Tag: hormones

Sex hormone-binding globulin (SHBG) is an important protein involved in the regulation of our sex hormones and in turn our ability to conceive. So what is a good, or ‘normal’ range for our SHBG levels? And how do we know when ours might be too high or too low? We’ve broken down all you need to know about SHBG levels, including what they mean, why they matter and what to do if you suspect yours might be out of range. Quick facts: What is SHBG? SHBG is an important protein that regulates the amount of testosterone and oestrogen available in the body by ‘binding’ to these hormones—which makes them inactive. This is because to bring about an effect in the body, hormones need to be unbound or free so they can enter cells and bring about their effect. The vast majority of testosterone and oestrogen in our bodies is bound to SHBG and other proteins. SHBG also controls the balance between testosterone and oestrogen, which is also important for the healthy functioning of our menstrual cycles. Why do SHBG levels matter? Because SHBG levels regulate the amount of testosterone and oestrogen available to be used by the body, if our SHBG levels are too high or low, this will have a knock on effect on our levels of both of these sex hormones.  If our SHBG levels are higher, we’ll have less free testosterone or oestrogen available. If our SHBG levels are lower, we’ll have more testosterone and oestrogen available.  Both of these sex hormones have important roles in the regulation of the menstrual cycle, ovulation, libido, energy levels and our mental health. Low SHBG When our SHBG levels are low, our levels of free unbound testosterone and oestrogen can become high. Let’s take a look at some of the symptoms, causes and what can be done to help. Symptoms of low SHBG These symptoms can often mirror those of excess testosterone including: Or excess oestrogen: Causes of low SHBG There is no single cause for abnormal SHBG levels, although increases in insulin, prolactin and androgens have been found to block SHBG production which could be a factor for those with low SHBG levels.  Low SHBG can also be caused by a number of lifestyle factors, certain medical conditions and genetics. Here are several conditions, as well as other factors, that low SHBG has been found to be associated with: How to raise low SHBG If you have low SHBG there are a number of lifestyle changes that may help to increase your levels. These include: High SHBG  On the flip side, when our SHBG levels are too high, our unbound testosterone and oestrogen can become abnormally low. Here are some symptoms, causes and what can be done to reduce high levels of SHBG. Symptoms of high SHBG These symptoms can often mirror those of low testosterone including:  Or low oestrogen: Causes of high SHBG Again, there is no single cause for abnormal SHBG levels, although as we mentioned previously, increases in oestrogen and thyroxine (T4) have been found to increase SHBG production, which could be a factor for those with high SHBG levels. There are also a number of conditions associated with high SHBG which include: How to lower SHBG Dietary changes are the most effective way to lower SHBG levels. Decreasing alcohol consumption, gaining weight if you have a low BHM and following a high-fat, low fibre diet may help decrease levels of SHBG. One study involving 48 premenopausal women showed that maintaining a high-fat, low diet decreased SHBG. However, more clinical studies are required to confirm this association. If the levels are elevated due to contraception use, this will usually return to normal levels once you stop using that contraception. Other possible causes such as type 1 diabetes and an overactive thyroid will need further investigation and will require medication specific to these conditions. SHBG tests Ultimately, if you suspect you may have abnormal levels of SHBG, the only way to definitively get a diagnosis is via a blood test. Because symptoms of abnormal SHBG levels can mimic those of high or low oestrogen and testosterone, your SHBG levels should be tested in tandem these hormones. You can test all of these hormones and more, with a Hertility at-home Hormone and Fertility Test. Resources:

Follicle-stimulating hormone (FSH) is really important for our reproductive health. In this article, find out how to know what normal FSH levels look like, what the symptoms of high and low FSH levels are and how to balance your FSH levels. Quick facts: What is FSH?  FSH stands for Follicle-Stimulating Hormone and is one of the main hormones involved in the regulation of your menstrual cycle and ovulation—making it an important hormone not only for your health but your fertility too. FSH is what’s known as a gonadotropin hormone. It’s released by the pituitary gland in the brain and then acts on the ovaries.There is only one other gonadotropin hormone in the body—luteinising hormone (LH). True partners in crime, there’s no FSH without LH, and they act in tandem to bring about changes which essentially regulate ovulation. Normal FSH levels in women Because our FSH levels are intricately linked to our ovarian reserve, what’s considered a ‘normal’ FSH level changes as we age. This is because our ovarian reserve declines as we age which makes our FSH levels increase.  