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Fertility testing shouldn’t be scary – here’s everything you need to know

By Tess Cosad, CEO and co-founder at Béa Fertility

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Tess Cosad

For many experiencing problems conceiving, fertility testing can offer valuable health insights. Here Tess Cosad, CEO and co-founder at Béa Fertility, explains everything you need to know.

Around one in seven couples will have difficulties conceiving. Fertility problems can be caused by a number of factors, including health conditions like endometriosis and fibroids, having a low sperm or egg count, or lifestyle factors such as smoking.

For one in four couples, a specific cause cannot be identified. Nevertheless, the best place to start if you’ve been struggling to conceive for over a year is to undergo fertility testing.

What is fertility testing?

Fertility tests are investigations designed to help determine if there’s an underlying cause as to why you’re not getting pregnant.

You can undergo fertility testing via your GP, or you can order tests online using companies such as Hertility (female hormone and fertility testing) and ExSeed (sperm testing).

Based on the results of your tests, your GP should be able to advise on next steps to help you conceive.

There are different tests available to determine male factor infertility, female factor infertility or unexplained infertility.

What to expect when undergoing fertility testing?

The fertility testing process will differ slightly depending on whether you order tests online, or seek testing through your GP.

If you are going through your GP, they will usually ask questions about your menstrual cycle, your medical history, if you take any medications, how long you’ve been trying to conceive for and when and how often you have sex. These questions will help your doctor work out what investigations to perform.

Most commonly, these investigations will often involve blood tests to establish if you’re ovulating, an ultrasound to assess your uterus, fallopian tubes and ovaries and a semen analysis which will show the quantity and quality of semen and sperm.

It’s important to be honest and transparent when answering your GPs questions. Although the questions may feel personal, responding honestly will help them make well-informed decisions on best next steps.

What are the different types of fertility tests?

When you first approach your GP for fertility testing, they will perform some initial investigations using blood tests.

If you order a fertility testing kit online, you will usually be asked a series of questions to help the company determine which tests to send you.

The exact tests you undergo will depend on your specific circumstances, but will typically involve tests to assess menstrual cycle hormones, thyroid hormones and indicators of ovarian reserve.

  • AMH (anti-müllerian hormone) test – AMH is produced by the follicles in your ovaries, little sacs. Just as women’s egg count decreases with age, so do our AMH levels. An AMH test can give a good indication of egg quantity, and can also help signal some reproductive health conditions like polycystic ovaries.

  • P21 or progesterone test – This is a blood test that is performed in the middle of the luteal phase, which is after ovulation and before your period begins. The test is scheduled for seven days before your period begins, so the timing is based on the length of your cycle. In a 28 day cycle, this test would commonly be performed on day 21. The test measures progesterone levels to assess if ovulation has taken place.

  • FSH (follicle stimulating hormone) test – FSH stimulates the growth and production of eggs in the first part of the menstrual cycle. This blood test may be used to give an indication of the ovarian reserve – how many eggs you have in your ovaries.

  • LH (luteinising hormone) test – LH should reach a peak before ovulation: a rise in the hormone signals to the ovaries to release an egg. If LH levels are overly high, this can have an abnormal effect on the ovaries. The LH test is used to assess LH levels and their impact on egg release.

  • E2 (oestradiol) test – High levels of oestradiol may suppress other reproductive hormones that are responsible for ovulation, so an elevated E2 could mean that you’re not ovulating each month. The E2 test assesses E2 levels to understand whether this hormone is impacting ovulation.

Depending on your circumstances, your GP may also arrange the following tests:

  • Prolactin test – Elevated levels of prolactin may suppress ovulation, so prolactin may be checked if periods are absent.

  • TSH (thyroid stimulating hormone) – Both an overactive and an underactive thyroid gland can have an impact on ovulation. Measuring TSH levels would give an indication as to whether this is the cause of any fertility issues.

  • Testosterone – Raised levels of testosterone in women can disrupt the menstrual cycle and may lead to irregular cycles. In men, low levels of testosterone can impact sperm production.

An ultrasound may also be performed to examine the uterus, fallopian tubes and ovaries and identify abnormalities.

Testing for male factor infertility

During early fertility investigations, a semen analysis is often performed to check if there are any issues with the sperm, such as a low sperm count or low motility (movement of the sperm). They will test for the following factors:

  • Semen volume

  • Sperm concentration (concentration of sperm per millilitre of semen)

  • Sperm count (total number of sperm number)

  • Sperm motility

  • Sperm morphology (whether majority of sperm are ‘normal’ or abnormal forms)

If the result comes back abnormal, a semen analysis would usually be performed again in three months’ time.

The term infertility can sound scary, but it doesn’t mean you’ll never become a parent.

Fertility testing is the first step to help doctors identify the potential root of the problem, and they will use this information to recommend treatments and next steps.

Even if you are diagnosed with ‘unexplained infertility’, there are lots of brilliant fertility treatment options out there to help you on your journey to starting a family.

