Have you got a list of potential baby names picked out? Not quite ready now, but wondering if kids are on the cards for you in the future? Let’s chat about fertility checks and whether we need to plan ahead and get them done in our 20s.

Getting your fertility checked is not common for those in their 20s, but that is what Rania Zamhadi did. After having irregular periods and learning of family fertility problems, Rania started her medical journey to figure out these issues.

She says, “obviously having your period or being fertile doesn’t make you a woman, there are so many other things, but seeing every other woman in my life complain about their period and knowing they didn’t have the same fertility worries as me made me feel so un-womanly so I went to get checked.”

With the average age of mothers sitting at 30.7 and men at 33.7 rising from 26.4 and 29.4 respectively in 1974, (according to the Office for National Statistics), starting a family in our twenties might not be a common primary focus or something we feel equipped for. In fact, it’s something a lot of us are actively trying to avoid. However just because the call for children isn’t immediate doesn’t mean it will never come.

When Rania received a diagnosis of Polycystic ovary syndrome (PCOS), she became aware that a symptom was lower fertility levels. She said, “the whole medical process taught me a lot about myself, there were so many things that confused me, like why did I grow body hair before everyone else and why I didn’t have my period.”

Even without a diagnosis of PCOS, you may simply be asking yourself, what if I can’t have children? How common are fertility issues and is there anything I can do about it?

“Many things can affect fertility but mostly, for women, it’s all about age,” says fertility expert Dr Amy Barrie, Group Scientific Director at Care Fertility. “Female fertility has always declined once a certain age is reached, that’s just biology. The good news is, there’s so much active research to find ways to help those struggling to conceive.” 

You may be thankful to know that for most, these natural declines do not happen in your 20s. “As women age the quality of their eggs declines such that after the age of 37 the chance of a successful pregnancy begins to fall rapidly year on year until ovulation ceases at menopause,” says Dr Barrie. “This is why it’s a good idea to understand your fertility at an early age because, for some, this decline in egg quality can start much earlier making their fertility window much smaller.”

If you do receive the news of having fertility issues, you are not alone. “Globally one in six people struggle with fertility issues,” says Dr Barrie. 

Talking about her diagnosis is not something Rania struggled with. “During my diagnosis, I never heard anyone speak about it, I felt I was the only one going through it, when I started speaking about it I loved how many people told me it helped them. Some of my friends got checked because of my openness and one was also diagnosed with the same thing.”

Men do not have an allotted period in their fertility journey like women, instead, the conversation is more concerned with quality versus quantity. “Men continue to produce millions of sperm every day for their entire life. However, this does not mean men are exempt from fertility issues. Only a small percent of sperm produced can fertilize an egg,” says Dr Barrie. 

Alongside PCOS other conditions can affect fertility, for women endometriosis can also affect the female reproductive system. For men, some hereditary and medical conditions can affect male fertility. For example, Klinefelter Syndrome is a genetic condition that means an extra chromosome is inherited and results in testicular failure which means no sperm is produced.

How can one get their fertility checked?

There are two ways to get a fertility check, you can go to your local GP, who can then refer you to a local private clinic for fertility investigations, or you can go directly to your local fertility clinic and request fertility investigations.

Under some circumstances, the NHS will fund your treatment but you may have to pay for it privately. The cost of a fertility test can vary from clinic to clinic estimated between £400-£500. 

Similarly to fertility levels, there are differences in the way men and women are tested. There are two things assessed for women; hormone levels and reproductive anatomy.

Rania says, “they tested my hormone levels through a simple blood test just like any other, my uterus and ovaries were checked by an ultrasound which I was hesitant about especially having a male doctor, he was very professional and straight to the point but I would have liked some more reassurance, still it wasn’t bad at all.”

These two tests are enough to tell experts how many eggs someone has left and whether their ovaries and uterus are as expected.

For men, you will be pleased to know it is a less complicated and less intrusive procedure. 

Fertility experts will conduct a simple semen analysis. During this analysis, the sperm’s ability to move, what they look like, and how many there are will be assessed. This is enough for experts to know what their chances are of conceiving naturally or if IVF treatment may be needed.

What happens after receiving the results?

It’s not always as simple as receiving good or bad news, fertility is a complicated muddle of answers. Sometimes the information you receive isn’t what you expected. If this is the case there are healthcare professionals on hand to help you understand what your results mean and what the next steps are. 

Rania received her results nearly three years ago. She said, “I’m so glad I went and got checked and found out when I was younger, I feel like finding out when you’re older is more devastating because at that point you have your life together, you are wanting to pursue something, whereas now I can just know the information as I go through life aware of other options such as IVF or adoption.”

Dr Barrie says, “It’s important to understand that you can’t do anything to significantly improve your fertility. The best thing people can do to give themselves the best chance of having a family now, or in the future, is to understand their fertility.”

This may not answer your question ‘Should I get my fertility checked in my 20s’ and it’s not meant to, it’s here to aid and help you make your own informed choice.

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