it does not provide any insight into the quality of those eggs. Despite poor egg quality being one of the most common causes of female infertility, there is currently no test that can definitely determine egg quality (unless testing embryos in IVF treatment). It can’t determine your exact egg quantity Your AMH result can give an indication of the size of your ovarian reserve.  This is because it is released by the follicles which contain our eggs, meaning that the more follicles we have, the higher the AMH that will be produced. However, it can’t tell you your exact number of eggs because each follicle may produce a different amount of AMH depending on its size.  In order to estimate the number […]

Prolactin has several important functions in the body. But what exactly does prolactin do and how do we know if our levels have become imbalanced? In this article, we’ll dive into exactly what prolactin is, what its functions are in the body, discuss imbalances in its levels and the importance of testing prolactin levels for reproductive and overall health. Quick facts: What is prolactin? Prolactin is a hormone that encourages breast growth and milk production during and after pregnancy, as well as maintaining our metabolism, regulating our stress response, maintaining a functioning immune system and in the development of our reproductive organs.  Similarly to follicle-stimulating hormone (FSH) and luteinising hormone (LH) it is secreted by the anterior pituitary gland, located at the base of the brain. From there, it’s released into the bloodstream where it travels around the body to carry out its functions.  Prolactin interacts with FSH and LH, and other cycle hormones, in a complex negative feedback loop. After ovulation prolactin production increases to prepare the body for a potential pregnancy. Prolactin’s role in breastfeeding In pregnant women, prolactin stimulates milk production in the mammary glands of the breasts—allowing for the secretion of breast milk. After birth, there is a postnatal rise in prolactin, which gets things started—but this isn’t enough to maintain breast milk development. When a baby suckles, prolactin levels in the blood increase in response, which stimulates the production of more milk. Prolactin levels spike around 30 minutes after the start of the feed, so this positive feedback effect is important for ensuring there is enough milk for the next feed.  This can also be stimulated by breast pumping, if you choose not to, or are unable to breastfeed. Prolactin levels Just like all of our hormones, from time to time, our prolactin levels can get off balance. This can cause a whole range of different symptoms and effects throughout the body, including affecting our thyroid hormones, stress hormones, menstrual cycles and ovulation. What are normal prolactin levels? Reference ranges for what is a normal prolactin level will be specific to the lab that is testing your sample.  Higher prolactin levels are usually present in those assigned-female-at-birth than those assigned-male-at-birth. In general, prolactin levels are expected to be less than 25 μg/L in those assigned-female-at-birth, who are not pregnant or breastfeeding. High prolactin levels Too much prolactin can stop our brains from producing FSH and LH—two key hormones involved in regulating our menstrual cycles and bringing about ovulation.  If FSH and LH are affected, ovulation can stop leading to the loss of periods, which is called amenorrhoea. No ovulation means no chance of a pregnancy, and therefore big issues for our fertility. Disruption to our menstrual cycle can also cause knock-on effects on our oestrogen levels, causing oestrogen deficiency. Some of the most common symptoms of high prolactin levels to look out for are milky white discharge from the nipples when not breastfeeding (galactorrhea), disturbances to the menstrual cycle, visual disturbances, headaches and symptoms of oestrogen deficiency. High prolactin levels can be caused by a variety of reasons, including imbalances in our thyroid and stress hormones. Additionally, a growth or tumour present in our pituitary glands, called a prolactinoma, can also cause persistent or increasing prolactin levels. Symptoms of high prolactin levels can include: Note: If you are experiencing any form of nipple discharge when not breastfeeding, get this checked by a physician or GP as it can be a symptom of breast cancer. Symptoms of high prolactin levels after menopause Although high prolactin levels are not common in those postmenopausal, it can occur. Excess prolactin after menopause often causes hyperthyroidism, when the body doesn’t make enough thyroid hormone. Symptoms can include: How to lower prolactin levels If you’re wondering how to reduce prolactin levels, this is very much dependent on the cause of your excess prolactin levels.  Your doctor may prescribe you medications like bromocriptine or cabergoline to lower your prolactin secretion. Surgery may also be recommended as the best treatment option for you.  Persistently high prolactin that has been caused by chronic stress, over-exercising or poor sleep may be lowered by lifestyle modifications. Low prolactin levels On the flip side, low prolactin levels, called hyperprolactinemia, is rare—and outside of pregnancy, baseline or ‘normal’ prolactin levels are usually low. Sometimes there aren’t any obvious symptoms of low prolactin levels, other than not being able to produce or release much breast milk after giving birth. Breastfeeding can increase our prolactin levels naturally—as the more we stimulate the nipples, more prolactin is produced.  Most people with low prolactin levels don’t have any specific medical issues, although there is preliminary evidence that suggests they might have reduced immune response to some infections and it could indicate that the pituitary gland isn’t functioning properly. Why should we test our prolactin levels? Like all of our reproductive hormones, it’s good to check in with prolactin regularly, especially if we’re trying to conceive or having any problems with our menstrual cycles or experiencing hormonal symptoms.  Testing our prolactin levels with a prolactin blood test can help us to determine if there are any hormonal issues affecting our fertility or menstrual cycle, or investigate any symptoms of prolactinoma. With a Hertility Hormone and Fertility test, we can test your prolactin levels alongside your Anti müllerian hormone (AMH), thyroid hormones and cycling hormones (FSH, LH and oestrogen) to help you gain a full insight into your hormonal health and fertility. If you’ve already done a test and received an abnormal prolactin result, you can book an appointment with one of our Private Gynaecologists specialising in hormone and fertility concerns to discuss your results and get a personalised care plan. Appointments are available daily, with no GP referral required. Prolactin FAQs Can I get an FSH, LH, Prolactin test all in one? Luckily, you’re in exactly the right place. With our Hormone and Fertility test we will test you for up to 10 reproductive hormones, including your FSH, LH, prolactin and more.  […]

