Here we are, once again, looking at the terms you may come across when you are on your fertility journey.

As medical professionals, we aim to make the language we use easy to understand and the last thing we want to do is overwhelm you, but there’s a lot to take in and you can’t always remember it

Of course, there will be times when you are already feeling anxious and worried, and adding a list of complicated words to this can just make things worse.

This A to Z is meant to help you take things in your stride and once the series is complete, we will create it into one document so you can use as you navigate your way forward and today we are looking at the letter ‘M’.

MAR test
MAR stands for mixed antiglobulin reaction and it is a test used on sperm to diagnose immunological infertility. What this means is that some men carry anti-sperm antibodies which unfortunately prevent the sperm moving forward and fertilising the egg. We suggest that all patients have a full fertility check-up and as part of this, semen is analysed, and the results can offer a clear picture on your fertility status and ability to conceive.

It’s not just women who deal with fertility challenges, men do too. It could be that you are supporting your partner, it might be that you have issues that are being investigated or maybe you’re a single or gay man looking for a surrogate. We always say, “Don’t forget the men!” when investigating fertility.

Menstrual cycle
Menstrual cycles are normally 28 days with ovulation occurring around day 14 and if fertilisation doesn’t happen, there will generally be the start of a period around day 28. We would suggest that you start to track your cycle and if it isn’t regular, or it has stopped altogether, talk to your GP to see what is happening as this can make getting pregnant more difficult.

Menorrhagia is heavy menstrual bleeding. Everyone has difference cycles and bleeding levels, but the average woman will lose between 30ml and 40ml of blood or two to three tablespoons of blood per period.

If your periods are heavy, you might lose more than this and when the level reaches 80ml of blood lost each period, it’s classed as heavy loss. The problem is, it’s hard to measure in ml, so we look at the impact your period has on your life – emotionally and physically.

If you’re changing tampons or towels often, blood is soaking onto your clothes or bedding, if you’re passing large blood clots or are bleeding for more than seven days, then speak to your GP who may refer you to a gynaecologist for some tests.

Menarche is the age at which menstruation starts, and typically this is in the early teenage years, but can happen earlier or later and can be affected by genetic, lifestyle and environmental factors.

The menopause is something that is being more openly talked about in 2020 which is a good thing as it’s not something to be ashamed or scared of. The menopause is when a woman’s periods stop and she’s no longer able to get pregnant naturally. Periods can become less frequent or stop suddenly and this tends to happen from your mid to late forties. It goes without saying, that the older you get, the harder it becomes to get pregnant and the onset of menopause can be a factor to consider.

Microsurgical tubal reanastomosis
If you’ve been sterilised, this is the procedure that can be used to potentially reverse it. An incision is made in the lower abdomen and the ends of the fallopian tubes are re-joined. The chances of becoming pregnant after this depends on the condition of your fallopian tubes, any scar tissue that has formed as well as any other conditions. Talk to your GP about this as a starting point.

When we are struggling and going through something tough and challenging, we become super-sensitive to comments from other people. We know that life is tough, but it doesn’t mean others will be as mindful of you and your situation. You might want to come off some social media sites, ask managers at work to let you know of any baby announcements and be honest with family and friends about what you are dealing with so they can be more careful around you. Jokes and jibes might not be meant to hurt you, but if people are aware of your situation, they will be more mindful of what they say.

A miscarriage is the loss of a pregnancy up to 24 weeks and is a deeply sad and upsetting situation for everyone. The main warning signs are vaginal bleeding, followed by cramping and lower abdomen pain. If you experience any of these, call your midwife or doctor straight away and you should either be referred to an early pregnancy unit or maternity ward if it is later in your pregnancy.

There are many reasons why miscarriages happen, and babies are lost, it is worth talking to your doctor, or a specialist to see if a cause can be identified and if it happens more than once, tests can be carried out.

A miscarriage is a loss and it is something you need to talk about and process, so take your time and if you need extra support, ask for it and don’t try to cope alone.

When we talk about sperm, we often mention motility, and this is power of their movement. Sperm needs to be able to move through a woman’s reproductive system and the cervical mucus in order to fertilise an egg. Tests can be done to see what is happening with sperm and if it is otherwise healthy, it might be that IVF or IUI can help increase the chance of pregnancy.

When it comes to fertility, there’s a lot of talk about body parts and fluids and cervical mucus is one of them. This is a natural substance that is produced by the cells of your cervix and it changes as your hormones change. For example, when you ovulate the mucus appears clear and stretchy, a little bit like a raw egg white, and at that stage it can be penetrated by sperm so that an egg can be fertilised. Once ovulation has occured, progesterone causes the mucus to become sticky and thick and this naturally stops sperm from getting through to the uterus. It might make you squeamish, but knowing your body and what is does, including producing cervical mucus, can help you work out when you are fertile and when it’s the best time to try for a baby.

Multiple birth
A multiple birth is where a pregnancy results in the birth of more than one baby – be that twins, triplets or greater. There are some risks for mother and babies with multiple births but good care, ongoing scans, observations, and looking after yourself will help ensure that everyone is healthy and well.

Mycoplasma genitalium
This is an STI that often goes undetected but can potentially cause fertility problems. We know you will have unprotected sex when you’re trying to get pregnant, but before that, and especially with new partners ,always use protection and when things get serious, both get a full test to ensure you are in the clear and not putting yourself at risk.

Myomas tend to be referred to as fibroids which are non-cancerous growths that occur in, or around the womb (uterus). The exact cause isn’t known, and they usually develop during your reproductive years as this is when oestrogen levels are high. There usually aren’t symptoms, but they may show up during a routine gynaecological exam, test or scan. Myomas tend to be more common in women of Afro-Caribbean ethnic origin.

A myomectomy is an operation that removes the myomas / fibroids we have discussed, but without removing your womb and it is something your doctor may suggest if you want to have children in the future. There are other alternative procedures to treat fibroids, but this is one option out there.

If you have any questions, or concerns, please get in touch and we would love to help you.

Harley Street Fertility Clinic Team