For Women

AMH is produced by the follicles surrounding the eggs in your ovaries that have yet to be developed. AMH levels can be average, high or low for your age. These results should be interpreted alongside your antral follicle count during the ultrasound.

Average: If you have an average amount of AMH, you likely have an average number of eggs for your age.

High AMH: A high AMH for your age could be pointing to a condition called PCOS that can lead to irregular or no ovulation (and ovulation is the key to pregnancy).

Low AMH: A low AMH for your age means you may have fewer eggs, and your fertility window may be shorter than average. A low AMH does not mean you won’t be able to conceive naturally.

Women are born with all the eggs we’ll ever have, and because the body is very inefficient with its use of eggs, the number declines throughout our lives, and very rapidly so after age 35. While we can’t change AMH results, it’s important to remember what AMH does and does not tell us. AMH gives us an insight into how many eggs are available to you in each cycle: how many are in the crop developed by your ovaries each month. A low AMH means a few eggs are available in each cycle, and the window of time you have to create your family may be shorter. However, it doesn’t tell us if you will or won’t conceive. Remember, too, that if you receive values that are lower than expected for your age, the quality of your eggs is also a factor, which is even more important than the number.

You can’t change the value of your AMH, but you can change your plan to work with what you have. Your AMH level can better understand your reproductive health and help you plan ahead in many ways. There isn’t any way to improve it, but the important thing to remember is that AMH is one piece of the fertility puzzle. Put together with a scan at a fertility clinic; it will give you important information you can use to discuss with your doctor to make informed decisions about fertility preservation or fertility treatment.

In general, this will depend upon your age. We recommend you to see a specialist if you are:

• Over 35 and trying to become pregnant for 6 months or more,
• Under 35 and trying for 12 months,
• 40 or over

See a specialist sooner if you have any of the following symptoms:

• Irregular or absent menstrual periods
• A history of pelvic infection
• A history of two or more miscarriages
• Difficulties with sexual intercourse
• Chronic pelvic pain
• A history of sexually transmitted disease
• A family history of early menopause

Fertility assessments are always useful, and you may not require any treatment.

Some lifestyle changes can maximise your chances of getting pregnant.

Give Up Smoking/Vaping: Smoking and vaping can cause problems for the entire reproductive system. Women who smoke are more likely to have difficulty conceiving, may not respond as well to fertility treatments and have more pregnancy issues. Smoking also impacts male fertility with lower sperm count, lower volume and a higher rate of erectile dysfunction.

Dietary Improvements: While there is no specific fertility diet, a balanced diet with plenty of fruit, vegetables, and grains is beneficial. Restrict the amount of processed foods, and where possible, choose organic. It can be helpful to follow a Mediterranean diet as it encourages everyone to consume more fruits, vegetables, whole grains, legumes, nuts and seeds, and fats that are healthy for your heart. It encourages you to consume fewer processed foods, sugars, refined grains and less alcohol. The Mediterranean Diet has been shown to help people manage their weight, which can be important for fertility. Being overweight or underweight can cause fertility issues.

Vitamins: If you are planning for a pregnancy, it is important to ensure you are increasing your intake of folic acid (or folate). Folic acid is readily available as a supplement, and you can also make an effort to eat more folate-rich foods such as leafy green vegetables (spinach, broccoli), avocados, berries, eggs, etc. You may also consider taking a prenatal vitamin.

There can be many reasons for female fertility issues, but they generally fall into the below categories:

Getting Older

Female age is the most predictive factor of the ability to conceive. The younger you are, the more likely your eggs are numerous, healthy and normal, making it easier to produce a pregnancy. As you age, the quantity of those eggs decreases and so does the number of eggs that are of normal quality that could produce a pregnancy. Lifestyle factors can have an impact on your eggs as well. Smoking, drug use, excessive alcohol intake and excess weight can all be detrimental to your fertility and to your eggs.  Healthy lifestyles can increase your chance of pregnancy.   

