2026, Responses from Fertility and Gynaecology Specialist, Dr Simon McDowell
“If age is a major factor in fertility, what other health factors should I focus on when trying to become pregnant, such as sleep, stress, weight, diet, or exercise?”
All of these factors are important – not only for fertility, but also for overall health and wellbeing. Maintaining healthy habits around sleep, stress management, nutrition, exercise, and weight can support general health and may also have a positive impact on fertility.
Factors such as stress are particularly difficult to measure, and it can be challenging to determine exactly how much they influence fertility. In general, people should aim to manage stress in ways that work best for them, whether through active strategies (such as exercise or counselling) or more passive approaches (such as relaxation techniques or hobbies). The most effective approach is the one that is sustainable and suits the individual.
“What options are available for finding out more about my current fertility?”
A consultation with a fertility specialist is the best place to start. They will consider a range of factors, including:
- Age
- Medical history
- Fertility history
- Future family planning goals
- Egg reserve testing
Looking at all of these factors together provides the most accurate assessment of fertility potential.
“If I have high AMH levels, how can my ovarian reserve be accurately measured?”
AMH (Anti-Müllerian Hormone) is not an exact measure of ovarian reserve. Rather, it is one useful tool that contributes to an overall assessment of fertility.
When evaluating ovarian reserve and fertility, specialists consider multiple factors, including:
- Age
- General health
- Fertility history
- AMH level
No single test can accurately predict ovarian reserve or a person’s ability to conceive. However, considering all of these factors together helps fertility specialists provide the most appropriate advice.
“If I have a low AMH and am in my early 20s, should I be rushing to freeze my eggs?”
Egg freezing has become a highly effective option in recent years and is likely to continue playing an important role for people with and without endometriosis, regardless of their ovarian reserve.
A low AMH (Anti-Müllerian Hormone) level may suggest a shorter reproductive window, but it does not predict whether someone can become pregnant. Many people with low AMH conceive naturally.
If you have concerns about a low AMH level, it is worth seeking advice from a fertility specialist. They can assess your overall fertility picture, discuss your ovarian reserve, and explore future options with you. While I would not recommend rushing into egg freezing, I would recommend a formal clinical review to discuss your individual circumstances.
“How can having an absent fallopian tube and ovary (due to torsion), in addition to endometriosis, affect my approach to fertility?”
In this situation, I would recommend seeking fertility advice earlier than usual.
Rather than waiting the standard timeframe, consider seeking help if pregnancy has not occurred within four to six menstrual cycles of trying to conceive. There is no downside to seeing a fertility specialist early. An early consultation can help assess your individual circumstances, discuss timelines, and provide guidance on when further investigations or treatment may be appropriate.
“I have endometriosis and adenomyosis. How long should I try to conceive before seeing a fertility specialist?”
For most people, we would generally recommend trying to conceive for 12 months before seeking fertility assistance.
However, for those with endometriosis and/or adenomyosis, I would suggest seeking specialist advice sooner after approximately six months of trying to conceive without success.
If there is a history of endometriosis or adenomyosis and you are over the age of 35, I would bring this timeframe forward further, potentially to around four months.
There is absolutely no harm in seeing a fertility specialist earlier, even before actively trying to conceive, to receive personalised advice and better understand your fertility options.
“If I am able to successfully conceive, how can endometriosis affect my body during pregnancy, and how can I keep myself and my baby safe?”
There is no strong evidence to show that endometriosis significantly affects the pregnancy itself.
People with endometriosis may have a higher chance of miscarriage early in pregnancy, but there are also other factors that can influence this risk. For example, increasing maternal age may contribute, making it difficult to determine whether endometriosis is the direct cause.
Many people find that their endometriosis-related pain improves during pregnancy. This may be partly because menstruation stops during pregnancy, which can reduce symptoms for those whose pain is linked to their menstrual cycle.
Pregnancy itself may also have a moderate suppressive effect on endometriosis, although the exact reasons for this are not fully understood.
In general, people with endometriosis do not require any additional pregnancy monitoring, surveillance, or treatment solely because they have endometriosis.