Skip to main content

Tag: fertility

A Comprehensive Guide to AMH Blood Test: Its Significance and Connection to IVF

Ever wondered how a simple blood test could offer a glimpse into your fertility? In this blog post, we’ll delve into one of the most crucial hormones affecting fertility—the Anti-Mullerian Hormone (AMH). If you’ve heard of this hormone and wondered what role it plays in fertility or IVF treatments, you’re in the right place.

What is the AMH Blood Test?

An AMH (Anti-Mullerian Hormone) blood test measures the levels of AMH in a woman’s blood. Produced by the cells of the ovarian follicles, AMH serves as a reliable marker of ovarian reserve, effectively indicating a woman’s fertility potential. This test aids clinicians and fertility specialists in predicting a woman’s response to fertility treatments, particularly in vitro fertilisation (IVF).

What is the Anti-Mullerian Hormone (AMH)?

The Anti-Mullerian Hormone, first discovered by Alfred Jost in the 1940s, plays a crucial role in the sexual development of foetuses. AMH was initially known for its role in male sexual development, but subsequent research has unearthed its pivotal part in female fertility. In women, the hormone is released by the antral follicles, the small sacs in the ovaries that hold the eggs.

Why is the AMH Blood Test Important?

As AMH levels correspond to the number of remaining eggs in the ovaries, the AMH blood test offers a reliable gauge of a woman’s ovarian reserve. However, it’s essential to understand that AMH levels do not directly correlate with the quality of eggs.

Low AMH levels might indicate a diminished ovarian reserve, which could be a concern for women attempting to conceive naturally or through IVF. In contrast, higher AMH levels may suggest conditions like Polycystic Ovary Syndrome (PCOS).

When is an AMH Blood Test Required?

The AMH test may be recommended in several circumstances:

  1. Evaluating Ovarian Reserve: AMH levels help assess the number of eggs remaining in the ovaries. The test may be suggested for women approaching their mid-30s, those with a family history of early menopause, or those who’ve previously undergone chemotherapy or pelvic surgery.
  2. Diagnosing PCOS: Elevated AMH levels may be indicative of PCOS, a common condition affecting a woman’s ovaries and ovulation.
  3. Determining IVF Success: Before starting IVF treatment, clinicians may order an AMH test to better predict how the ovaries will respond to the fertility drugs used to stimulate egg production.

Connection between AMH Levels and IVF

The AMH blood test holds significant value in the field of assisted reproductive technology, especially IVF. It helps clinicians devise personalised treatment strategies for their patients.

For women with low AMH levels, special considerations may be needed during the stimulation phase of IVF. These women often respond less to ovarian stimulation, leading to a smaller number of eggs retrieved, which can affect the success rate of IVF. Conversely, women with high AMH levels might be at risk for Ovarian Hyperstimulation Syndrome (OHSS), a condition that can occur when the ovaries are overly stimulated by fertility drugs.

When is the Best Time to Have an AMH Blood Test?

An AMH blood test can be performed at any time during a woman’s menstrual cycle, as AMH levels remain relatively constant throughout. However, many fertility clinics might suggest the test as a part of an initial fertility assessment or prior to beginning fertility treatments like IVF.

In Conclusion

The AMH blood test serves as a potent tool in assessing a woman’s ovarian reserve and planning personalised fertility treatments. Whether you’re attempting to conceive naturally, preparing for IVF, or just wish to know more about your fertility, an AMH test could offer invaluable insights. Always consult with a fertility specialist to discuss your options and understand what’s best for your individual circumstances.

Discover more about the Blood Tests we offer at London Pregnancy Clinic.

Pregnancy Testing – Deep Dive into the Beta HCG Test

Pregnancy tests aim to provide a simple yet effective method of determining if you’re pregnant. There are two primary types of pregnancy tests available: urine tests and blood tests. While urine tests are more commonly used due to their convenience and over-the-counter availability, blood tests, specifically the Beta HCG (Human Chorionic Gonadotropin) test, offer a more detailed insight into the pregnancy. Here’s an in-depth look at the Beta HCG pregnancy test, how it differs from urine tests, its accuracy, uses, and how to interpret the results.