If you choose to seek fertility testing using a private company, rather than going through your GP, do your research to ensure you’re ordering your tests from a reputable source with a track record of accurate and actionable results.

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Maven Clinic launches programme for couples struggling to conceive

The programme aims to address the gap between trying to conceive and fertility treatment

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The US virtual clinic Maven has launched a health coaching programme in an effort to expand family-building options for couples struggling to conceive.

With 86 per cent of women not receiving preconception care from their family physician or OB/GYN, Maven’s Trying-To-Conceive (TTC) health coaching programme aims to support people who may be struggling and want to get pregnant without IVF.

The programme includes one-to-one support, reproductive education, ovulation tracking kits, as well as referrals to resources for mental health and nutrition.

“Maven is making sure every family can access the shortest pathway to having a healthy baby,” said Kate Ryder, Maven Clinic founder and CEO.

“We have constructed a unique model that, for the first time, aligns incentives among the stakeholders in healthcare to support people who are trying to conceive.”

To address the gap between trying to conceive and fertility treatment, Maven’s TTC Coaching service brings the benefits of health coaching to fertility care, providing members with “personalised” support and reproductive education, Ryder said. 

Dr Neel Shah, Maven Clinic’s chief medical officer, added: “While most sex education is spent teaching people how to avoid pregnancy, very little time is invested in empowering them with the guidance needed to become pregnant when they’re ready.

“Our coaching program supports couples to understand why they are struggling to conceive and in many cases helps them get pregnant without needing IVF.”

Further product enhancements the Maven team has announced include the Maven Managed Benefit platform, as well as an expansion of the company’s reproductive urology provider network for male fertility support.

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Brazilian fertility network FertGroup partners with Future Fertility to launch innovative oocyte assessment software across all clinics

The collaboration marks a significant milestone in advancing fertility care in Brazil

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FertGroup Medicina Reproductiva, a dynamic network of fertility clinics in Brazil, is proud to announce its partnership with Future Fertility to introduce cutting-edge oocyte assessment software, VIOLET™ and MAGENTA™, across its expanding network of clinics.

With nine clinics currently under FertGroup ownership, the network is poised for significant growth, aiming to surpass 15 clinics within the coming year.

This expansion is a response to the escalating demand for fertility services in Brazil, a market that has seen remarkable growth (17.6 per cent CAGR compared to the global average of ~10 per cent).

Factors driving this growth include an underserved market, rising medical tourism, and evolving population dynamics emphasising the need for advanced fertility solutions.

Led by private equity investors XP Private Equity fund, FertGroup is committed to revolutionising the fertility care landscape in Brazil and beyond.

Future Fertility is the first and only AI company to offer a comprehensive and easily integratable solution to oocyte assessment for clinics around the world.

With the world’s largest oocyte dataset, the use of this software (VIOLET™ and MAGENTA™) is at the forefront of this partnership, enabling clinicians, embryologists and patients to gain broad access to AI-driven insights about oocyte quality.

Nelson Guerreiro Pestana, CEO of FertGroup Medicina Reproductiva, highlighted the importance of integrating such innovative technologies: “At FertGroup, we are committed to bringing forward medical innovation that directly benefits the lives of Brazilians.

“Partnering with Future Fertility reinforces our market-leading position and reputation for excellence in fertility care.”

This technology optimises decisions regarding oocyte cryopreservation, ICSI IVF treatment approaches and oocyte donation. It also empowers patients by offering valuable insights into how their health status impacts expected fertility outcomes, helping clinics differentiate their service offering and provide a more patient-centric approach to fertility care.

Christy Prada, CEO of Future Fertility, expressed excitement about the expansion into the Brazilian market: “We are thrilled to partner with FertGroup Medicina Reproductiva in introducing Future Fertility’s innovative oocyte assessment software to Brazil.

“FertGroup is leading the market as the first network in Brazil to implement this technology, marking a significant step forward for fertility care in the region.”

Dr Edson Borges Jr, chief medical officer of FertGroup Medicina Reproductiva, emphasised the significance of oocyte quality in care delivery: “As a scientific leader in the field, we believe in bringing cutting edge technology to our patients, and supporting further research into new approaches to measuring and assessing progress in fertility treatment.

“Oocyte quality is a critical aspect of fertility care, and we believe that by integrating Future Fertility’s advanced tools into our care models we will advance the science in this space and demonstrate the value of leveraging oocyte quality in decision making.”

“Integrating the Future Fertility technology into our labs has been completely seamless” remarked Maria Cecilia Cardoso, group lab director.

“We already can see the value of the workflow integration, and this was a major decision factor for us. We are excited to see the benefits this will bring to decision making, providing an objective and personalised view of quality control into the process.”

This collaboration between FertGroup Medicina Reproductiva and Future Fertility marks a significant milestone in advancing fertility care in Brazil.

The introduction of VIOLET™ and MAGENTA™ software underscores FertGroup’s dedication to innovation and patient-centric care, solidifying its position as a pioneer in the Brazilian fertility market.

