“I knew mum had health problems when I was growing up and was on different medications, but we didn’t really talk about it and she didn’t know we were trying for a baby,” says Lauren, who with hindsight says she would have asked more about the family fertility history.
“It wasn’t until I shared my Bourn Hall test results that I realised she’d gone through the menopause at 34 and my grandmother at 36.
“Mum had conceived easily with me so she didn’t realise it might be a problem, but my nan had lost a pregnancy.”
“It was quite shocking to find out about the family history just before I turned 30. If I had known earlier, I would have frozen some of my eggs when I was younger and they would have been better quality.”
Women tend to go through menopause at the same age as their mothers, usually in their mid-fifties, with their egg store or ovarian reserve declining from 35. The AMH (Anti- Mullerian Hormone) is produced by the cells in the ovary and can be used as an indication of the number of eggs that are left in the ovary. In the Bourn Hall ‘Fertility Health and Wellbeing Service’ the test is combined with a scan of the ovaries and a consultation to discuss the options.
Lauren and her partner Chris were in their mid-twenties when they started to get concerned about their fertility. They were told by their GP they had to try naturally for longer before they could access tests on the NHS.
The NHS tests showed that Lauren was ovulating regularly and a HyCoSy – a test where dye is injected into the tubes – showed that one of the tubes connecting the ovary to the womb was clear.
“They did that ‘weird thing’ of leaving the male testing until later on and just tested me initially,” says Lauren. “It was only when Chris was tested that it was found that while he had a very high sperm count there was an issue with their shape (morphology).”
Semen analysis looks at number, motility, and morphology of the sperm.
“What I found with the NHS was that that you get an email or go on your portal to see your results, but they don’t call you or explain what anything meant,” says Lauren. “So, Chris was googling ‘what is a normal range for sperm? What does this mean?
“At that time there was no funding for IVF where we live, so we weren’t able to get any more help from the NHS and so we decided to do self-funded fertility testing at Bourn Hall to understand our options. I sent them all our existing tests and they recommended that we did some further ones.”
Sperm is produced every 9 weeks and although the quality is affected by illness and temperature it can be improved with good nutrition, so it is recommended that several tests are taken at intervals if there is an issue with the quality. Blood tests taken at different stages of a woman’s cycle can also give different results and the AMH test is not routinely available on the NHS.
“It was really helpful to have a Zoom consultation with a fertility specialist at Bourn Hall and actually talk about our results. We knew that something was obviously ‘up’ but we didn’t know what route to go down.
“The Bourn Hall consultant told us that I had a low egg count for my age and we had less than 3 percent chance of conceiving naturally. She talked through our options and explained if we had IVF then this would overcome issues with the sperm, as we could have ICSI where the best sperm is injected into the egg instead of letting nature take its course.”
The couple had IVF treatment. “I started taking the medication to prepare for egg collection on Chris’s 29th birthday and three days before my 30th and we also got engaged so it was a really busy time!
“I had nine eggs retrieved, five of which made it to day two but only one made it to day five. It wasn’t the best quality so we weren’t too hopeful that it would turn in to a baby…”
The couple’s first attempt at IVF was successful, but waiting for the test result and then confirmation of pregnancy with a scan creates a rollercoaster of emotions.
Lauren remembers: “When we went for our seven-week scan at Bourn Hall I had a little cry and couldn’t stop hugging all the nurses! I was just so thankful to them all, I had seen the same people throughout my treatment and it was incredible for them to be there when we saw the little heartbeat and our little baby on the screen, it was amazing.
“Our daughter Alana was born in January 2023 at the Rosie in Cambridge. When she arrived, I was sobbing my eyes out when I held her in my arms for the first time. We still talk about it now, to have seen the embryo transfer up on the screen at Bourn Hall and then see her little heartbeat at 7 weeks and then to have her finally arrive, a full-sized baby! Incredible!
“I am very aware that with my family history my menopause could be around the corner and, ideally, we would like to give Alana a sibling. We will be talking to Bourn Hall about a freeze-all cycle to have some embryos ‘in the bank’ for the future.”
When asked if she would have done anything differently Lauren says:
“My advice to others would be to be open and honest when people start asking questions about whether you are planning on having a family. A lot of people don’t admit how long they had been trying or that they had IVF, or needed help to induce ovulation. Seeing yet another pregnancy announcement can make you feel sad when you are trying, but you don’t know the journey behind it.
“I wish now that I had told my mum earlier that we were struggling to get pregnant because if I’d known about the family history it would have saved us years of heartbreak and upset by having that knowledge.
“So, I will definitely be having that conversation with Alana when she is older because I think the earlier you freeze your eggs, even if you are not sure if you want a family, the better, because you have got them ‘just in case’.”