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Fertility MOTs aren’t accurate - so why are we charging women for them?

Amidst the doubts and uncertainty, it’s important that women are given the right information regarding their fertility, says Kat Lister

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By Kat Lister on

In a “well, whaddya know” moment, latest research published this week has revealed that fertility MOT tests marketed for women who are worried about their ability to conceive may be a waste of money.

The study, published in the Journal of the American Medical Association (JAMA), found that ovarian reserve tests - designed to tell women how many eggs they have left - are ineffective in establishing whether they will go on to conceive. The JAMA research profiled 750 women aged 30 to 44 years who had no history of infertility and had been trying to conceive for three months or less.

So, what did they discover specifically? Low AMH or high FSH (vital reproductive hormone markers) actually had no bearing on whether a woman became pregnant. In fact, many women who had a low egg reserve could potentially conceive without any problems, whereas those with promising reserves might still struggle.

Despite this, the test - which can cost up to £200 - is routinely offered in clinics as a way of determining a woman’s response to fertility treatment. As someone who has gone through a cycle of IVF and two cycles of IUI, it’s the kind of procedure I’m familiar with. The last time I was offered an AMH test I was sitting opposite my consultant at an NHS fertility clinic considering IVF for a second time. What followed was a bizarre conversation that played out like an exchange between Alice in Wonderland and the Cheshire Cat.

Did I want the test, I was asked? “It’s not always accurate,” he continued. “Even if it says your ovarian reserve is good, it may still be low.” So, what’s the point of doing it? I laughed – more out of exasperation than anything else. “It’s rudimentary,” his no-nonsense reply shot back with a shrug. “But it’s the only test we’ve got.”

Amidst the doubts and uncertainty, it’s important that women are given the right information

I was in a fortunate position that day: I was being treated in an NHS hospital and I wasn’t expected to stump up several hundred pounds to take a test where the results are arbitrary at best. But how about the thousands of women who are footing large bills under the misapprehension that it will accurately predict their ability to conceive in years to come?

According to Dr Channa Jayasena, a fertility expert at Imperial College London, it’s time to be honest about the limitations of fertility testing. "This study tells us that measuring these hormones to predict fertility in potentially worried and vulnerable women is wrong,” she told the BBC, “and should be stopped."

There is still so much we don’t know about fertility. In a world where facts seem to be slipping away from us at a rate of knots, this kind of unknowability may be an uncomfortable reality for many of us, but it’s important that we acknowledge it. According to official NHS statistics, a quarter of infertility cases remain unexplained.

Amidst the doubts and uncertainty, it’s important that women are given the right information – and warned of the limitations. False promises should never come with a price tag.


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