Trying to conceive can be a bit of a journey, especially for older moms with fibroids. Uterine fibroids (those non-cancerous little growths in the uterus) can affect your fertility and pregnancy in a few different ways. But with the right information and tests, you can better understand what’s going on and increase your chances of a successful pregnancy.

Here’s a breakdown of the key tests to consider if you’re an older mom with fibroids trying to conceive.

1. Ovarian Reserve Testing: How Many Eggs Do You Have Left?
As we get older, our ovarian reserve (basically, the number and quality of our eggs) naturally declines. For women with fibroids, this is even more important to check because fibroids might affect ovulation or implantation. Here are a few tests to see where your egg count stands:
• Anti-Müllerian Hormone (AMH) Test: This blood test measures your AMH levels, giving an idea of how many eggs you have left. The higher the number, the better.
• Follicle-Stimulating Hormone (FSH) Test: This test checks your FSH levels, usually on day three of your menstrual cycle. Higher FSH can mean you’re running low on eggs.
• Estradiol (E2) Test: Another hormone check, this one measures a type of estrogen. If this level is high, it might mean your ovarian reserve is lower than it seems.
These blood tests give you a snapshot of your fertility health and help guide your next steps.

2. Ultrasound: Let’s Check Out Those Fibroids
Fibroids come in different sizes and locations, and some types affect fertility more than others. A pelvic or transvaginal ultrasound is a quick, non-invasive way to get a look at the fibroids in your uterus.
• Size and Location Matter: Fibroids inside the uterine cavity (submucosal) are more likely to affect your ability to get pregnant than those outside the uterus. Big ones or those that distort the uterine lining might cause issues with implantation or miscarriage.
• Growth Monitoring: Fibroids can grow, especially during pregnancy, because of hormonal changes. Regular ultrasounds can help keep an eye on them.

3. Hysterosalpingogram (HSG): Are Your Tubes Open?
An HSG is an X-ray that looks at your fallopian tubes and the shape of your uterus. This test is great for checking if your fallopian tubes are open and ready for business!
• Open Tubes = Good News: Blocked tubes prevent sperm from reaching the egg, so you want to make sure they’re clear.
• Uterus Shape Check: Fibroids can sometimes distort your uterus, and an HSG can help determine if surgery might be needed to fix the shape and improve your chances of conceiving.

4. Magnetic Resonance Imaging (MRI): Getting a Closer Look at Fibroids
If you have large or multiple fibroids, your doctor may recommend an MRI. It’s like a more detailed, high-res look at your uterus and fibroids than an ultrasound.
• Fibroid Mapping: MRI gives a better idea of exactly where the fibroids are and how they might be impacting your uterus or fallopian tubes.
• Planning for Treatment: If you need surgery to remove fibroids (myomectomy), the MRI helps your doctor plan the procedure in a way that preserves your fertility.

5. Endometrial Biopsy: Is Your Uterine Lining Ready?
The uterine lining is where the embryo implants, so it needs to be in good shape. If fibroids are disrupting this lining, an endometrial biopsy can check for inflammation or other issues that could be making implantation harder.
• Chronic Inflammation: Fibroids might cause inflammation that can prevent a successful pregnancy. This biopsy can catch that.
• Lining Receptivity: This test can also see if your uterine lining is ready for an embryo to stick, which is especially useful if you’re considering IVF.

6. Hormone Level Blood Tests: How’s Your Balance?
Hormones are the key players in reproduction, so it’s important to make sure everything is balanced. Fibroids can sometimes throw things off, so these blood tests help check your hormone levels:
• Luteinizing Hormone (LH) Test: LH triggers ovulation, and this test makes sure it’s at the right level at the right time. Imbalance between LH and FSH might indicate issues like polycystic ovary syndrome (PCOS).
• Progesterone Test: Progesterone is crucial after ovulation for preparing your uterine lining for implantation. If your levels are low, it could be harder to stay pregnant.
• Thyroid Function Tests (TSH, T3, T4): The thyroid hormone regulates a lot, including your menstrual cycle and ovulation. If it’s out of whack, it can affect your fertility.
• Prolactin Test: High prolactin levels can interfere with ovulation, and fibroids might elevate these levels. A simple blood test can check for this.
• Testosterone and Androgens (DHEA-S): Even though testosterone is a “male” hormone, it’s important for women too. High levels could indicate PCOS or other conditions that affect fertility.

7. Genetic Testing: Planning Ahead
As we age, the risk of genetic abnormalities increases. Genetic screening can check if you or your partner are carriers for any conditions that might affect your baby, like cystic fibrosis.
• Carrier Screening: This test checks for genetic conditions you might pass on to your child.
• Karyotyping: If you’ve had miscarriages or trouble conceiving, this test checks for chromosomal abnormalities that could be impacting your fertility.

8. Comprehensive Blood Panel: Checking Overall Health
A comprehensive blood panel checks things like iron levels, blood sugar, and liver function. Keeping your overall health in check is crucial for a healthy pregnancy.
• Complete Blood Count (CBC): This test looks at your red and white blood cells, haemoglobin, and platelets. It checks for anaemia, which can be a problem during pregnancy.
• Blood Glucose Test: High blood sugar levels could indicate diabetes, which can complicate pregnancy.
• Vitamin D and Folate Levels: These nutrients are essential for pregnancy, so checking your levels can help guide any supplements you might need.

For older moms with fibroids, trying to conceive can feel like an extra layer of complexity. But with the right tests, you can get a clearer picture of your fertility and what’s going on with your body. Whether its hormone blood tests, ultrasounds, or genetic screening, all these tools help you make informed decisions on your journey to motherhood. Work closely with your doctor, take things one step at a time, and stay positive—there are many paths to a successful pregnancy!