Gonadotropic hormones are hormones released from the pituitary gland in the brain and released into the bloodstream. Gonadotropins then go on to act on the ovaries. There are two types of gonadotropins, follicle-stimulating hormone (FSH) and luteinizing hormone (LH).  The pituitary gland produces FSH which acts on the ovaries to stimulate the growth of follicles containing your eggs. As well as growing the ovarian follicles, FSH stimulates the granulosa cells that surround the follicle to produce oestrogen from testosterone, an essential hormone for regulating the menstrual cycle (1). You can read more about oestrogen here.  What does FSH do? FSH has two primary functions:  Follicular development FSH does pretty much exactly what it says on the tin—it stimulates the growth of follicles which contain your eggs.  You’re born with ‘immature’ eggs. So each month, a number of them start maturing before one is released during ovulation. Your eggs are housed in tiny follicles inside your ovaries, and it’s these follicles that FSH signals to prepare your eggs for ovulation (2). Oestrogen production FSH also stimulates the cells that surround the follicles to make an enzyme called aromatse, which converts testosterone into oestrogen, another essential hormone for regulating the menstrual cycle and reproductive health (1). The relationship between FSH and LH When your eggs are fully mature and ready to be released during ovulation, LH steps in. A surge of LH is released, again by the pituitary gland in the brain, causing the most mature follicle to rupture—releasing an egg into your Fallopian tube. This is ovulation.  Despite FSH causing numerous follicles, and therefore numerous eggs, to mature each cycle, only one follicle will release an egg each month. This is because FSH and LH are both involved in negative feedback loops, controlled by E2. But what does negative feedback loop mean? Increasing FSH levels in the early stages of your menstrual cycle leads to more oestrogen being made, but this ha, a negative feedback effect on FSH levels. In other words, when you have lots of oestrogen, it feeds back to the brain that it needs to stop making more FSH. Similarly, with LH, oestrogen levels keep increasing through the cycle and once they reach a peak around the middle of the cycle, it causes a sudden surge in LH that promotes ovulation. After ovulation, the empty follicle that once contained the egg makes another hormone, progesterone, to support conception, implantation and the early stages of pregnancy. High levels of progesterone tell the brain to stop making more FSH. Now if a pregnancy doesn’t happen, there is a drop in oestrogen and progesterone which triggers your period. It also tells the brain it needs to start making FSH to start the whole process all over again in the next menstrual cycle (5). High FSH levels Okay, but what happens when we have high FSH levels? Let’s take a look at the causes and symptoms of high FSH levels. What causes high FSH levels? The most common reason for high FSH levels is a low ovarian reserve (egg count), or ovaries that aren’t functioning properly. When we have a low ovarian reserve, this essentially means we have a smaller number of immature follicles available in our ovaries and our bodies will produce less oestrogen.  Because oestrogen controls how much FSH we produce (remember that negative feedback loop), when we have less oestrogen, our FSH levels may go up.  High FSH levels can therefore indicate that our ovaries aren’t functioning properly, be an indicator of low ovarian reserve or an indicator of the onset of menopause. Other reasons for high FSH levels can be ovarian cancer (although this is very rare) (9) and Premature Ovarian Insufficiency (POI) which is the loss of ovarian function before the age of 40 (6,7). In some cases, dietary and lifestyle factors can moderately raise FSH levels. Symptoms of high FSH levels Symptoms of high FSH levels usually mimic symptoms of menopause and are related to low oestradiol levels —which is why it’s so important to test a range of your reproductive hormones to get to the bottom of symptoms. Symptoms can include: How to lower FSH levels? It is important to understand that if high FSH levels have been caused by menopause or a low egg reserve, modifications to your diet or lifestyle will not be able to reverse this. However, there are some dietary lifestyle factors associated with a higher FSH, such as smoking and high alcohol consumption.  If you’re trying to conceive, consider cutting alcohol and cigarettes completely as this will improve your chances of conception and prevent harmful effects to the baby during pregnancy (17). For advice on how to quit smoking, see the full list of NHS quit smoking services here. Nutrition can be a really powerful tool in balancing hormones and helping to alleviate symptoms. You can book a nutritional health consultation with one of our registered nutritionists via your health hub. […]

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 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’