What is a Beta HCG Pregnancy Test?

A Beta HCG test is a blood test used to detect pregnancy. Human Chorionic Gonadotropin (HCG) is a hormone produced by the placenta after implantation. The beta subunit of HCG can be detected in the blood serum of expectant mothers approximately 11 days after conception; HCG can be detected in the urine 12-14 days after conception.

There are two types of HCG tests:

  1. Qualitative HCG test: This test simply detects the presence of HCG in the blood. It gives a “yes” or “no” answer to the question, “Are you pregnant?” Doctors often order this test to confirm pregnancy.
  2. Quantitative HCG test (Beta HCG): This test measures the specific level of HCG in the blood. It can detect even very low levels of HCG, making it a highly accurate test.

How Does a Beta HCG Test Differ from Urine Tests?

While both urine pregnancy tests and Beta HCG tests aim to detect the presence of HCG, there are distinct differences:

  1. Method of Testing: Urine tests can be done at home, while Beta HCG tests require a blood sample taken in a healthcare setting.
  2. Sensitivity: Beta HCG tests are more sensitive than urine tests and can detect lower levels of HCG. This means they can confirm pregnancy earlier than urine tests — typically around 11 days after conception.
  3. Information Provided: While urine tests only provide a positive or negative result, a Beta HCG test can provide more information about the pregnancy, like the approximate age of the fetus, or if there are potential complications.

The Accuracy of Beta HCG Pregnancy Test

Beta HCG tests are highly accurate. Because they can measure the exact amount of HCG in the blood, they can detect pregnancy earlier than urine tests, and they can also confirm or rule out potential problems.

However, while the Beta HCG test can detect if you’re pregnant, a single test can’t always accurately predict a healthy pregnancy. Levels of HCG can vary greatly among individuals, and a single measurement isn’t always indicative of a problem or complication. Doctors often will test HCG levels more than once, looking at how the levels change over time.

Uses of Beta HCG Pregnancy Test

Aside from confirming pregnancy, a Beta HCG test can be used for the following:

  1. Monitoring Pregnancy: Doctors may use Beta HCG tests to monitor the health of a pregnancy, particularly in the early weeks. They may use serial measurements to see if HCG levels are rising as they should.
  2. Identifying Ectopic Pregnancy: Lower than usual levels of HCG or levels that do not increase as they should may suggest an ectopic pregnancy — where the fertilized egg implants outside the uterus.
  3. Screening for Down’s Syndrome: As part of the “double,” “triple,” or “quadruple” screen test, the Beta HCG test can help assess a baby’s risk of Down syndrome.

Interpreting Beta HCG Test Results

Interpreting Beta HCG test results isn’t always straightforward, as normal HCG levels can vary widely. Typically, in a healthy pregnancy, HCG levels double approximately every 48 hours in the first weeks following conception.

However, unusually high or low levels, or levels that don’t increase as they should, might indicate a problem, such as an ectopic pregnancy, a miscarriage, or a potential chromosomal abnormality. In such cases, your healthcare provider will likely order further tests to determine the cause of the abnormal HCG levels.

It’s important to remember that while the Beta HCG test is a crucial tool in pregnancy monitoring, it is just one aspect of a larger picture. It should be used in conjunction with other tests and examinations to ensure a comprehensive understanding of both maternal and fetal health.

In conclusion, the Beta HCG pregnancy test is a sensitive, accurate, and versatile tool in the early detection and monitoring of pregnancy. By understanding its uses and how to interpret the results, you can gain a more comprehensive view of your pregnancy journey.

Here are typical ranges for hCG levels during pregnancy:

  • 3 weeks: 5 – 50 mIU/mL
  • 4 weeks: 5 – 426 mIU/mL
  • 5 weeks: 18 – 7,340 mIU/mL
  • 6 weeks: 1,080 – 56,500 mIU/mL
  • 7 – 8 weeks: 7,650 – 229,000 mIU/mL
  • 9 – 12 weeks: 25,700 – 288,000 mIU/mL
  • 13 – 16 weeks: 13,300 – 254,000 mIU/mL
  • 17 – 24 weeks: 4,060 – 165,400 mIU/mL
  • 25 – 40 weeks: 3,640 – 117,000 mIU/mL

Looking to book a blood test with us? Please visit our Blood Tests page. If you already had your pregnancy confirmed, we recommend to book an early pregnancy scan to check for the baby’s wellbeing.

