What exactly is a fertility MOT?
“Think of it as a top-line assessment of your reproductive health. Tests vary from clinic to clinic – with some being more comprehensive than others – but they tend to include a blood test to gauge ovarian reserve (known as your AMH), another to assess levels of a hormone called follicle stimulating hormone (FSH) and an ovarian and uterine ultrasound to determine the number of follicles in the ovaries on that given month, as well as to check the lining and health of your uterus. It’s worth noting these tests were originally designed to assess viability for IVF, or a guide to estimate how many eggs are likely to be collected in an IVF cycle, rather than a measure of natural fertility. So, where an MOT can be useful to catch any ‘red flags’ as early as possible to guide decision making, many of the markers aren’t accurate predictors of how likely you are to get pregnant.” – Emily Barker, registered nutritional therapist at the Fertility Nutrition Centre
What are the benefits?
“These tests may give you peace of mind about delaying starting a family or could help you decide if egg freezing is something you wish to consider. Or perhaps you’re looking for reassurance after some months of trying to conceive. When the results aren’t what you expected, these tests can provide the impetus to seek fertility treatment and motherhood sooner than planned – either with a partner or without.” – Dr Lara Hodges, fertility specialist at TFP Fertility UK
How accurate are these tests?
“Most standard fertility MOTs only test a limited number of parameters, one of them being AMH, which makes them an inaccurate measure of your fertility when done in isolation. AMH is made by the small sacs, called follicles, in your ovaries, and these follicles house your eggs. Your levels can give you an insight into your ovarian reserve, or how many eggs you have at the time of testing. We are born with all the eggs we’ll ever have, and as we age both our egg quality and quantity declines. 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 PCOS). Understanding your ovarian reserve can help determine if IVF or egg freezing could be suitable for you. People with lower AMH levels are known to have less successful IVF treatment cycles, meaning lower implantation and pregnancy rates. However, although AMH levels can give insight into your egg quantity, it does not provide any insight into the quality of those eggs.” – Dr Helen O’Neil, CEO & co-founder of Hertility Health
“Many clinics use your AMH level as a marker of your fertility, but a bigger picture is needed for accuracy. Some women with low AMH won’t struggle to get pregnant, and some with an above-average level will need IVF, so it’s important to bear this in mind. Looking at levels of oestrogen, LH, progesterone, testosterone, prolactin and thyroid function will give you a fuller picture and help you troubleshoot any hormonal issues as early as possible.” – Emily
Should you repeat the test after a certain timeframe?
“Depending on your results in an initial assessment, an annual AMH blood test could be a good way to screen and monitor your ovarian reserve. If it’s stable and there’s no rapid decline in your egg store, you may feel reassured by this. However, the tests are a snapshot in time and don’t predict future fertility absolutely. An annual check-up is reasonable.” – Mr Ed Coats, medical director at The Evewell
Does contraception affect your results?
“Yes – you should wait for a minimum of three months after coming off contraception before testing or getting a scan. There is evidence that AMH levels are temporarily suppressed when using contraception, and your menstrual cycle patterns when on contraception won’t be representative of what’s normal for you. Getting your AMH levels tested when using contraception can still flag conditions like a very low egg reserve or polycystic ovaries, although for the most comprehensive assessment, wait three months.” – Helen
“We recommend waiting for two natural cycles after coming off contraception before getting tested. If you’re taking the test for future fertility, it’s always good to understand your natural cycles before getting professional support.” – Zita West, fertility expert
Is there an ideal age to get tested?
“Statistics show us 80% of people conceive within the first 12 months of trying, and if you’re under 40, this rises to 90% after two years. So, if you’re under the age of 40, you don’t want to wait until you have tried naturally for two years. However, after six months of trying, no matter your age, you should request some routine blood tests via your GP and a semen analysis as a basic starting point. Where many of us are leaving it later to have children, this may help uncover potential issues promptly, so that if IVF is needed, you aren’t leaving it too late. Following this, if you have found out about potential issues on both sides, it would then be beneficial to pursue a fertility MOT.” – Jen Walpole, nutritional therapist specialising in fertility & IVF nutrition
Is it worth getting checked with your GP first, then?
“Yes. If you are struggling to get pregnant, your GP can test some basic hormones, but ensure they guide you on what days of your cycle these bloods need to be done, whether the test should be fasted or not, and whether it needs to be taken in the morning. Often, I see female hormone blood tests haven’t been taken on the correct day of the cycle. Some often overlooked markers which can be helpful to consider in a fertility picture also include prolactin, vitamin D, iron, and SHBG. Your GP can also put your partner forward for a semen analysis, rather than paying a premium price for this via a fertility clinic MOT.” – Jen
Is there anything else you can do to assess your fertility?
“If you’re in a relationship, it’s worth getting a comprehensive semen analysis. Whilst we cannot test the quality of eggs, we can test semen quality via a DNA fragmentation – or SpermComet – test. All too often, I see normal semen parameters, yet the DNA fragmentation testing can tell us otherwise – that inside the head of the sperm, there is significant DNA damage, which can mean an increased risk of miscarriage or even birth defects. On the female side, it’s also worth testing your vaginal microbiome, which is gaining traction in the fertility world due to the strong links between the beneficial bacteria present in the vagina and better fertility outcomes.” – Jen
“Unless you know you want to pursue IVF, it could be more beneficial to have a comprehensive check of your reproductive health. There is no test that can fully predict your ability to conceive, but you can still check for common conditions known to affect fertility, such as pelvic issues or ovulatory disorders. At Hertility, our fertility MOT starts with an online assessment that screens for 18 common conditions, so we can provide you with the most appropriate blood tests and direct you towards additional investigations, like pelvic ultrasound scans, tubal patency tests or a fertility clinic referral. This enables us to perform the same checks as a female fertility MOT, but also assess for anything which may affect your general reproductive or gynaecological health.” – Helen
The bottom line?
“Fertility MOTs can be misleading. They often aren’t as comprehensive as some couples are led to believe. If you’re doing an MOT with an IVF clinic, for example, they’ll only be checking for your suitability for IVF rather than trying to get to the root cause of your fertility struggles.” – Jen
“Don’t forget these screening tests are just a snapshot in time and your fertility changes. These tests can be very informative and raise important issues that need attention, but at the same time, if your results are good, bear in mind this may change in the future. If the results aren’t so good, you may need emotional support and guidance as to what to do next.” – Ed
“Remember every test has a result, and you should think about what you’d do if the results aren’t quite what you expected. Are you in a position to try for a baby immediately, or will this add unnecessary stress?” – Zita
“Navigating your fertility can be wrought with anxiety, and when there’s fear in the mix we often seek reassurance in the way of black and white answers. With fertility, unfortunately, there’s always a degree of unknown, and it’s important to understand this when going down the testing route. No test can guarantee you’ll have no issues conceiving, so it will never provide 100% reassurance. MOTs are just part of the fertility picture.” – Emily
DISCLAIMER: Features published by SheerLuxe are not intended to treat, diagnose, cure or prevent any disease. Always seek the advice of your GP or another qualified healthcare provider for any questions you have regarding a medical condition, and before undertaking any diet, exercise or other health-related programme.