Check your fertility The results revealed that between fertility preservation methods: egg, embryo or ovarian tissue freezing, there was no significant difference between these methods for women to have live births after pregnancies. At Hertility we are so proud to not only offer new and different care pathways for women but also to be home to so many amazing researchers. So we thought in this article we would take you through the research, and the findings and explain them to you. After all – knowledge is power! First up, let’s recap on fertility preservation…. We’ve already published an article that covers all the different types of fertility preservation for people with ovaries but here is a brief sum up: There are both medical and social reasons to undergo fertility preservation.  Medical fertility preservation means preserving parts of your fertility in people who might lose their ability to reproduce due to upcoming medical treatment, for example, cancer patients about to undergo chemotherapy/radiotherapy or people undergoing gender reassignment surgery, or for some who have an autoimmune condition that want to protect their fertility. Whereas, social fertility preservation is when you are opting to freeze your eggs because of social and age-related factors. There are several different fertility preservation methods, some of which include: Egg freezing – This is what it says on the tin: collecting your egg cells and putting them on ice for later use. Embryo freezing – This process involves fertilising your collected egg with IVF using either donor’s or your partner’s sperm and then the resulting embryo is frozen until you are ready to use it. Ovarian tissue cryopreservation – This method is created mostly for younger patients who have not yet gone through puberty and are therefore not able to fully mature their egg cells. Tissue containing immature eggs is cut from their ovaries and is preserved in a tissue bank until the tissue can be re-implanted and used at a later stage, however, this is not routinely used for the general population. There are more fertility preservation options but in this study, researchers only included cancer patients who had undergone oocyte, embryo or ovarian tissue cryopreservation (freezing) What did this study do? Researchers followed cancer patients that had both fertility preservation and then had fertility-damaging cancer treatment (gonadotoxic therapy) who were now looking to start a family using their cryopreserved oocyte, embryo or ovarian tissue. The main outcomes this research looked at were if there were clinical pregnancies (clinical signs of the foetus can be either seen or heard), miscarriages (pregnancy loss) and live birth (completed pregnancies that result in a live birth). What were the results? This study found that between fertility preservation methods: egg, embryo or ovarian tissue freezing, there was no significant difference between these methods for women to have live births after pregnancies. (In science it’s all about whether a difference is significant or not!).  Also high clinical pregnancy rates and live birth rates were observed in all techniques. They also found that freezing ovarian tissue results in significantly less miscarriages than embryo freezing, which is interesting and is something to further investigate! What do these results mean? Like anything in science, there are limitations in the study and this research does report some limitations since it was an early analysis. However, this is a really important and interesting starting point in this area of research and for cancer-related fertility preservation.Researchers hope that this study helps to establish better reporting of outcomes in cancer patients and will encourage clinicians to use appropriate statistics and information to counsel women who find themselves facing a cancer diagnosis on their chances of biological motherhood. If you fancy having a read of the article yourself, have a look here! At Hertility, we are dedicated to revolutionising women’s healthcare, whether that be through improving care pathways, helping women receive answers about their bodies through our at-home tests or contributing to the Women’s Health research. It’s all part of our mission for a #ReproductiveRevolution. Recent research conducted by some of our Hertility Team, led by one of our co-founders Dr Natalie Getreu, has been published in the Fertility and Sterility Journal. Fertility can be affected by cancer and cancer treatment to such an extent that women may have reduced family planning options once they’ve completed their treatment. Although, records of the success of fertility preservation methods in cancer patients are not routinely collected by hospitals, fertility clinics or researchers. Instead, when it comes to egg and embryo freezing, clinicians routinely use success rates from patients that have undergone fertility preservation for social reasons as opposed to medical reasons. Therefore, our research team aimed to look into pregnancy outcomes in cancer survivors who had used their frozen tissues to provide more up-to-date and relevant information for these patients. Check your fertility The results revealed that between fertility preservation methods: egg, embryo or ovarian tissue freezing, there was no significant difference between these methods for women to have live births after pregnancies. At Hertility we are so proud to not only offer new and different care pathways for women but also to be home to so many amazing researchers. So we thought in this article we would take you through the research, and the findings and explain them to you. After all – knowledge is power! First up, let’s recap on fertility preservation…. We’ve already published an article that covers all the different types of fertility preservation for people with ovaries but here is a brief sum up: There are both medical and social reasons to undergo fertility preservation.  