# 49 - I want to know if I am still fertile - will NHS test this for me?



## Imogen (Jul 18, 2003)

I am 49.
I have 2 children aged 10 and 12.
I want to know if I am still fertile and able to conceive (2xicsi due to MF).


Will the NHS offer me any tests or will they tell me to go away?


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## artist_mum (Jun 19, 2012)

I doubt it! But it's worth a try - if you get on with your GP you could ask.  

If not, the clinics will usually do a simple test for AMH levels - i think the one I did at a London clinic was £90 and I sent off the bloods (so didn't go up there).  It came back very low telling me there was really no chance.

Other people may know more than me..  I'm sure they'll post

Good luck with it

x


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## Imogen (Jul 18, 2003)

Thanks! *artist_mum*

Congratulations on your impending bundle!


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## bundles (Jul 16, 2011)

Hi  
I don't want to be the bearer of bad news but at about 44 I was told my amh was practically not detected and my only hope was DE, obviously not what I wanted to hear at the time. I'd had 2 miscarriages, due to Antiphospholipid syndrome. The first being when I was 42, and in my last pregnancy the consultant did wonder whether egg quality had played a part too. I've been around these boards a while, and whilst you can try supplements like dhea etc to improve egg quality, I really think that you would probably endure a number of failures (in whatever form) before you had any success, if at all    It really is a numbers game, and of course all about the egg quality. You need to consider the emotional cost as well as financial. 
Your gp should be able to arrange a hormone profile for you, including FSH. Mine was very supportive & I had lots of testing before I went private for treatment. 

Good luck  

Bundles xx


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## Lily0750 (Aug 1, 2015)

Imogen,

Local clinical commissiong groups CCGs decide on cut off age. My GP said the cut off age was 42 and NHS won't pay for any tests for my tx.


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## Imogen (Jul 18, 2003)

Thanks, *Bundles* 
Thanks, *Lily*
I guess i knew it was a long shot.
I have always been quite fertile (it was a MF issue) but this would be a different partner so it would be down to my contribution this time!


I guess we just need to start trying.
My cycle is 28 days and I think I ovulate around day 16 (single side cramps, EWCM)
so...


when is the best time to DTD and how frequently


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## deblovescats (Jun 23, 2012)

Imogen - good luck - at least you can have fun trying!
I agree with the others - I think it depends on your GP. As NHS fertility treatment is only available up to 42, I think they'll be reluctant to agree to this, but you may be lucky. I was 45 when I first went for IVF as I had been hoping to meet a partner to have a family with and as he didn't come along in time, I went it alone .... my GP was helpful in organising some tests for the clinic, but I don't think NHS will do AMH. The clinic said that my odds due to age were about 5% (this was not based on any blood tests) but purely age, so I think at 49, unfortunately, it is not going to be very high, but obviously you could be lucky. If you go down the IVF route, I think the clinics will strongly suggest DE as this is more likely to result in a healthy baby ... I now have 2 gorgeous children as a result of double donation - a little boy, 3 in July and a 6 month old baby girl, and am contemplating trying again with my 2 frosties!


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## Beside_the_seaside (Oct 9, 2012)

*Imogen* - as far as I know the NHS don't offer blood tests for AMH, at least not unless you're being referred for IVF on the NHS. I expect you already know that you wouldn't qualify for IVF on the NHS due to already having children/being over 42. You could get your AMH tested privately, but don't forget that people still get pregnant with very low or even undetectable AMH; it's not the be all and end all. (For example, there's a 2011 article by Drs Gleicher and Barad of Center for Human Reproduction in New York saying that since they began supplementing with DHEA "we so far have established close to 50 clinical pregnancies in women with anti-muillerian hormone (AMH) below 0.4ng/mL, many with undetectable levels of AMH (<0.1ng/mL)").

Your GP ought to be able to request a basic hormone profile for you though; at least cycle day 3 FSH, LH + Oestradiol. Possibly also day 21 Progesterone (this one indicates whether you ovulated earlier in the cycle).

Maybe approach it along the lines that you're wondering whether to TTC or whether you're anywhere near menopause, because I think GP's also run these tests for women concerned about approaching menopause (indicated by high FSH, v low oestradiol) and deciding whether to start HRT etc. So although that isn't strictly your concern, if you put it like that, I can't see why a GP should turn you down? You may well find you have normal (i.e. low-ish) FSH levels - particularly as you have very regular cycles - and in that case, you might as well give TTC a try, now that MF is no longer an issue.

You could also have an ultrasound scan (antral follicle count) to see how active your ovaries are/how many follicles in any given cycle. You won't get it on the NHS, but you can pay privately about £100. This type of thing: http://www.ultrasound-direct.com/women-ultrasound-scans/pelvic-scan-fertility/

Re your question 'when is the best time to DTD and how frequently?' - You can use OPKs, personally I think the smiley face/flashing smiley face ones are best ('Clearblue Digital Ovulation Test with Dual Hormone Indicator'). DTD every other day over your fertile period (or every day if you can).

If you wanted some 'help', you'll find there are clinics that will still help you try with own eggs, even in late 40's, provided that you understand that the chances of success are likely to be really quite low, but nevertheless, having any chance (however small) may be important to you. You could perhaps consider an IUI as a relatively low cost/risk option, or a natural cycle IVF.

As others have said, you'd have a much greater chance of success with donor eggs, but I could imagine it might be very difficult/impossible to consider using donor eggs when you already have your own genetic children. It's something only you can weigh up, obviously.

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