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Don’t politicise fertility, leaders warn after MP’s ‘patronising’ intervention

It is worrying to see a “deeply personal” women’s health issue being debated by politicians, fertility benefits providers told Femtech World

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UK femtech leaders have warned of the dangers of playing politics with fertility services following what they call “unhelpful, patronising and disrespectful” comments from an MP. 

The Conservative MP Miriam Cates raised concerns this week that women are being exploited into freezing their eggs, claiming that “most hopeful mothers are sold a lie”.

She said she fears women are being given “false promises” by large corporations offering them money to freeze their eggs to put off having children to a later age.

However, reproductive benefits providers labelled the comments as “unhelpful, patronising and disrespectful”.

Eileen Burbidge MBE, executive director at reproductive health start-up Fertifa, said: “Policymakers should absolutely be giving more attention to protecting reproductive health access and treatment options for women, given how shamefully ignored women’s health has been for too long.

“However, characterising egg freezing in the way that Miriam Cates has recently done is unhelpful, patronising and disrespectful to women who rely upon the option to freeze their eggs whether for medical reasons, to donate to others who suffer from infertility or for their own future optionality to relieve patriarchal societal pressures of finding a life partner or starting a family.”

Far from being exploitative, employers who offer financial and wellbeing access to reproductive healthcare are responding to what their talent is asking for, Burbidge, who served on former British prime minister David Cameron’s Business Advisory Group, told Femtech World.

“Data has consistently shown that women do not choose to freeze their eggs in order to work longer or prioritise their careers, but rather because they’ve yet to find a life partner and wish to not succumb to patriarchal societal pressures to do so.

“The fact that companies are supporting this will hopefully mean more women recognise the fact that the likelihood of success increases the earlier they freeze their eggs.”

Leila Thabet, UK general manager at Maven Clinic, said it is concerning to see a highly emotionally charged women’s health issue being debated by politicians and commentators with their own agendas.

“It is correct that egg freezing will not work for all women, but rather than paint an entirely bleak picture of the practice, it is vital that we empower women with facts around the procedure so they do not fall prey to exploitative clinics and operators who may not have their best interests at heart,” she said.

“At a time when data shows that women’s health care needs are still largely being neglected, it is unhelpful to dismiss the provision of women’s and family health benefits in the workplace as exploitative. This is as unhelpful as it is untrue.”

Jenny Saft, co-founder and CEO of fertility benefits provider Apryl, said there is a misconception that fertility benefits platforms offer egg freezing to keep women in the workplace.

“This is not how these programmes are designed or implemented. From my experience, it’s rare to find a company that limits its fertility benefits to egg freezing alone,” she explained.

“Typically, employers provide a comprehensive suite of fertility and family-forming options, including but not limited to egg freezing, sperm freezing, IVF, adoption, and surrogacy.”

Egg freezing has seen a sharp rise in the UK. More women than ever before are undergoing procedures, with egg and embryo freezing now the fastest growing fertility treatments in the country.

According to the Human Fertilisation and Embryology Authority (HEFA), egg freezing and storage saw a 64 per cent increase in 2021 compared to 2019.

The procedure, which is not available on the NHS, is largely carried out by private clinics at a price tag of £7,000 to £8,000. Fertility benefits platforms claim to provide financial and emotional support for egg freezing, giving women more freedom over when to start a family.

“When egg freezing is offered as an employee benefit it takes away the financial burden of egg freezing,” said Dr Catherine Hill, head of policy and public affairs at Fertility Network UK.

“However, it does not remove the health risks and side effects associated with the invasive medical process, or the emotionally demanding and often upsetting nature of freezing your eggs – all of which women need to consider before making any decision.

“Because this is such a big life choice, it is vital women do not feel under any obligation from their employer to take advantage of this employee benefit.”

Although the procedure enables some women to delay motherhood until the time that is right for them, egg freezing should never be seen as a fertility insurance policy, Hill said.

She added: “Making a decision on the right time to approach parenthood or to attempt to postpone it is a very individual commitment and must be made without pressure from anyone else, including employers. Egg freezing should be about widening women’s reproductive choices on when to have a baby, not enabling a scenario where women feel forced to delay motherhood.”

Becky Kearns, co-founder of Fertility Matters at Work, said it is crucial that companies educate employees and empower them to make informed choices.

“While egg freezing will be seen as a huge benefit and attraction for the next generation of workforce, it needs to be balanced with information and facts to allow people to make informed choices,” she told Femtech World.

“Organisations should be supporting fertility treatment as a whole where possible, not just for those early in their careers. If the focus is solely on egg freezing there’s the risk that this may be perceived as a means to encourage employees to delay having a family, to the short-term benefit of the employer.

“This benefit on its own, without balanced information and education about outcomes and overall fertility awareness, may result in people purposely delaying having children, thinking they have a guarantee for when the time is right, when in reality it gives them a chance.

Miriam Cates has been approached for comment.

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