Medical fertility preservation means preserving parts of your fertility in people who might lose their ability to reproduce due to upcoming medical treatment, for example, cancer patients about to undergo chemotherapy/radiotherapy or people undergoing gender reassignment surgery, or for some who have an autoimmune condition that want to protect their fertility. Whereas, social fertility preservation is when you are opting to freeze your eggs because of social and age-related factors. There are […]

AMH (anti-Müllerian hormone) is a hormone made by the small, developing follicles in your ovaries. Measured with a simple blood test, and is a marker of your ovarian reserve or broadly, how many eggs you have left. It reflects egg quantity, not quality, and it’s one important piece of your wider fertility picture, not the whole story. If you’ve come across it while looking into your fertility, egg freezing, or “checking your egg count,” you’re in the right place. Here’s what AMH actually is, what your result can and can’t tell you. Quick facts: What is AMH? Anti-Müllerian hormone (AMH) is made by cells surrounding the small, developing follicles in your ovaries. Each of these follicles contains an immature egg. Because the number of these follicles is related to the size of your remaining egg pool, the amount of AMH in your blood can provide an indication of your ovarian reserve. Think of AMH as an indirect marker rather than an egg counter. It cannot tell you exactly how many eggs are left in your ovaries, but it can help show whether your ovarian reserve appears higher, lower or around what would be expected for your age. You’re born with all the eggs you’ll ever have, as we age, both our egg quality and quantity declines. As the pool shrinks, so does your AMH, which is what makes it such a useful window into where your reserve sits for your age. What is a normal AMH level for my age? There is no single normal AMH level that applies at every age. AMH naturally declines as you get older. A level that might be considered relatively low for someone in their 20s could be entirely expected for someone in their early 40s. That means the most useful question is not if you levels are good or bad, but more about how your levels compare with what is expected for someone your age? Broadly, AMH is higher in your twenties and declines through your thirties, with a steeper drop from the mid-thirties onwards, though there’s wide natural variation, and some people have a lower reserve earlier than expected. AMH results are also assay-specific. Different labs use different testing platforms, and because there’s no single international standard for calibrating AMH, a number from one lab can’t be directly compared to a number from another. This is why a result is only meaningful when it’s read against the reference range of the exact lab that ran it. At Hertility, AMH is interpreted using age-stratified reference ranges, so your result is compared with the expected range for people of a similar age rather than against one universal cut-off. Your result should also be interpreted alongside factors such as your cycle history, symptoms, hormonal contraception, medical history and fertility goals. How does AMH change with age? AMH is generally highest earlier in reproductive life and decreases as the ovarian follicle pool declines with age. There is, however, a lot of variation between individuals. Two people of exactly the same age can have quite different AMH levels without either necessarily having a reproductive health problem. This is why age matters so much when interpreting AMH. AMH also shouldn’t be confused with egg quality. Although both egg number and egg quality decline with age AMH measures the follicle pool. It does not tell us whether the eggs within that pool are chromosomally healthy. What does a low AMH level mean? A low AMH result means your ovarian reserve appears lower than expected for your age. It does not mean that you cannot get pregnant. This distinction is really important. AMH is much better at predicting how your ovaries may respond to fertility medication than it is at predicting whether you will conceive naturally. Current NICE guidance specifically says AMH should not be used to predict the chance of pregnancy through spontaneous conception. Instead, AMH or an antral follicle count (AFC) can be used to predict ovarian response when planning assisted conception. So if your AMH is low, it may mean that fewer eggs would be expected to develop during an IVF or egg-freezing stimulation cycle. Depending on your age and plans for pregnancy, it may also be useful information when thinking about fertility timelines. But it does not tell us whether the eggs you have are healthy, whether you are ovulating, whether your fallopian tubes are open, whether there are any issues