It's not breaking news that women are leaving starting a family until later. But it can be a bit of a gamble to assume you'll be able to have a baby when you choose to – especially if it's when you're a bit older.
A new trend for 'Fertility MOTs' suggests couples are becoming less complacent and are keen to find out if everything is in working order, even before they have any intention of starting a family.
Mrs Yasmin Sajjad, fertility consultant at Spire Liverpool Hospital, says: "The growing popularity of our fertility MOTs reflects a rising trend of young couples and singles seeking peace of mind on their fertility status."
There is less complacency, as more and more couples suffer from infertility – almost 40,000 British women had IVF in 2011. Gone are the days when women think: "I'll be fine, I'm fit, I don't drink much, I don't smoke, I exercise..."
In fact, women in their mid to late thirties are more likely to have a friend – or several – who have had problems conceiving and are less likely to assume they will have no problems.
"At 25 to 27 years old a woman's fertility is already starting to decline", explains Yasmin. "Upon reaching 35, chances of conception have often halved. Women who take an early assessment of their fertility can make informed decisions about their options later down the line, including the possibility of having eggs frozen for a later date."
The NHS will, in some cases, provide an assessment for free. But in most cases, women or couples will need to book into a private clinic or hospital. Clinics and hospitals offering the service, which costs in the region of £200-£400, include:
Yasmin also adds that they have seen an increase in the use of the clinic by couples in the middle of trying for a family. "Many couples are leaving it later to try for children, which simply put means they can't afford to wait around. If they have been trying for a year with no success then they should visit a GP, but often taking this route can mean they end up on waiting lists for tests and to see a fertility expert.
"This wait can mean the difference between having a child and not, as some couples have left it too close in terms of their fertility or accessing IVF on the NHS, where the cut off for funding is often around the age of 40. This means that the women should be referred for assisted conception treatment at least six months before their 40th birthday."
So what sort of test do these MOTs actually include? Usually, the tests will just take an hour or so and you'll be asked to come back and discuss the results in a follow up appointment. A blood test for anti-Mullerian hormone (AMH) is often carried out, to check egg reserve, an ultrasound scan is also sometimes done for the same reason and to check blood flow, ovulation, womb lining, blood flow to the womb and exclude any abnormalities (immediate result).
Tubal patency tests are also sometimes included. For men, a semen analysis is usually offered.
But what are the downsides of this kind of test? We asked Ffyona McKeating, creator of the non-profit website Fertility Fighters. "I think they can be a good idea, but there is a danger that someone will be lulled into a false sense of security of thinking that all is well, when it isn't. These tests won't show immune issues or many others that we come across on the forum – and a third of infertility is idiopathic anyway, meaning these tests wouldn't shed any light at all.
"The biggest cause of infertility is egg quality – many women would do as well to have their eggs frozen as have a test like this, giving them all the time in the world. You freeze your eggs at 30, and you can have those children at 50 if you want with pretty much the same success rate as a 30 year old!"
Erica, 34, and Ken Wilson, 35, have undergone a Fertility MOT to allow them to plan when to start trying to conceive.
Erica Wilson used the fertility MOT to help make an informed decision on when she and her husband should start trying for children.
She says: "I came to Spire a few years ago for a fertility MOT at the age of 31. I was keen to see if there were any issues, and help become better informed so myself and my husband Ken could find out when we should start trying for children. It ended up being a very good decision because we found out early on that there were problems and it has given us time to address this."
Erica is now going through a treatment called ICSI, Intra-cytoplasmic sperm injection. This involves injecting a single sperm into an egg in order to fertilise it. It's then transferred back to the woman's womb as an embryo.
"So far we have undergone a few treatments of ICSI through the NHS", Erica says. "The treatment went smoothly but unfortunately it hasn't worked. It's now been diagnosed by Mrs Sajjad that I have certain cells, which identify the embryo being put back in my womb as a foreign body and I am now on a course of steroid treatment which should prevent this.
"Ken and I are now really hopeful that we can start a family and having a fertility MOT has given us the time to solve the issues, and have a good chance at trying for a family before time and the odds are against us."
Article: 21st November 2013 www.parentdish.co.uk