It's been 4 years since I've undergone pre-conception testing. I'm now exploring my fertility as a 34-year old (well okay... 35-year-old from this Thursday).
Having been through IVF, and had 3 transfers, 1 natural transfer and 2 frozen embryo transfers (both were PDG tested embryos). Since my last transfer, which was September 2017, I've had endometriosis removed from my back of my uterus, along with a few cysts. I'd like to see what's going on for me now.
In comparison to 4 years ago, I now have a lot of body wisdom when it comes to my cycle. My cycle is regular now. My period isn't painful. I do get mild cramps and discomfort for the first day and then I feel fine thereafter! It's also super regular, like literally 28 days to the day. Before endo surgery, my period came either late or early and was very light.
I'm in tune with my body now and know I ovulate early in my cycle. I also have a balanced and healthy approach to wellness. I was a bit extreme in how I approached health and wellbeing in my early 30s. It was all-consuming and toxic. I created another level of stress in my life by being super controlled and disciplined, and thus removed any enjoyment from my life.
These days, I drink load of water, I drink wine too - approx. 2-3 glasses a week (although some weeks I don’t drink at all and when I'm actively trying to conceive I will not drink), I eat red meat now and then, I run for a croissant every week (pretty sure I was a French woman in a past life), I limit gluten but don't cut it out completely, I eat sugar but not a lot and not often, and I fill my plate with loads of veggies and I love salmon (omega-3)! I now exercise 2-3 times a week, I walk most days, I do yoga, I dance around my unit like a child (lol) and I swim a lot - in the harbour or ocean. I have more peace and joy in my life now. I surround myself with loving people - I share life with the most amazing loving family and friends.
The one thing I need to address is stress - I work full-time and also run TWW. This is sometimes overwhelming and a lot of pressure. But, I love both gigs - so until TWW has more resources, I have to find ways to cope. I see my kinesiologist once a month, I get reiki, I try to meditate every day and I do 5 minutes of breathwork when the overwhelm kicks in. For now, I'm mostly just use to being tired a lot...yawn... yup my family are so sick of me saying how tired I am.
Anyhow, I went to my amazing GP a few weeks ago to get my pre-conception tests ordered. Dr Kelly Bofkin from East Sydney Doctors.
To start the appointment, Kelly and I spoke about life. She enquired about my wellbeing. We also spoke at lengths about the importance of being an informed consumer of health and the importance of health literacy.
She's super supportive of me and Together We Wait - and has seen me through some really tough times. She's also a very caring, curious, and compassionate doctor. I have a way of spotting a good doc.
There is no one-size-fits-all approach for GPs when ordering pre-conception testing because we are all so unique. But, there are some baseline tests ordered for each individual.
Kelly mentioned that lifestyle plays a big part in pre-conception testing, hence my rundown on my lifestyle above.
Preconception lifestyle screening factors taken into account by GP's can include but are not limited to:
weight - under or overweight
Other stressors such as finances etc. - side note Kelly mentioned stress can play a big role in infertility
Kelly then ordered me "routine blood (fasting) tests" which includes as an example:
Full blood count (FBC): this is a test to check the types and numbers of cells in your blood, including red blood cells, white blood cells and platelets.
Iron studies (Fe)
Hepatitis B and C
Rubella (German measles) antibody status
Cytomegalovirus (CMV) viruses
UEC - Kidney function test
Comprehensive Metabolic Panel (CMP)
Urine MCS; urine microscopy & culture; urine culture & sensitivity (picks up a urinary tract infections)
Thyroid function tests (TFTs)
Blood group and antibody screening
Liver Function Test (LFTs)
Kelly added to the routine blood test the Anti-Mullerian Hormone (AMH) test also known as the "egg timer" test. This test measures your ovarian reserve or egg count. It gives some insight into the number of eggs you have left in your ovaries and the number of fertile years you have left - no pressure right! This is such a dreaded test.
But, what it can't do is determine the quality of those eggs. And I will say this... it only takes one good quality egg (and sperm) to create an embryo. So, I will consider this test but will not regard the results as the entire truth for my fertility and the number of years I have left to conceive. In this domain alone, I do not work well under time pressure. So back off AMH test. Sorry, a little vent about this test - we have a bit of a love-hate relationship.
It's certainly worth having in my opinion. Oh and I'm going to get this test done when I'm ovulating because I feel that may make a difference, and I will track my ovulation by urine tests from the chemist.
Kelly added a blood test order to check my homocysteine levels. This was ordered because I asked about MTHFR.
MTHFR, in short, can prevent you from converting folic acid into folate. I know of a few women in TWW that have been diagnosed with MTHFR. I'm curious and always have been about why I didn't fall pregnant with those perfect little embryos. Probably various reasons, but I want to ensure nothing is underlying going on.
The test for the homocysteine levels is not the full MTHFR test, but Kelly mentioned that usually, if you have high homocysteine levels than you are more likely to have MTHFR. To read more about MTHFR, check out this journal article that Kelly kindly forwarded to me.
The last test ordered is an ultrasound of my pelvis. YAH! My friend Mish and I were joking that this ultrasound (and childbirth etc.) is exactly why men need to buy all the drinks and open doors for us. Just joking, it isn't that bad, and we can buy our own drinks and open the doors on our own.
This test will check the endometrial thickness, and check for fibroids. I do have a fibroid but it isn't obstructive to growing a baby in my uterus (I should never be a doctor hahaha). It will also check for polyps and endometriosis, but Kelly advised (which I already know) that endo doesn't usually show in ultrasound.
Kelly also mentioned she would order the 3 core carrier screening for tests which is a genetic test that can determine if you are at increased chance of having a baby with Cystic Fibrosis (CF), Fragile X (FXS) or Spinal Muscular Atrophy Test (SMA). There are also a bunch of other genetic tests that can be added based on your medical history, as well as family medical history.
Also, I will add I'm doing this solo - but, if you do have a significant other - he should go to the GP with you and get male preconception tests ordered at the same time.
Disclaimer: None of the above should be taken as professional medical advice and is unique to me personally. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition/s.
This is my blog about my personal experience getting preconception tests ordered. It's like you are reading my journal. Stop reading my journal, just kidding - I'm letting you read my journal. I want it to prompt you to go get your preconception tests done asap, and to get curious about what should be included in those tests, to ask questions of your GP and well to write a journal that is unique to you and your experience. Now off you go!
Remember to RSVP to attend the webinar discussion on "All the Fertility Tests" it will be a game-changer (so just move your hair appointment) - Because knowledge is power and with it you can save time and money on your heart-led quest to conceive.