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Private fertility tests & MOT in London

 

Our fertility health MOT provides a baseline to check the health of the female reproductive system including high definition ultrasound scanning.

 

 

*Verbal Result. Written report within 24hrs.

What is the objective of the fertility MOT?

The fertility MOT will assess the general gynaecological health of  the female reproductive system using ultrasound and blood tests. It will also provide valuable information about the potential of the ovaries to provide eggs, called the ovarian reserve. The blood test will provide information about ovarian health in several different ways and also include information about the ovarian reserve. This information can then be used in conjunction with a fertility specialist to provide you with further guidance regarding your fertility.

 

What is the objective of the ultrasound scan?

The transvaginal ultrasound will check the general gynaecological health of the womb (uterus), the lining of the womb (endometrium)  and more specifically in relation to fertility allow a detailed inspection of the ovaries. Examples of potential problems related to fertility include uterine fibroids and polycystic ovaries. 
The transvaginal ultrasound also includes assessment of ovarian antral follicle count (AFC). The AFC is an important tool used to evaluate ovarian reserve, or the potential of the ovaries to provide eggs.
This test shows how many eggs a woman has at any given point in time and is currently regarded as one of the best tests to check for ovarian reserves. 

 

What do the blood tests check for?

We offer 2 packages with blood testing, the basic and advanced fertility MOT.

The basic MOT includes the following female reproductive hormones:

 

 

Basic Fertility MOT

Ideally on days 2/3 of your cycle

Luteinizing Hormone​ (LH)

Follicle Stimulating Hormone (FSH)
Prolactin

Oestradiol (17-Beta)

Antimullerian Hormone (AMH)

 

The advanced MOT includes a wider range of parameters, including female reproductive hormones:

 

Advanced Fertility MOT 

Ideally on days 2/3 of your cycle and with you fasting

Luteinizing Hormone​ (LH) Follicle Stimulating Hormone (FSH)
Antimullerian Hormone (AMH) Prolactin
Oestradiol (17-Beta) Testosterone
Sex Hormone Binding Globulin (SHBG) DHEAs
​Glucose Lipids

NB. Blood results should be shown to your regular health care professional / Fertility specialist for interpretation.

 

How do I prepare for this health check?

  • A full bladder is required for this scan – Please drink 1 litre of fluid approximately 1.5 hours before your scheduled appointment and please try your best not to empty your bladder before the examination.
  • An internal scan is often necessary therefore please wear loose clothing to help facilitate this. 
  • Fasting is required for advanced fertility MOT. In all other tests you may eat as normal.

 

 

Fertility: Background 

Fertility is defined as the ability to conceive children. Subfertility is defined as reduced or impaired fertility, or production of fewer offspring than is normal or average. Infertility is the inability to conceive children.
Many factors are needed to work correctly for both partners in order to successfully conceive. These factors include age, weight, sexually transmitted infections (STIs), smoking, environmental factors such as exposure to certain pesticides, heat or solvents and stress.
In women, specifically, other factors also have an effect. They include ovulation disorders such as polycystic ovaries, thyroid problems and gynaecological disorders including problems with the womb (uterus) or fallopian tubes, scarring from surgery, medicines and drugs.
In men other factors include abnormal semen, testicular problems, hormonal problems, medicines, drugs and alcohol. 

Fertility problems affect 1 in 7 couples in the UK, around 3.5million people. For most couples, engaging in regular unprotected sex is all it takes to become pregnant, however knowing the basic facts about fertility can often be very insightful and helpful in conceiving.

 

Your monthly cycle - the low down

Ovulation

Every month hormonal changes in a woman's body cause an egg to be released from her ovaries. This egg travels into the fallopian tubes, which connect the womb to the ovaries. Conception is most likely to occur if unprotected sex occurs a day or so after ovulation. In many women, ovulation takes place around 14 days after the first day of her last menstrual period (LMP).

 

The Setting

For conception to occur the sperm must fertilise the egg within 12-24 hours after it is released, however as sperm can live inside a woman's body for up to 7 days, an egg can, therefore, get fertilised by sperm that entered the body before the egg was released. 

How long does it take to get pregnant?
  • 90-92% of couples in which the female is under 30 will conceive  after one year of having regular unprotected sex. The risk of miscarriage for women under 35 is around 6%.
  • 75-80% of couples in which the female is between 35-39 will conceive after one year of having regular unprotected sex, however, the risk of miscarriage increases to around 15%. 
  • For women in their early 40s, the chances of conception further decrease to around 50-60% with the risk of risk of miscarriage increasing to around 23%.

 

As women age they will become less fertile and have a lower quantity and quality of eggs, potentially reducing the chances of conceiving children and increasing the chances of miscarriage. Certain medical problems in the past such as ectopic pregnancy or surgery can also affect fertility. 