The New Age of Prenatal Screening: An In-depth Look at Non-Invasive Prenatal Testing (NIPT)

Pregnancy, while a joyous period in life, is also a time filled with uncertainties. One significant concern for expectant parents is the health of their unborn child. Fortunately, modern-day medical advancements, such as Non-Invasive Prenatal Testing (NIPT), are here to provide some peace of mind.

This article explores NIPT’s accuracy, introduces other prenatal screening options, highlights key NIPT providers, discusses its limitations and benefits, and explains instances where NIPT may not be suitable.

Unveiling Non-Invasive Prenatal Testing (NIPT)

NIPT is a revolutionary screening test that leverages advanced technology to detect the risk of specific genetic disorders in the unborn child using a simple maternal blood draw. Common conditions screened through NIPT include Down Syndrome (Trisomy 21), Edwards Syndrome (Trisomy 18), and Patau Syndrome (Trisomy 13). The screening can be performed as early as the 10th week of pregnancy.

Delving into NIPT’s Accuracy

When it comes to screening accuracy, NIPT outshines other prenatal screening tests. Its sensitivity and specificity for detecting Trisomy 21 exceed 99% and 99.9%, respectively. For Trisomy 18, the sensitivity and specificity approximate 97-99% and nearly 100%. For Trisomy 13, the sensitivity is between 90-96%, and the specificity again nears 100%.

However, it is paramount to understand that NIPT is a screening test, not a diagnostic tool. It can indicate the potential of a genetic disorder, but it cannot definitively diagnose the condition. A positive NIPT result suggests a higher risk, warranting further diagnostic tests like amniocentesis or chorionic villus sampling (CVS) for confirmation.

Exploring Other Prenatal Screening Options

NIPT isn’t the only prenatal screening available to expectant parents. Other alternatives include:

  1. First-trimester combined screening: This screening comprises a maternal blood test and an ultrasound examination. Although it can detect about 85% of Down Syndrome cases, it does carry a higher false-positive rate compared to NIPT.
  2. Quad screen: This blood test is capable of detecting around 81% of Down Syndrome cases in women under 35.
  3. Cell-free DNA screening (cfDNA): Technically similar to NIPT, this screening method has a high level of accuracy and is typically reserved for pregnancies considered high-risk due to the associated cost.

Introducing Key NIPT Providers

Several leading companies globally offer NIPT services:

  1. Eurofins (PrenatalSafe Test): A globally recognized leader in the field of genetic testing, Eurofins offers comprehensive NIPT services.
  2. Natera (Panorama Prenatal Screen): Natera stands out for its ability to perform tests as early as the 9th week of pregnancy.
  3. Roche (Harmony Prenatal Test): Pioneers in the NIPT field, Roche’s Harmony test is widely available, being offered in more than 100 countries.
  4. BillionToOne (Unity Prenatal Test): A more recent entrant into the NIPT field, offering a more cost effective test with promising clinical data.

Each provider has unique strengths, and choosing the right one depends on several factors, including your doctor’s recommendation, the test’s availability in your area, and insurance coverage.

Weighing the Limitations and Benefits of NIPT

Like all medical procedures, NIPT has its pros and cons.

Benefits of NIPT:

  • Non-invasive: NIPT requires only a maternal blood draw, posing zero risk to the fetus.
  • Early and accurate risk assessment: Compared to traditional screening methods, NIPT provides an earlier and more precise risk evaluation for certain genetic conditions.
  • Fewer invasive procedures: With its high level of accuracy, NIPT reduces the need for invasive diagnostic procedures, which carry a risk of miscarriage.