affecting your uterus or, where relevant, whether sperm factors could affect conception. Does low AMH mean I can’t get pregnant? Many people with low AMH conceive naturally and without difficulty, particularly when they are younger and their egg quality is high. What low AMH does mean is: It tells you that your egg quantity is lower than average for your age. If your AMH is very low, particularly if you are under 40 and also have irregular or absent periods or symptoms associated with early menopause, your doctor may want to investigate further for conditions such as premature or primary ovarian insufficiency (POI). AMH alone, however, does not diagnose POI. Does high AMH mean I am fertile and won’t have problems conceiving? A high AMH level usually means there are more small follicles in the ovaries than expected for your age. It does not automatically mean you are more fertile. This is another common misconception about AMH. More follicles may mean a larger ovarian reserve, but natural fertility depends on much more than egg quantity. AMH cannot tell you about egg quality, whether you ovulate regularly, the health of your fallopian tubes or uterus, or sperm quality. Higher AMH is also commonly seen in people with PMOS, formerly known as PCOS, because the ovaries often contain a greater number of small follicles. A high AMH result therefore needs context rather than being interpreted as simply “good”. Can AMH diagnose PMOS or PCOS? AMH can contribute to a PMOS/PCOS assessment in adults, but it cannot diagnose PMOS on its own. Under current international guidance, AMH […]

Hormones help to regulate almost all of the body’s processes, including reproductive health and fertility. Testing your hormones regularly can give you insights into your overall health and help you track changes in your menstrual cycle and fertility over time. Here we’ve broken down which hormones you should test and why.  Quick facts: What are hormones? Put simply, hormones are small chemical messengers that travel through the blood to different parts of your body. They help control many different functions from growth and development to metabolism, the menstrual cycles, fertility and mood, just to name a few. Hormones are made by special cells in the endocrine system. Some of the major endocrine glands are: Why are sex hormones important? Sex hormones are a group of hormones that help to regulate the female and male reproductive organs and fertility. They are important not only for reproductive health but for overall health too—often having multiple functions within the body.  The main hormones involved in the female reproductive system are:  Thyroid hormones can also impact your levels of reproductive hormones. Why do you need to test your hormones? Hormones are often involved in complex feedback loops with one another. This means if one hormone gets off balance, it can often disrupt the whole system and bring about multiple, often overlapping symptoms.  Our hormones are also changing constantly, as we age and in response to things like lifestyle factors, medications or external stresses. A change in your hormone levels could be the reason you’re feeling sluggish or slightly emotional, explain your irregular periods or why you’re struggling to get pregnant. Our hormone levels can give us insight into both our overall reproductive health, show our risk factors for certain conditions, explain any unwanted symptoms, or indicate the health of our ovarian reserve and fertility.  Which hormones should I test? Which hormones you need to test and monitor will depend on your individual medical history, symptoms, biometrics and fertility goals. Luckily, our Online Health Assessment is built on a proprietary algorithm that does the leg work for you, recommending you hormone panel personalised to you.  Let’s take a look at each of the main female sex hormones and what testing them could tell you.  Follicle-stimulating hormone One of the main hormones that regulate the menstrual cycle and fertility is follicle-stimulating hormone (FSH). Its main job is to stimulate your ovaries each month to mature a set of follicles (the sacs that house the immature eggs) into mature eggs.  If FSH gets out of balance, ovulation can be affected, negatively impacting fertility and causing irregular cycles.  FSH levels increase with age. High FSH is usually an indication that ovarian reserver is declining and more FSH is needed to encourage your eggs to grow. This is why monitoring FSH can help you understand the health of your ovaries.  FSH levels will slowly increase with age as your ovarian reserve declines. When your ovarian reserve is finally depleted (and menopause occurs), FSH levels become substantially elevated. This is why FSH is used as an indicator of menopause.  Persistently high FSH levels in someone younger than 40, along with irregular periods and vasomotor symptoms, could indicate premature ovarian insufficiency (POI). This is when someone experiences menopause before the age of 40. FSH levels are usually not recommended as an indicator of menopause beyond the age of 45. Oestrogen (Oestradiol) Oestrogen is an important hormone for the growth and maturation of eggs and the thickening of the uterus lining each cycle. It’s also incredibly important for overall health, regulating bone, heart, skin and hair health, as well as mood.  