I Still Don't Know If I Want Children. I Desperately Hoped a Fertility Assessment Might Help Me Decide
I wanted something to make my mind up for me. Instead, my fertility assessment reminded me that biology isn't always the biggest barrier to becoming a mother.
At 35, I'm still not sure whether I want children. Like so many women my age, I hoped a fertility assessment might offer the kind of certainty I couldn't find on my own. Instead, it left me asking a much bigger question than whether I'd ever become a mother.
What It Feels Like Looking for Answers About Your Fertility
I used to think that getting older meant becoming more certain of yourself. At 15, I was steadfast in my decision not to have children. At 25, I wore that certainty almost as a badge of honour. At 35, I find myself utterly bamboozled, plagued by indecision, unable to answer what feels like one of adulthood's most fundamental questions.
I've lived in this state for the best part of five years now, and it seems to me that the harder I search for answers, the more they elude me.
"Whether I want kids is a secret I keep from myself—it is the greatest secret I keep from myself," Sheila Heti writes in Motherhood. A friend sent me the book from Japan after reading an essay I'd written about being 33 and unsure whether I wanted children. She'd taped that sentence to the front cover with a Post-it note.
"Will I ever know?" I'd written back then.
Over two years later, I'm more confused than ever.
It seems I'm not alone. "It's not something that's always at the forefront of my mind," one friend told me when I asked whether she felt similarly. "But it's always there."
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Another friend had recently taken an AMH test; a blood test that measures Anti-Müllerian Hormone and is often misleadingly marketed with ominous taglines suggesting it can tell women "how long they've got left". In reality, it offers an indication of ovarian reserve and is mainly used in IVF to estimate how many eggs might be retrieved during treatment. What it can't tell you—and what no current test can—is whether those eggs are viable, or whether you'll ever need them.
Still, she'd found reassurance in her results. "It might give you some clarity," she suggested.
Clarity, rather than an egg count, was what I was searching for.
The World's Most Fertile Couple (Or So I Hoped)
I'd like to tell you that what followed was exhaustive research into the most reputable fertility clinics, spreadsheets comparing success rates and patient reviews.
Instead, the clinic found me. While reporting on the UK's fertility industry , I'd spoken to IVI London about the growing number of misconceptions women have about fertility. Later, they reached out to ask whether I'd be interested in experiencing their most comprehensive fertility assessment. I said yes.
On the surface, I didn't think I had particularly strong feelings about it. I was grateful for a job that occasionally grants me access to experiences I'd never otherwise be able to afford, especially on an editorial salary. The couple's fertility assessment would normally have cost hundreds of pounds, before the additional AMH blood test.
And yet I couldn't bring myself to book it. The clinic emailed every few weeks. I kicked the can down the road. Months passed. A new year arrived. "The Year of the Fire Horse is going to kick you into action," a friend joked when I admitted I'd still not arranged an appointment.
Eventually, I ran out of excuses.
Booking the assessment was easy. Neither my partner nor I needed to prepare in advance, and so all I did was harbour the secret fantasy that we'd be told we were the most fertile couple the clinic had ever seen.
"My God," I imagined the nurses gasping. "You two are so fertile it's a wonder you haven't had an accident yet."
Needless to say, this did not happen.
Good Swimmers, Great Expectations
I walked down Harley Street on an a bright morning towards IVI London's discreet entrance. By the time I arrived, my partner had already completed his part of the assessment. His sperm analysis was over before mine had even begun.
We were shown upstairs, where a nurse checked my BMI and blood pressure before leading us into the consultant's office. Before the examination began, we talked through the mechanics of fertility, and I was surprised by how little I actually knew.
Waiting for my fertility assessment, I hoped the appointment might answer a question I'd been asking myself for years.
Despite years reporting on women's health, often with a laser focus on the so-called "fertility cliff" and motherhood, so much of fertility remained a mystery. The conversation also seemed almost entirely directed towards my body; the egg rather than the sperm.
When my partner's results came back, I was relieved—and vaguely repulsed—to hear he had "good swimmers". Then I felt something else: pressure. He'd been given the all clear, now it felt as though everything rested with me.
There's something about seeing the inside of your own body displayed on a screen that makes catastrophe feel inevitable.
Lying back on the bed, I watched as the ultrasound moved across the walls of my womb before darting from one ovary to the other. Every so often, the consultant would pause to point something out. I tried to hold onto the information, but another thought kept crowding out what the doctor was telling me: What if they find something?
The feeling reminded me of an investigative colonoscopy I'd had the previous year. Rationally, I knew this appointment was meant to reassure rather than alarm. But there's something about seeing the inside of your own body displayed on a screen that makes catastrophe feel inevitable.
The consultant talked us through what she was seeing. I had a small uterus, she explained, though not one that should cause concern. It was slightly triangular rather than T-shaped, but unless I experienced difficulties carrying a pregnancy, there was no reason to intervene. If problems ever did arise, some procedures could reshape it. Knowing there were options felt reassuring.