Around 2 in 3 people assigned female-at-birth will develop a fibroid at some point in their lifetime. But what are fibroids, how do we look out for symptoms and what are the treatments if we’re diagnosed? Read on to find out.  Quick facts: What are fibroids? Uterine fibroids are benign or non-cancerous growths in and around the uterus, or womb. They are made up of fibrous muscle tissue and are extremely common. Around 2 in 3 people assigned female-at-birth will develop a fibroid at some point in their lifetime (1). Your risk of developing a fibroid increases with age and if you: Where do fibroids grow? Fibroids can vary in size and you may have one or multiple fibroids. They can develop as singular fibroids or as clusters. There are three different types of fibroid, depending on where in the body they grow: Signs and symptoms of fibroids Not all people who develop fibroids experience symptoms. Most are actually asymptomatic and have no symptoms at all. Only approximately 1 in 3 people with fibroids will experience symptoms. The symptoms of fibroids can include: What causes fibroids?  Unfortunately, like many reproductive health conditions, the exact cause of fibroids is unknown. What we do know though, is they’re affected by oestrogen and progesterone—two hormones important for regulating the menstrual cycle. After menopause, when oestrogen and progesterone levels drop, fibroids tend to shrink (3). How are fibroids diagnosed? To diagnose fibroids you’ll need a pelvic ultrasound scan. Usually, your doctor will discuss any symptoms you’ve been experiencing with you first. Then they’ll carry out an abdominal examination to look for any areas of tenderness or masses in your abdomen, before referring you for a scan.  The ultrasound will look at your reproductive organs including your uterus, Fallopian tubes, ovaries and general pelvic area. This can be done either transvaginally (through the vagina) or transabdominally (looking at your uterus through your abdomen). A scan is the only way to definitively diagnose fibroids and to determine their size and location. You may also be offered a blood test to screen for iron deficiency anaemia, which is a condition that can occur as a result of heavy bleeding.  Because lots of people with fibroids don’t experience symptoms, often fibroids are found coincidentally. This could be during an ultrasound for a pregnancy or another suspected condition. Black women have an increased risk of developing fibroids Black women are three times more likely to develop fibroids than white women. They’re also more likely to be diagnosed with fibroids at a younger age, have a longer duration of symptoms and have larger, more rapidly growing fibroids. Although the increased risk of fibroids in Black women is known, there’s been little research conducted to understand why this is. Some research suggests genetics, such as Vitamin D deficiency in Black women (4) could be a link. Other research has suggested certain environmental factors could be linked. These include exposure to chemical relaxers, used for afro-textured hair, which have been linked to a higher risk of developing fibroids (5). Will fibroids affect my fertility? Some fibroids can cause problems with fertility (6). This largely depends on their size and where they are located.  Fibroids can affect the structure of the uterus and its surrounding organs. Meaning they can prevent sperm from fertilising an egg or prevent an embryo from implanting. However, lots of people with fibroids do not have any difficulties getting pregnant. How are fibroids treated?  Treatment for fibroids depends on:  If you have fibroids that are not causing symptoms and aren’t likely to affect your fertility, then generally no treatment is required. But if you begin to experience any new symptoms, it is really important to go back to the doctor to have a check-up.  The treatment methods for fibroids can be broken down into non-surgical and surgical methods. Non-surgical methods If you commonly experience heavy periods as a result of your fibroids, you may be given medications such as tranexamic acid. This is a medication which breaks down blood clots in the womb. You may also be given anti-inflammatory medications, like ibuprofen or an oral medication called Ryeqo. The combined oral contraceptive pill and hormonal IUD can also be prescribed to help you have lighter, less painful periods.  As well as treating heavy periods directly, you may also be given a gonadotrophin-releasing hormone (GnRH) analogue. This is to try and shrink your fibroids and is also commonly prescribed before any surgical treatment.  GnRH analogues work by reducing your levels of oestrogen. Low levels of oestrogen can lead to several other long-term complications, so this method can only be used for a short period.If you have larger fibroids, you may be offered a procedure called Uterine Artery Embolisation. This is used to block the arteries which supply blood to the fibroids. If you have smaller fibroids, you may also be offered a procedure which removes the lining of the womb called Endometrial Ablation. Surgical methods There are various surgical techniques which can be used to treat fibroids. Surgery can be explored if medical treatments don’t work for you or aren’t suitable in the long term.  You may be offered one of the following surgical treatments for fibroids:  What type of procedure is most suitable for you depends on the location, size and number of your fibroids. Each varies in terms of invasiveness, risks and its potential effect on fertility. Some people’s fibroids may grow back after surgery, known as ‘recurrence’.  Suspect you may have fibroids? As the symptoms mentioned above are commonly experienced in various types of pelvic issues, they may be linked to other causes apart from fibroids.  If you’re suffering from painful periods or any of the above symptoms, it’s important to get your hormones tested, to rule out a hormonal cause. This, alongside a pelvic ultrasound scan, can help you get to the bottom of symptoms and get a recommended care plan based on your biology.  If you’ve been diagnosed with fibroids, you can also talk to our team of […]

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 Hormone & 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.