Limitations of NIPT:

  • Screening, not diagnosis: NIPT isn’t a diagnostic test; thus, a positive result warrants confirmation with further invasive testing.
  • Limited screening scope: NIPT can’t screen for all genetic and chromosomal abnormalities.
  • Not suitable for screening physical/structural anomalies which are often more prevalent and severe.
  • Possible inconclusive results: There can be instances where NIPT results are inconclusive, necessitating a retest.

NIPT Exclusions: When is NIPT Not Suitable?

Despite its many advantages, NIPT isn’t for everyone. Certain situations can limit its effectiveness, depending on the provider of the test and their algorithm. These can be, but not limited to:

  • Pregnancies involving more than two fetuses (triplets or more).
  • When the expectant mother has a history of bone marrow or organ transplant.
  • Pregnancies resulting from a donor egg.
  • Vanishing twin pregnancies.

In such situations, a detailed discussion with the healthcare provider will help in determining the best approach for prenatal screening.

In conclusion, NIPT brings a significant shift in prenatal screening with its high accuracy rate and non-invasive nature, contributing immensely to maternal and child health care. However, it’s essential for expectant parents to discuss all options with their healthcare provider and make an informed decision. The understanding that no test is perfect and that screening tests have limitations is crucial to setting appropriate expectations.

Your health and that of your baby are of the utmost importance. An open dialogue with your healthcare provider will be the best approach to address your concerns and make an informed decision about prenatal screening.

Your Fertility Scan Guide 

Endometrial Lining Scan 

Endometrial Lining Scan, also known as the ‘Baseline Scan’, is designed to assess the thickness of the womb as well as its general outline and structure. 

These scans are popular amongst patients going through IVF treatment and are designed to guide your referring clinician, helping them to understand and plan your treatment accordingly. This is done by estimating the best time and chances for conception in addition to preparation prior to embryo transfer. Book here.

London Pregnancy Clinic offer three price packages for Endometrial Lining Scans: 

  • Endometrial Lining Scan/Baseline Scan – £120 
  • One lining ultrasound scan 
  • Rose Package – £220 
  • Two lining ultrasound scans 
  • Lily Package – £320 
  • Three lining ultrasound scans 

Follicular Tracking Scan 

Follicular Tracking Scan, also known as Antral Follicle Count, assesses the total number and size of the follicles in each ovary. 

These scans are popular amongst those going through IVF treatment. Follicle Tracking Scan helps your referring clinician to make important decisions in your fertility treatment and as such it is imperative to get accurate readings. Book now.

Similar to Endometrial Lining Scan, we offer three price packages for Follicular Tracking Scans: 

  • Follicle Tracking Scan/Antral Follicle Count: £150 
  • One follicle tracking ultrasound scan 
  • Rose Package – £270 
  • Two follicle tracking ultrasound scans 
  • Lily Package – £390 
  • Three follicle tracking ultrasound scans 

HyCoSy Scan 

This is an advanced ultrasound scan to examine the fallopian tubes, uterus and ovaries providing an important insight into your fertility. 

HyCosy scans are performed by our expert Consultant Gynaecologist, Mr Prashant Purohit, specialises in reproductive medicine and fertility assessment. HyCoSy scans are recommended for patients who have experienced difficulties in getting pregnant. Book now.

  • Cost: £500 including a pre-procedure consultation 

Blood Test Services 

London Pregnancy Clinic offers a variety of different blood tests with a short turnaround time. The results will be sent to you and your referring consultant through our secure online system. 

Transvaginal Scan (TVS)

What is a transvaginal scan (TVS)?
“Transvaginal” means an internal examination through the vagina. TVS probes have extraordinary resolution and may provide unique information regarding the fetal anatomy, placenta, womb, cervix and other important structures.

Technically, examination by TVS during pregnancy is identical to gynaecological ultrasound. The special high-resolution probe is aseptically cleaned, covered with a sterile cover (like a condom) and sterile lubricating gel. The transducer inserted is no larger than a finger. It is gently passed into the vagina to generate images of the baby, while you lay on your back. This may cause some slight discomfort but should not cause any pain. It is important you let us know if you have a latex allergy, in which case we will use latex-free probe covers.

