THE BLOG

Infertility - Let's Shift The Paradigm From Treatment To Prevention

24/08/2017 17:22

Comments recently published in The Independent have deemed fertility testing unnecessary and even harmful, causing both false reassurance and unnecessary anxiety. I could not disagree more, and believe such statements detract from the very important role "fertility testing" has in reducing the UK's reliance on IVF and assisted conception. Fertility testing is a key tool in changing our focus as a country to prevention, and not just treatment.

With 1 out of 6 couples now requiring a fertility doctor to help them achieve a pregnancy, I disagree with the suggestion that women do not need such tests unless they are having trouble conceiving. These tests provide both men and women with crucial information about their chances of conceiving that enables them to make informed decisions before it may be too late. In 20 years of testing men and women for fertility, I have had countless express gratitude for results that have enabled them to take proactive measures to conceive naturally and avoid expensive and stressful IVF treatment. Equally it has provided others with peace of mind that they still have time before they need to consider having children.

Such tests are very simple, with the most common being the Anti-Müllerian Hormone (AMH) blood test. AMH is a hormone produced by cells surrounding the egg inside the follicle ( egg sac) within the ovary, which provides an indication of the woman's egg reserve and fertility potential. In simple terms; a normal level and the egg reserve is still good, but a lower reading and your egg reserve could be falling thus indicating a reduced fertility potential. Ultimately, understanding your AMH level will allow you to understand your fertility potential and time-line. Another important test is the Fertility Ultrasound Scan which can check the woman's womb and ovaries for any problems that might affect conception and also count the number of small eggs-sacs (antral follicle count) to estimate the egg reserve.

Fertility testing is not a honey trap to lure couples into having treatment. These tests give men, women and couples the opportunity to plan their parenting journey using professional medical advice. There are many women with family history of early menopause, thyroid problems and other medical conditions who need an early diagnosis in order to address their fertility potential. Women with medical conditions such as PCOS (polycystic ovary syndrome) can be given expert information to improve ovulation and help natural conception. Testing gives people the knowledge and the power to understand their situation and make decisions for the future that are based on scientifically reliable results. Results can also provide peace of mind to those who simply want to know more about their fertility, and in turn enable them to adjust their lifestyle, career choices or family life accordingly.

One of the most difficult situations as a doctor is seeing patients who are struggling to fall pregnant and now require IVF, yet with earlier diagnosis, many could have avoided treatment altogether. Education is key, and I am working hard to ensure the younger generation grow up with a better understanding of their fertility. Last year we launched fertility education classes in a number of London secondary schools, delivering young people the information they need to make proactive choices about parenthood when they're older, and also ensure they make lifestyle choices that don't affect adversely their fertility.

By providing an early indicator of whether someone's fertility is on the decline, potentially some years before they may have decided to start trying to conceive, we are providing people with the best possible chance of enabling natural conception. Given that NHS funding for IVF is on the decline, encouraging natural conception should be an aim as it is the only way that we can reduce these costs. Compared to IVF, fertility testing is inexpensive and straightforward, and could save the NHS huge amounts in the long-term by reducing the need for treatment.

I believe the fertility MOT's preventative capability is the most crucial tool we have in encouraging natural conception in the UK. Fertility testing empowers women by providing them with knowledge on their own unique fertility health, and in the long term can result in costly and stressful IVF treatment being avoided. When looking to start a family, for me the solution is clear - women and men need to be as informed and educated as possible about their fertility, empowered with the choice to make decisions that are right for them and their future. Knowledge is power.

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