Oestrogen is made by the ovaries, so monitoring oestrogen levels gives a good indication of how well your ovaries, and menstrual cycle in general, are functioning. Oestrogen levels will fluctuate and eventually significantly drop when your ovarian reserve becomes depleted and menopause occurs. Low oestrogen levels are therefore linked with many symptoms of menopause, such as dry skin and hair, vaginal dryness, hot flushes, brain fog, night sweats, difficulty falling asleep and fatigue.  Luteinising hormone (LH) LH is the hormone responsible for triggering ovulation, which is the release of the mature egg from an ovary each month.  If your LH levels are too low or too high, it can interfere with ovulation. High LH levels are often seen in those with Polyendocrine Metabolic Ovary Syndrome (PMOS, formerly known as PCOS), which can cause irregular ovulation and issues with periods and fertility. Anti-Müllerian hormone (AMH) Anti-Müllerian Hormone (AMH)  is a super important hormone for fertility and overall reproductive health. AMH is made by the small sacs, called follicles, in your ovaries. These follicles house your eggs.  Since AMH is made by the follicles, your AMH levels can therefore give you an insight into your ovarian reserve, or how many eggs you have at the time of testing.  We were all born with all of the eggs we’ll ever have, and as we age, both our egg quality and quantity decline. Generally, our AMH levels will decline with age as our egg count diminishes, unless we have an underlying condition or lifestyle factor which is affecting our AMH levels (like PMOS).  High AMH levels can be an indicator of polycystic ovaries and can be used to diagnose PMOS based on recently updated clinical guidelines. On the other hand, low AMH along with high FSH and low oestrogen is usually an indicator of low ovarian reserve.  AMH is often also used to predict someone’s chances of success during fertility treatment, such as egg freezing and IVF. However, it’s important to remember that AMH can only tell you about the quantity, and not the quality, of your eggs. Testosterone Testosterone can be converted to produce the wonder hormone oestrogen and is also associated with libido, maintaining muscle mass, vaginal health, breast health and bone health.  High levels of testosterone can cause symptoms such as excess body and facial hair, acne, and irregular or absent periods. These symptoms are often seen in women with PMOS […]

COVID-19 and the shift to remote working has catalysed the demand for mental health benefits – it is now a “must have” for employers in 2021. In fact, in a recent survey, 91% of respondents stated that a company’s culture should support mental health. It is no coincidence that mental well-being is included in how reproductive health is defined by the World Health Organisation, stating that “Reproductive health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes”. These two elements of well-being are interconnected. As a result, it is impossible to provide comprehensive mental health benefits without considering the impact that reproductive health conditions can have and figuring out how employees dealing with those can be supported. How do reproductive health conditions affect mental health? InfertilityTake infertility, which affects 1 in 6 couples in the UK. Despite its prevalence, it is often met with confusion and denial.. This can seriously impact mental well-being – feelings of anxiety, depression and loss are all common. Besides, treatment can be time-consuming, stressful and a significant financial burden for individuals. Leading employers in the benefits space are recognising the impact that infertility may have on mental health and offering “fertility leave” as well as compassionate leave after miscarriage. EndometriosisReproductive health conditions such as endometriosis are associated with difficulty conceiving and chronic pain, both of which impact quality of life. Alongside having increased sick leave and loss of productivity, women with endometriosis feel their career goals were impacted negatively. Premenstrual syndrome (PMS)PMS describes the array of physical and emotional changes that occur as part of the monthly cycle. Approximately 90% of people who menstruate experience PMS. In some cases, this can be debilitating, a condition known as premenstrual dysphoric disorder (PMDD). PMDD can be so severe that suicidal thoughts are common in these women. Undiagnosed health issuesUnfortunately, it is not just the physical manifestations of the conditions alone that may impact employees’ mental health. Stigma and shame on reproductive health conditions from society and inadequate support from healthcare with symptom dismissal and months or years required to get to a diagnosis can be a significant cause of anxiety or depression for people suffering from a reproductive health condition. Many things in this journey even after getting the answers are outside of employees’ control. There are no guarantees that fertility treatments will succeed; failed attempts can seriously affect mental health, especially in those cases where little can be done to change the outcome. How can you support your employees on their reproductive health