Fertility testing offers you the chance to make informed choices. No two couples are exactly the same and there are a myriad of factors to consider when thinking about family planning – career, finances, and as much as many couples don’t want to hear this – age and biology.

Is my ovarian reserve still looking good? Might I need any treatment? Is my partner showing signs of sperm deterioration? When you have the answers to these questions, you can decide to either take your time, hurry things along, or seek fertility treatment accordingly.

But how do you know if you need fertility screening? We spoke to Co-Director of The Fertility and Gynaecology Academy, Dr Gorgy, to find out. He told us that to answer that question, you actually need answers to the following questions.

1) Have you been trying to get pregnant for a year or more?

‘Generally we fertility doctors say a year is the standard amount of time a couple could try to conceive before seeking fertility screening,’ Dr Gorgy said. ‘However, whether you should actually wait a year or not will completely depend on other factors (addressed here).’

2) Are you aged 35 or older?

‘If you are 35 or older, regardless of how long you’ve been trying, you might want to get tested because in large part, time is fertility,’ Dr Gorgy said. ‘Even IVF is time-sensitive – the younger you are, the more chance it has of working. Your odds of getting pregnant start to decrease markedly after age 35 and so if there are any potential bumps in the road, it’s better to find out sooner rather than later.’

3) Are you considering delaying parenthood?

‘If you are thinking about delaying parenthood it is a good idea to get a sense of how your ovarian reserve is looking,’ Dr Gorgy said. ‘Remember, women don’t all possess the same number of eggs, and the speed with which their quality decreases varies from woman to woman.

‘And bear in mind, male fertility decreases with age too. Yes, men continue to produce new sperm but crucially, the quality of that new sperm will decrease as the man ages. The older he gets, the greater his chances of lower sperm count and sperm quality. What’s more, studies have demonstrated that older sperm is more likely to carry genetic errors, which have been associated with problems like ADHD, bipolar disorder, and autism in children.’1

4) Are you considering freezing your eggs and/or sperm?

‘Freezing your eggs or sperm is an investment. For example, a woman over the age of 40 has more chance of achieving a healthy pregnancy with eggs frozen in her mid-thirties, than with fresh eggs over 40 years old.’

‘That said, gamete (egg/sperm) freezing is a significant financial outlay so really, a responsible fertility doctor will say to any woman or man looking at fertility preservation: “get screened first.” in order to know what the quality of your gametes is before deciding to freeze them.’

5) Have you had medical treatment or surgery that may have affected your fertility?

Treatments such as chemotherapy can cause infertility. Pelvic surgery can also result in scarring and damage of the fallopian tubes. Surgery on the cervix can sometimes lead to cervical damage or scarring too. Testicular cancer and/or testicular surgery can also affect fertility.

Neuroleptic medications (such as antipsychotics) can cause problems. Long-term steroid use in men can lead to a decrease in sperm quality.

6) Do you have irregular periods, or a medical condition that can affect ovulation (such as polycystic ovarian syndrome, endometriosis)?

If you have any of these kinds of problems, it is worth seeking fertility testing. Endometriosis and polycystic ovarian syndrome can affect ovarian function and although many women with these issues will not experience problems falling pregnant, many will. What’s more, conditions like endometriosis progress at different rates for different women2. A fertility test will examine your reproductive system and ovarian reserve, letting you know whether to think about assisted conception.

7) Have you had an ectopic pregnancy, or experienced recurrent miscarriage?

‘If you have experienced several miscarriages in a row, you should get screened,’ Dr Gorgy says. ‘There could be all sorts of problems in play and here at The Fertility and Gynaecology Academy, we have a range of special tests that we can also employ if we suspect the problem may be something more unusual, like an immune issue.’

If you have had a previous ectopic pregnancy, conceiving can be difficult and there are associated risks. The fallopian tubes of women that have had ectopic pregnancies are often scarred, blocked or damaged. Fertility investigation can determination this.

8) Have you had a sexually transmitted infection that could have affected your fertility (such as chlamydia or gonorrhoea)?

Chlamydia and gonorrhoea can lead to infertility in both men and women. For example in women if left untreated, chlamydia and gonorrhoea can spread to the uterus, ovaries or fallopian tubes, and cause pelvic inflammatory disease (PID). These conditions can go under the radar for a long time, so when you were diagnosed you may have had no idea how long you had been affected. Therefore if you have had these problems, particularly if you are in your mid-thirties, you may want to get checked in order to save time.

If you answered yes to one or more of these, we recommend you seek fertility testing.

Here at The Fertility and Gynaecology Academy, we offer gold standard fertility screening for women and men. We specialise in complex cases and our assisted conception success rates are among the UK’s highest.
To find out more call 020 7224 1880.

References

 [1] http://jamanetwork.com/journals/jamapsychiatry/article-abstract/1833092
 [2] https://www.endometriosisaustralia.org/single-post/2016/12/05/Fertility-and-Endometriosis-%E2%80%93-Should-I-worry