If you have been trying for more than a year and have not been successful then it is useful to seek advice from a healthcare professional who can perform tests such as hormone blood tests and an ultrasound scan to identify possible fertility problems.

 

Subfertility & Infertility

​Common causes of subfertility and infertility that affect women include age, cancer treatment, lack of regular ovulation, blockage of the fallopian tubes, endometriosis, certain lifestyle factors such as stress, and sexually transmitted Infections (STI). 

  • Age - As a women's age increases the number and quality of eggs in her ovaries decreases. This reduction can have an effect on fertility as there are potentially fewer eggs that are suitable to be fertilised.
  • Menopause - A women's biological clock is always ticking. Sooner or later her menstrual cycle will come to a stop as the number of eggs in the ovaries reduces to a few thousand. This change is called the menopause and in most instances occurs in the 40s or 50s. There is, however, no specific age that the menopause develops.
  • Miscarriage - Unfortunately data from recorded miscarriages show more than 1 in 5 pregnancies ends in miscarriage.

 

In around 25% of couples the cause of fertility problems cannot be found and is unexplainable. 

 

What is Ovarian Reserve?

As mentioned age is one of the most important factors when estimating the probability of conception as it is a strong determinant of egg quality and quantity. Each woman is born with all the eggs she will ever need. The number of these eggs constantly decreases with age and by the time she undergoes the menopause the store is depleted. 
Screening tests can check how many eggs remain in a woman at any given point in time, however, cannot provide information about the quality of the eggs. Age is currently regarded as the best test for egg quality.

These tests performed to check the number of eggs are often referred to as ovarian reserve, which essentially refers to the remaining egg supply or store of the ovaries at a given period in time. 

 

What are antral follicles and why are they important?

Follicles are small fluid sacs that contain an immature egg, found in the ovaries. During ovulation, a mature egg is released from a mature (dominant) follicle. 
Antral follicles are small follicles present in the ovaries that we can see during the transvaginal ultrasound scan. These follicles are typically very small, between 2-9mm in diameter, and can be regarded as ‘developing’ follicles which contain an immature egg. These follicles can potentially produce a mature egg and ovulate in the future. The amount of these follicles is indicative of the number of developing follicles remaining in the ovary and thus provide a guide on the number of eggs. 
The fewer the number of visible antral follicles, the fewer the eggs remaining. Conversely the higher the number of visible antral follicles, the higher the remaining eggs. As already mentioned as a women ages, she will naturally have fewer eggs remaining, therefore, having fewer antral follicles. 

During the ultrasound, these small follicles are counted, providing a quantitative figure called the antral follicle count (AFC). This information, along with female age is currently considered by far the best tool for estimating the ovarian reserve.

Also in IVF, the number of eggs retrieved correlates with IVF success rates and chances of IVF success. AFCs are also a good predictor of the number of mature follicles that will be able to stimulate with medicines used in IVF.

 

What is Anti-Mullerian Hormone (AMH)?

Women are born with their lifetime supply of eggs, and these gradually decrease in both quality and quantity with age. Anti-Mullerian Hormone (AMH) is a hormone secreted by cells in developing egg sacs (follicles). The level of AMH in a woman's blood is generally a good indicator of her ovarian reserve.

 

AMH is a hormone found in the blood. It is produced by cells in the ovarian follicles during reproductive age. These follicles have different stages of development from their earliest “sleeping” stage to a mature stage where it has produced and released a mature egg.  AMH is first produced in the very early stages of a follicles life cycle. At this stage these tiny follicles that make AMH are only visible under a microscope and cannot be seen on an ultrasound. AMH increases and is highest in the preantral and antral stages of development (typically less than 4mm in diameter). As small antral follicles further develop AMH production falls and eventually stops once it reaches over 8mm. 
Measurement of AMH is not dependent on the stage in the menstrual cycle and can be performed at any time. 

 

Why is Anti-Mullerian Hormone (AMH) important in fertility?

AMH is only produced by the smallest of follicles in the very early stages of development, which cannot be seen on an ultrasound scan. Therefore by checking the levels of AMH it is possible to measure the size of the pool of growing follicles in a woman which reflects the size of the remaining egg supply or “ovarian reserve”.
Unfortunately, AMH does not provide an indication of the egg quality. 

Women with higher AMH values will tend to have a better response to ovarian stimulation for IVF and therefore have a greater number of eggs retrieved and in general, the more eggs retrieved gives a higher success rate. 

 

Please note

  • We will require details of your GP / Health Care Professional, which may be requested prior to or at the time of the scan.
  • This scan requires access to the area of interest, therefore it is recommended to wear loose clothing to facilitate this process.
  • Blood results require interpretation and all results should be shared with your regular health care professional / GP / Fertility specialist.
  • All of our first line ultrasound scans & health MOT's are optional. You must be at least 16 years old and you should have no existing medical condition or treatment pending that relates to the scan/MOT you are booking. If you are in any doubt about having any type of test, you should consult your GP.