The operator performing the transvaginal scan in pregnancy must have a high level of expertise and experience. TVS scan represents a significant challenge for the doctor or sonographer because of difficulties in obtaining correct images. As such, there are only a few specialists in London performing transvaginal assessment of the early fetus, including Dr Ushakov.

Please empty your bladder immediately before the transvaginal scan. Even a small amount of urine in the bladder will change the position of the womb and will reduce the quality of image. A trained chaperone is also available and present for internal examinations and may be requested for any of our other scans.

Is TVS safe?
TVS uses the same safe ultrasound waves as transabdominal scans to obtain the images of the baby and womb. The probe cannot get into direct contact with the fetus. Normally, due to better resolution the time of TVS imaging is shorter in comparison to a transabdominal scan (approximately 10 minutes). We use rigorous aseptic technique for preparation of the probe and there is no risk of infection.

Visit our Instagram account for comparison of transvaginal (TVS) & transabdominal scans for the SAME pregnancy. Can you see how much better the resolution of the TVS scan (1st video)? This is generally the case for ultrasound scans up to 11weeks when the fetus is still very small, less than 1.6 inch!

COVID-19 Vaccine and Pregnancy

We have collected some information and official guidance from the government and relevant professional bodies about the Covid-19 Vaccine, Your Pregnancy and Fertility:

RCOG – Royal College of Obstetricians and Gynaecologists

JCVI – Joint Committee on Vaccination and Immunisation

Who can have the vaccine?

Currently the vaccine has yet to be tested on pregnant women, and so the vaccine is not recommended to be provided routinely to all pregnant patients. At present, the Covid-19 vaccine is only being offered to the following groups of pregnant women who are at a higher risk of catching the virus:

  • Those working in the health and social care sectors.
  • Those considered clinically extremely vulnerable* (RCOG definition)

If you fall into one of these two categories, you may be offered the vaccine and have the choice to accept it or alternatively wait for more data to be published regarding its effects.

I am eligible for the vaccine – will it affect my baby?

The RCOG have previously reassured pregnant women that since the vaccine cannot replicate (unlike biological viruses) it cannot cause infection in the mother or baby.

I am breastfeeding – will the vaccine affect my baby?

The RCOG and JCVI have stated that there is no known risk associated with giving non-live vaccines such as the Covid-19 vaccine to breastfeeding patients. At present there is no data available on the effects of the vaccine on breastfeeding or the breastfed child. However, the JCVI recommend that you receive the vaccine whilst you are breastfeeding, based upon the vast benefits that breastfeeding provides for your growing child. If you have any concerns, you may decide to wait until you have completed breastfeeding before having the Covid-19 vaccine.

I have had my first dose of the vaccine but have become pregnant since, should I have the second dose?

The JCVI recommend that you delay your second dose until you have delivered your baby, unless you fall into the high-risk categories described above.

Can the Covid-19 vaccine affect fertility?

The Royal College of Obstetricians and Gynaecologists (RCOG) and Royal College of Midwives (RCM) have recently published a joint statement in response to misinformation spread about the Covid-19 vaccine’s effect on fertility. The RCOG and RCM state that there is no evidence to suggest that the vaccine may affect fertility. The RCOG President expands: ‘There is no biologically plausible mechanism by which current vaccines would cause any impact on women’s fertility.

Evidence has not been presented that women who have been vaccinated have gone on to have fertility problems.’ – Edward Morris, President of RCOG (2021) The RCM and JCVI recommend that you speak to your midwifery/primary healthcare team regarding any queries or worries you may have about the Covid-19 vaccine.

For more information on who may be eligible and further details on the above statements, please visit the referenced links below:   References: RCOG (2021). I am Pregnant and Have Been Offered a COVID-19 Vaccination. What are My Options? [Online] [Link]

RCOG (2021). The RCOG and the RCM Respond to Misinformation Around Covid-19 Vaccine and Fertility. [Online] [link]

RCOG (2020). Updated Advice on COVID-19 Vaccination in Pregnancy and Women who are Breastfeeding [Online] [link]

JCVI (2021). COVID-19 Vaccination: A Guide For Women of Childbearing Age, Pregnant or Breastfeeding [Online] [link]