Nowadays, women have more options than ever in terms of when (and if) they want to start creating their own mini-me.
And with the average Aussie woman having their first child at 30 years old, many of us aren't in a rush [1].
It is true, however, that age holds a lot of the cards when it comes to our fertility — and no matter how good your poker face is, age will always have the upper hand. So, what can we do about it? Read as we answer this question and dive into the world of fertility testing for women.
The importance of understanding your fertility health
We’ll get to the how real soon, but first, let us tell you why it is a good idea to get acquainted with your fertility health.
Learning about our own bodies gives us the power to make choices that align better with our goals — whether that’s starting a family earlier, thinking about egg freezing, or simply beginning the family planning conversation.
Now, more than ever, there’s a need to be educated and get access to information about our bodies earlier in life. We do, after all, use this information to make decisions about our fitness, diet, sleep routine, and finances, so why do we so often take a stab in the dark when it comes to fertility?
The reality is that it doesn’t have to be that way.
There's a simple blood test that can provide you with insights about your ovarian reserve (how many eggs you have), ovulation (the process of releasing those eggs), and how your general health (like your thyroids) impacts your fertility [2].
Where to start with fertility testing
There's one thing that can give you better predictions about your fertility than just age alone — your hormones.
Hormones are powerful chemical messengers in your body that are released into your bloodstream to control various functions of your organs.
One of those functions is your fertility, and hormones are responsible for regulating your monthly menstrual cycle and reproductive abilities.
So how can you get to know your hormones better? Well, for starters, there's a blood test you can take to measure your fertility hormones: the AMH test.
What's an AMH test?
Hormone blood tests have a lot to say about your fertility. They help you understand your body’s ovulation process and check in on several hormones that support a healthy pregnancy.
But the most critical hormone for understanding your fertility is AMH (we’ll talk about the rest of them in detail later) [3].
AMH testing can help you count how many eggs are left in your ovaries.
How does it do that? Each egg inside our ovaries lives inside a fluid-filled sac known as a follicle. These follicles produce AMH, and the more AMH we have in our bodies, the more eggs are likely to be in our ovaries.
AMH can also tell us other parts of our fertility story, like when we are likely to reach menopause and how our body will likely respond to IVF and egg freezing [4][5][6].
Plus, in general, your fertility hormones can tell you about your ovulation, or if you're showing any signs of underlying conditions that may affect your fertility, like Polycystic Ovarian Syndrome (a.k.a. PCOS) [7][8].
From there, you can start a conversation with your doctor or fertility specialist (and we can help with this). The more you know about your fertility hormones, the more it allows you to make informed decisions about planning a family in the future.
But these tests are not an exact science.
What are the limitations of fertility tests?
At Kin, we’re focused on helping women know what testing can (and can't) help us with when it comes to understanding our fertility. So, it's important you know that fertility tests aren't perfect.
As much as you'd love some kind of fertile percentage score, these tests shouldn't be treated as the one source of truth.
A fertility assessment can't tell you your chances of getting pregnant. No test can. Your hormones are just one piece of the puzzle.
Let’s take it back to basics for a second.
To get pregnant, you need a number of steps to happen:
- Your ovary releases a healthy egg
- The egg travels down one of your fallopian tubes, making its way to the uterus
- A healthy sperm joins the party and fertilises the egg
- The fertilised egg implants into the lining of the uterus
Where are we going with this?
Well, every little step is essential to a healthy pregnancy, and just like you’re following a recipe, each step depends on the one before it.
Your hormones can tell you the number of eggs you have, but they can't tell you anything about the quality of your eggs (or of your partner's sperm), or if there are structural issues within your reproductive organs.
On that note: Your fertility specialist may suggest other tests that can give you more advanced insights into your fertility, like a transvaginal ultrasound scan or a fallopian tube x-ray. These tests provide more insights into the physical structure of your reproductive organs.
Despite these limitations, by taking a hormone test, you're giving yourself more information that you can use to inform your family planning decisions and do what's extremely personal and right for you.
The more you know, the better, right? It’s the opposite of hindsight, and we like that.
How can you get your fertility tested?
