Womb with a view: Fertility MOTS: wake-up call or waste of money?

As fertility testing doubles, Amy Iggulden meets the new breed of MOT mums – and the experts who are not so sure…

Lola berthod has just become a mother for the first time. At 34, she owns her own house, has conquered a male-dominated industry and built a wide, supportive circle of friends. Now she is embarking on the biggest challenge of her life – raising the baby son she conceived with donor sperm after a fertility ‘MOT’ produced frightening results. Lola decided to ‘go solo’ after learning that her egg reserve is low and may last just a few more years.

Pragmatic, resourceful and selfsufficient, she is among a growing number of women who are changing the IVF landscape: the fertility MOT mothers. These are professional women who, after paying around £500 for a series of checks that claim to provide an insight into fertility, take matters into their own hands.

The tests use blood samples and ultrasound to investigate the body’s key fertility hormones, scan the ovaries to check how many follicles (or egg sacs) are present, look into the womb and, ideally, investigate the individual’s full family history and lifestyle. They can also pick up signals for particular conditions. When the results are worse than expected, it can provide a powerful impetus to seek fertility treatment and motherhood sooner than planned – either with a partner or without.

Lola, a pharmaceuticals expert originally from France, is among those who decided not to wait for a partner, and far from focusing on the anxiety of single parenthood, is already thinking about her second. Even through the fog of sleep-deprivation imposed by a week-old baby boy, her enthusiasm is infectious. ‘[ The situation] is hard to explain to people, but when they asked me if I was excited to know if it was a boy or a girl, to be honest I knew I would be so happy as long as they were healthy.’

Recalling the moment she was told her egg supply was very low and that her right ovary was minuscule, she says, ‘I always knew I was going to be a mum at some point in my life and when I got my results I was devastated. I had a pity party for about a week then thought, right, I’ve got to look at my options.’ She considered whether to ‘wait’ for a partner, but having seen so many of her friends who are in relationships struggle to conceive, she decided to go for it via a donor at the London Women’s Clinic on Harley Street.

‘I reflected for a long, long time, then decided to jump in solo. What I am really excited about now is getting to know my son, because I’ve used a sperm donor who I never met. I can’t wait to see how much of me is in my baby, but also to discover all the unknown parts. I’m already thinking that, ideally, I’d like to have another child.’

Figures from the Human Fertilisation and Embryology Authority show that women underwent 4,306 treatment cycles using their own eggs and donor sperm in 2016, up 15% on the year before. While this number also includes couples using donor sperm, experts predict that the number of solo women will rise as more and more undertake fertility MOTS. The London Women’s Clinic, for example, has seen the number of single women undergoing MOTS double to more than 1,100 in two years. Another leading clinic has seen a rise of over 40%.

Lola is convinced that the testing should be more widespread: ‘Definitely more women should have it done – because knowledge is power. Once you know, you have that information and you have the freedom to choose what you want to do. My only regret is not having it done sooner.’

But do the tests really help predict whether conception will be easy or difficult, as some of the clinics claim? A study last year found that levels of AMH – the anti-mullerian hormone that is a marker of egg reserve and forms a key component of fertility MOTS – had no impact on the time it took for a woman to get pregnant. Women aged from 30 to 44, with no history of infertility, were tracked as they tried to conceive over 12 cycles. The rates were the same for women with very low AMH as those who tested as ‘healthy’ for their age.

The same was true of women with ‘unhealthy’ high FSH – the folliclestimulating hormone that triggers the release of an egg. Lead author of the study Dr Anne Steiner, professor of reproductive endocrinology and infertility at the University of North Carolina, tells Grazia, ‘I have an issue with these checks being called fertility tests. It’s potentially misleading. Age is the best test we have for fertility. If someone is not actively trying to get pregnant, and they just want to get some tests, our data would suggest [the tests] are not a good use of their money.’

However, Zeynep Gurtin, reproductive sociologist and senior research associate at the London Women’s Clinic, says that the MOTS are part of a wider trend in women 

learning more about their fertility. ‘I have interviewed so many women who lament the fact that they left it too late to have a baby, who were not aware of the biological constraints they were facing,’ she says. ‘I think it’s great for women to plan their childbearing in the way that best suits their lives and desires, but it is also good to know if your biology will cooperate with those plans.’

Dr James Nicopoullos, specialist in reproductive medicine at The Lister Fertility Clinic, part of HCA Healthcare, told Grazia, ‘Fertility “MOTS” can tell you your “egg number” – the number of eggs you have left – and how you might respond to fertility treatment, but they are not a good predictor of how long it will take to get pregnant naturally.’

But for marketing manager Katie, another successful woman who wanted more information about her reproductive health, the only thing that matters is the baby she is now hoping to conceive with her gay best friend. The 35-year-old, who is currently single, underwent an MOT at the London Women’s Clinic earlier this year and was devastated by her results, which showed an AMH or egg count of 4.5 (typically it can be as high as 47.8 in women of her age) and four follicles across both ovaries.

She says, ‘Deep down I hoped I’d meet a partner before the time came to have a baby, but getting the results was a real shock and made me realise how much I really do want children. After a lot of talking, I’ve decided to go for treatment with a known donor, a really close friend of mine who lives with his boyfriend. He’s always been a huge support to me and will be an amazing father.’

London Women’s Clinic medical director Nick Macklon says that MOTS should be seen in the context of increasing fertility awareness, and that AMH only forms one aspect of the check. ‘ This can help [women] make informed decisions rather than trusting to fortune. With women increasingly wishing to delay childbirth, such information is potentially very useful.’

However controversial the tests, Lola feels nothing but relief that hers provided the trigger for her to seek treatment. ‘I feel very grateful and lucky that I did it at this time. It gave me the opportunity to choose, without being at the mercy of time.’