FSH, LH, oestradiol, AMH, rubella IgG, a pelvic scan and a TSH — if you're lucky! For men? Often just a semen sample.
For many couples, this represents much of the testing they've undergone before arriving at an IVF clinic. And while these investigations provide useful information, they don't always answer the question that brought them there in the first place: why aren't we conceiving?
And frankly, I find that astonishing.
The fact of the matter is that this small handful of tests barely scratches the surface of a couple's combined reproductive health. And yet, couple after couple are channelled towards IVF without necessarily understanding why they're struggling to conceive.
It's important to say that not all IVF clinics operate in this way. Some are far more diagnostics-led than others. But if you're someone who's only had the bare basics, you may feel compelled to do a DIY dig into your own case. The problem is knowing where on earth to start?!
Our patients tend to be split between those who've experienced failed IVF cycle after failed IVF cycle and are already questioning whether their diagnostic workup has been as rigorous as it could be, and those who are newer to their journeys who, understandably, trust that their consultant is 'on this'.
For those in the second camp — this one's for you.
IVF is a treatment. But what about the cause?
We appear to live in a world where fertility consultants increasingly do IVF. IVF is an extraordinary medical achievement, but its ability to overcome certain fertility problems can sometimes mean that the focus shifts towards achieving a pregnancy rather than fully understanding why conception has been difficult in the first place.
In its crudest sense: patient comes in and wants a baby. Consultant knows IVF may offer the quickest route. If it doesn't work, try again. Ask questions later.
If the outcome is positive… Brilliant! Problem solved. Until you want another baby.
Because there may have been no time spent understanding where the problems lay in the first place, you now have to consider a second round of IVF, which, fingers crossed, works again.
Now you have two beautiful children. One day they grow up and ask, "Mum, Dad, is there any family history of fertility problems? We want to start a family of our own."
You can safely answer, "Yes! Though we have absolutely no idea what the problem was. Good luck!"
I'm being facetious, of course. But the information that can be gathered from a proper diagnostic workup isn't just valuable in the here and now. Certain findings may have implications for your wider health and, potentially, your children's reproductive health too.
But I just want acupuncture!
When new patients preparing for IVF contact us for acupuncture, they don't always understand why we recommend a comprehensive fertility consultation first. "I just want acupuncture to help me through IVF," or "I just want acupuncture to stop me miscarrying again."
Now, I'm the biggest advocate of acupuncture you could ever find. But even I'm not so naive as to think that acupuncture can fix every fertility problem. It's never going to unblock a fallopian tube, repair a varicocele that's affecting sperm health, treat a reproductive tract infection, correct sperm DNA damage or redress a balanced chromosomal translocation. And how would you ever know whether any of these issues might be relevant to your case if they've never been investigated?
If I simply wanted to take someone's money, I could say, "Sure. Book some acupuncture."
But I know that acupuncture alone isn't going to address every factor that might affect the success of an IVF cycle or the outcome of a pregnancy. By incorporating appropriate investigations and medical care alongside acupuncture, we can offer something much more considered than treatment in isolation.
The heart of Truth Fertility
And really, this wider approach is important context for understanding our clinical audits and pregnancy outcomes.
The patients included in our audits weren't simply turning up for acupuncture in isolation. They were receiving care within a broader fertility framework, beginning with a comprehensive consultation and review of their reproductive health. Where appropriate, we identified gaps in previous investigations, recommended further diagnostics, discussed treatment options or referred patients to our network of medical specialists.
Our audits reflect outcomes observed within that wider approach to fertility care. They don't prove that acupuncture, diagnostics or any individual intervention caused those pregnancies. But they do demonstrate why it's important to understand the care patients received when interpreting the results.
That's the heart of Truth Fertility. We want to make sure that when the day of IVF arrives, we've done what we reasonably can to help you prepare. Because, frankly, we can't sit back and do anything else.
Our acupuncturists don't want to be delivering treatments wondering whether something significant has been missed. Nor do I want them working with patients whose fertility histories we haven't properly understood. To do this well, I need to know about you.
I need to understand your thyroid health, not just glance at a standalone TSH result when your history suggests further investigation might be appropriate. I need to know whether you could be iron deficient, have an underlying autoimmune condition or be edging towards diabetes without realising it. I need to know whether there's a male-factor issue, such as a varicocele or sperm DNA fragmentation, that deserves further specialist assessment.
Not because everyone needs every test. They absolutely don't. But because knowing what to investigate — and, equally importantly, what not to — is a fundamental part of good fertility care.
Ultimately, these are the juicy pieces of information that can influence decisions about your fertility treatment, inform your wider healthcare and, in some circumstances, provide valuable information for your children in the future.
Not sure where to start? Check With Verity First.
Of course, not everyone knows whether they need acupuncture, further investigations or a comprehensive fertility consultation. And that's exactly why I introduced Check With Verity First.
For £35, you can send me an overview of your fertility history, previous investigations and the questions you're struggling to answer. I'll review the information and help you identify the most appropriate next step.
That might be acupuncture, a comprehensive fertility consultation, a discussion with your fertility specialist or simply reassurance that you're already on the right track.
It's not a substitute for a full consultation or medical diagnosis. It's an opportunity to get some initial direction before committing to a service you might not need. And if you subsequently book an acupuncture appointment or consultation with us, we'll credit the £35 towards it.
Because sometimes the most valuable first step isn't another treatment. It's asking the right question.