Ovulation Problems 

Ovulation is the key to pregnancy. Women with a monthly cycle will ovulate 12 times a year, so in reality, there are only 12 opportunities to get pregnant in a year. Many couples miss these ovulation opportunities because they are unaware that the window of time when they are fertile is in the days before ovulation. If they wait until the days after ovulation to try, they will be passed the fertile window and will have missed that month’s opportunity to get pregnant. If there is an issue with ovulation, however, we can intervene with a simple treatment to make sure that ovulation happens.

Tubal Problems 

When you ovulate, the egg is released into one of your Fallopian tubes. If sperm is present, it is fertilised in the tube and then travels to the uterus to implant. Anything that blocks the Fallopian tubes will create fertility difficulties. Blockages can be created by issues such as previous Pelvic inflammatory disease (PID) as it can cause scarring in the tissue; certain STIs such as chlamydia or gonorrhoea can cause scarring or pelvic inflammatory disease; fibroids can block the tubes, particularly if they attach to the uterus; past abdominal surgery or past ectopic pregnancy can scar the fallopian tubes.

Endometriosis 

Endometriosis is a condition where the endometrial tissue that is found in the lining of the womb grows outside of the womb. Endometrial tissue can be found on the ovaries, in the Fallopian tubes, on the bowel, or in the pelvic cavity. Each month, hormones released by the body cause this tissue to build up causing pain, inflammation and scarring which can impact fertility. 

Sexual Dysfunction 

Some women experience involuntary tightening of the walls of the vagina during sex. This is called ‘vaginismus’. Vaginismus can interfere with sex by causing pain during penetration, and it can make penetrative sex impossible for some.

Unexplained Infertility  

Sometimes, it is a combination of these factors that leads to female subfertility. In many cases, however, no reason can be found, and it is called “Unexplained Infertility”. 

Not at all. The point of fertility testing is to know where you stand and to get recommendations. We provide honest advice based on your results and scientific evidence.

We may simply give you reassurance, advice on when exactly in your cycle to try so that you can conceive unassisted, or suggest a simple intervention. We will not suggest treatments unless they are necessary. We may also suggest fertility preservation if you don’t want to start your family straight away.

Care at Waterstone Clinic is individual to you: we will build a plan together.

If you are confident that this is the best plan for you right now, then fertility testing is crucial to know where you currently stand. It won’t, however, tell you what your fertility will be like in five years. Our best advice is to sit down with your partner and discuss how many children you want in your future family: Would you both like more than one child? Have you discussed the implications of waiting to start your family? Are you prepared to undergo fertility treatment if it’s required?

Having a fertility test now will give you an idea of how realistic your plan may be, but keep in mind that five years is a long time in fertility. Waiting until 35 to start your family, the age at which fertility declines rapidly, could risk your dream of having a second or third child.

Being aware of your fertility is always the first step, and it might be wise to explore fertility preservation to avoid disappointment later. Discuss your plans with a specialist so you can make informed decisions.

The short answer is as early as possible. The right time will vary from person to person and will also depend on your personal circumstances and life plans, but ideally, women would start thinking about freezing their eggs in their twenties. The younger you are when you freeze your eggs, the more likely you will have more eggs to freeze. In turn, this will increase your chances of a successful outcome from treatment at a later stage. The aim of freezing your eggs is to have them available as your backup plan; hopefully, you will never need them.

If you want a family in the future or even think you might want one, it’s really important to assess your fertility potential periodically from your twenties. That information will give you a baseline and tell you if there are any issues. Ideally, fertility health checks at a fertility clinic would be as routine as general health checks such as cervical smears. Of course, tracking your AMH isn’t the full picture and should be looked at in conjunction with an ovarian scan, as these will help assess ovarian reserve and help you make decisions about your future.

If you’re not ready for a baby right now or not in a relationship, freezing your eggs in your twenties can be a way to safeguard your future fertility. Being proactive about fertility can make all the difference when you are ready.