Traditionally, these are the steps you need to go through in order to get your fertility test:
- Book your first appointment and ask your doctor for the test
- Then, you get referred to a pathologist to get your blood drawn
- Go to your doctor to get your results interpreted
- Finally, you may get referred to a specialist to have the rest of your questions answered
This process may vary depending on the clinic and fertility specialist you choose.
How often should you get your fertility tested?
It’s great to get started with your first test, but there’s more to your fertility than just a single snapshot. It’s a good idea to retest your hormones every 12 months.
That way, you can see how your hormones change and have the most up-to-date information to make decisions about your fertility. This comes down to age being such a massive fertility factor. Your body changes quickly with age, even if you don’t notice it as much on the outside [9][10].
How can you use your fertility test results?
With the information you learn about your hormones, you are better positioned to make decisions about when (and if) you want to start a family, whether or not egg freezing might be for you, and if you need to take action, in case your proactive tests show any red flags.
You’ll be in a much better position to have a conversation with your doctor to help you answer some questions that may have been stressing you the eff out.
- Is my timeline for having kids likely to work out?
- Should I consider egg freezing?
- Am I going to need assisted reproductive technologies like IVF or IUI?
- What’s my family medical history? Will that impact me?
- Am I healthy? Do I need to exercise more?
What fertility hormones are there?
There are 8 fertility hormones we suggest you get familiar with, all of which somehow link in with each other — like a magical, holistic yellow-brick road to your fertility.
1. Anti-Mullerian Hormone (AMH)
This one we mentioned earlier but we'll explain how it works, for those who missed it.
Basically, each egg inside our ovaries lives inside a follicle, which is responsible for making sure its egg grows up big and strong so one day it could turn into a little human.
These follicles produce hormones and, you guessed it — that hormone is AMH. So, when you measure this hormone, you get an indication of how many eggs you have in your ovarian reserve.
2. Follicle Stimulating Hormone (FSH)
FSH’s job is to grow those follicles we mentioned before, and start ovulation. Your FSH levels give you information about any pituitary disorders or hormone imbalances you might have.
3. Estradiol (E2)
Estradiol is a sex hormone. It thickens the uterine lining to allow the egg to successfully implant.
When your E2 levels are high, your body lowers FSH in response. Since high E2 can mask a high FSH, we test both hormones together.
4. Luteinizing Hormone (LH)
LH is the hormone that tells your egg that it’s time to roll (triggering your ovulation).
5. Thyroid-Stimulating Hormone (TSH)
Our thyroid gland has a say in all things to do with our metabolism — the process that converts everything we eat and drink into energy. TSH controls the production of our other thyroid hormones, regulating the thyroid function and reflecting our thyroid health.
It’s good to keep our thyroids happy, or they can suppress our ovulation.
6. Free Thyroxine (FT4)
FT4 is the main hormone released into our bloodstream by the thyroid gland. It cares about our digestion, brain development, and heart and muscle function.
Too much or too little of this hormone in our bloodstream can cause changes in our metabolism, general health, and fertility. We test this along with TSH to check that your thyroid is healthy and balanced.
7. Prolactin (PRL)
Known as the milk hormone, prolactin stimulates breast milk production, and high levels of it can interfere with our ovulation.
Besides lactation, prolactin is also involved in more than 300 functions, including reproductive, metabolic, regulation of fluids, regulation of the immune system, and behavioural functions.
Prolactin is typically high when you're pregnant or breastfeeding, which explains why women typically can’t get pregnant again while breastfeeding.
8. Free Testosterone (Free T)
Yes, women have testosterone too — it’s actually a steroid hormone that both men and women produce.
For women, raised testosterone levels may lead to thick hair growth, excessive acne, increased muscle bulk, and thinning hairline. Too little, and we may experience loss of bone mass or lower libido.
Final thoughts
We all plan our timelines in life a little differently, especially when it comes to starting a family. Fertility testing is about arming ourselves with knowledge about our fertility earlier in life.
With this type of test, you can use science to inform your family planning decisions and do what’s right for you, knowing that if anything interrupts your timeline, you have options.
With a simple hormone blood test, you don’t have to wonder anymore. You can finally get answers and take action.
If you're looking for ways to lead a fertility-friendly lifestyle, be sure to move your body regularly, include fertility-boosting foods in your diet, take a good prenatal vitamin, and limit coffee consumption.
For more tips, check out our guide on how to improve female fertility.
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