journey?There are several things that you can do to help alleviate the burden reproductive health conditions can place on mental health. Destigmatise reproductive health conditions by encouraging education and learning. This is a great way to challenge the current attitude to reproductive health conditions in the workplace and facilitates supportive conversations. Joining schemes provided by charitable bodies such as the Endometriosis Friendly Employer scheme can help you to make those first steps. Create a supportive workplace environment through flexible working hours for those who need to attend multiple appointments, inclusive leave policies and offering free menstrual products in bathrooms. Provide comprehensive reproductive health benefits by partnering with companies like Hertility to connect your employees to expert care and help them make informed decisions with regards to their reproductive health. These can include things such as proactive testing opportunities with actionable insights, fertility counselling, referrals to trusted clinics and specialist care with experts in the field. About Hertility HealthHertility Health is shaping the future of Reproductive Health by giving women the ability to understand and manage their fertility and hormone health from menstruation to menopause. 1 in 3 women suffer from a reproductive health issue, yet conversations around fertility, menopause and menstrual symptoms are still stigmatised in the workplace. As employees suffer in silence – up to £4k is lost per year per employee due to reduced productivity, absenteeism and presenteeism. Hertility reduces the need for unnecessary appointments and delay in diagnosis time through an online health assessment and at home test. To learn more about our Reproductive Health Education and Benefits for Employers, reach out to benefits@hertilityhealth.com or visit our website.

Deciding to start a family is never an easy process, but for some employees who identify as part of the LGBTQ+ community, their journey to parenthood might need some more support. Being a 21st-century employer means establishing an inclusive, progressive and supportive work environment to attract and retain employees. A 2017 study by Mercer found that 33% of UK respondents do not offer equal benefits to LGBTQ+  employees because they do not know how to implement such a benefit! Check your fertility Here are some ways to provide support to your LGBTQ+ employees in their fertility journeys Recognise that there are multiple paths to parenthood Partner with experts like Hertility to raise awareness about the advances in fertility treatments such as IVF (in vitro fertilisation), IUI (intrauterine insemination), surrogacy, etc., that made it possible for LGBTQ+ couples to have biologically related children. Refer your employee to resources like Hertility that may help them understand the basics of all things reproductive health will make them more confident in their reproductive journeys. Don’t treat fertility treatment as a lifestyle choice Gender-affirming treatments can impact fertility, and therefore, many require fertility preservation, such as banking eggs, sperm or embryos before medical transition. With the number of NHS-funded cycles declining rapidly, LGBTQ+ couples have to fulfil extensive criteria before being eligible for a funded cycle, because of which,  many are opting for private treatment, where the average cost per cycle can be about £5,000, varying significantly depending on the treatment options chosen and the clinic (HFEA). Listen to feedback from employees,  ask them what they would want to feel more supported in their choices and try to develop policies around them. Establishing fertility benefits policies – covering proactive fertility testing, fertility treatment or egg freezing costs or providing low-interest loans – can help align your interests with your employees, supporting their individual journeys to parenthood, facilitating equality, diversity and inclusion. Ensure you have fertility leave policies and make sure they are inclusive If you have existing family planning and health benefit policies, revisit the language and clauses to ensure LGBTQ+ employees are eligible for the equal benefits to support them as they embark on their parenthood journey, whether that be through fertility treatment, surrogacy, adoption, or parental leave. Hertility can help train your staff on all things related to policies. About Hertility Health Hertility Health is shaping the future of Reproductive Health by giving women the ability to understand and manage their fertility and hormone health from menstruation to menopause. 1 in 3 women suffer with a reproductive health issue, yet conversations around fertility, menopause and menstrual symptoms are still stigmatised in the workplace. As employees suffer in silence – up to £4k is lost per year per employee due to reduced productivity, absenteeism and presenteeism. To learn more about our Reproductive Health Education and Benefits for Employers, reach out to benefits@hertilityhealth.com or visit our website. Trusted resources: https://www.imercer.com/uploads/dmi/2017_lgbt_sample.pdf https://www.bpas.org/media/3484/bpas-fertility-investigation-nhs-funded-fertility-care-for-female-same-sex-couples.pdf