I couldn't shake the feeling that he'd somehow passed his test while I hadn't.
Then she counted the follicles on my ovaries: six on one, eight on the other. Instinctively, I knew those numbers were lower than I'd hoped.
Perhaps because my partner had already been told he had "good swimmers", I couldn't shake the feeling that he'd somehow passed his test while I hadn't. The consultant tried to assure me this wasn't how fertility worked; she'd be far more concerned by visible cysts or structural abnormalities than the number of follicles she'd counted.
And yet I knew I hadn't heard the last of those follicles.
The Advice I Wasn't Ready to Hear
Once we'd gone through the results in detail, those follicles appeared again. The consultant explained ovarian reserve and how follicles are used to estimate the number of eggs remaining. Every month, a group begins the process of maturing before one is released and the rest disappear.
Because of my follicle count, I was told it would probably take two or three retrieval cycles to freeze enough eggs to give myself the strongest chance of success in the future.
The answer was both simpler and somehow crueller: I should freeze my eggs because I am 35.
Then came the advice. It wasn't delivered dramatically or with any hint that something was wrong, but it was there: if I thought I might want children, I should freeze my eggs now.
If I thought I wanted more than one child, I definitely should.
I was totally unprepared for how being told to freeze my eggs would floor me, even though the advice was expected at my age.
Not because I was infertile or because there was cause for alarm. No, the answer was both simpler and somehow crueller: I should freeze my eggs because I am 35.
I hadn't expected to be so floored by that. Of course, I know that I'm 35, but like so many women my age, forced into a state of prolonged adolescence because of myriad reasons outside our control—graduating into a recession, stagnating wages, a housing crisis—I don't feel 35.
But I am. And that reminder stung.
Regardless of my results, regardless of how many follicles had appeared on the scan, regardless of the blood test I was still waiting for, the recommendation would almost certainly have been exactly the same.
Freeze now.
I felt that I was supposed to feel empowered, equipped with new information about my body. But although I understood my physiology better than I had 90 minutes earlier, I felt no closer to understanding myself.
The reassurance I'd hoped to find felt more elusive than ever, slippery like the jelly that had been squirted onto my stomach for the scan.
The fear that time was running out had become more acute. The reassurance I'd hoped to find felt more elusive than ever, slippery like the jelly that had been squirted onto my stomach for the scan.
While I waited for my AMH blood test, another couple argued with a nurse in the waiting room about transporting frozen eggs overseas for a surrogate. The woman became increasingly frustrated. Her husband tried to calm her down.
It struck me then that every conversation taking place inside this Harley Street clinic was, in one way or another, about money. The consultation. The medication. The retrievals. The freezing. The storage. The possibility of IVF years from now. Even uncertainty, it seemed, came with a price tag.
The fertility assessment revealed more about my body than ever before, but it couldn't tell me whether I wanted children.
I know that AMH tests don't do what they're so often marketed as doing. They can't tell you how long you've "got left", predict whether you'll conceive naturally or tell you if you'll ever become a mother.
I'd written an entire investigation into this myth that women are sold in pursuit of motherhood, and yet I still found myself desperately waiting for that number. I guess I hoped the results would show a surprisingly high egg reserve in defiance of my low follicle count, even though I knew it was the quality, not the quantity, that mattered.
I wanted something that could buy me more time.
It felt like a perfect chicken-and-egg situation. The irony did not escape me.
The irony wasn't lost on me that I couldn't afford the one thing that, in some ways, could buy me more time—egg freezing—even though that, too, came with no guarantee.
Freezing my eggs would likely cost somewhere between £15,000 and £20,000. Money my partner and I are currently trying to save for a house deposit. Spending it on eggs that may never be used would almost certainly delay buying a home. Delaying buying a home would almost certainly delay having children. Delaying having children would only make those frozen eggs feel more necessary.
It felt like a perfect chicken-and-egg situation. Again, the irony did not escape me.
Without stable housing, I can't imagine bringing a child into the world. But waiting until I have that stability means my fertility continues to decline.
I already knew, walking into that clinic, that the biggest obstacle between me and motherhood wouldn't be biological. I walked out steadfast in the knowledge that it was financial.
The Price of Possibility
It's now been six months since the assessment. Largely, I feel the same as before I went: unsure whether I want children, but increasingly aware that time continues to move whether I've made my mind up or not.
The only real difference is that uncertainty has infiltrated my everyday life. Boozy summer nights, stressful weeks at work and my incessantly poor sleep all make me wonder whether I'm damaging eggs I haven't even decided I want to use.
I knew it was naïve to hope the assessment would give me answers. I knew I was simply trying to absolve myself of making my own decision and defer it for a little longer.
Everyone is asking why fertility rates are in decline, why "women aren't having babies". But not enough people are asking how exactly anyone is supposed to make this decision in a world where the timeline of our biology no longer matches the timeline of our lives.
That's the question that angrily flitted around my head as I left IVI London. And, unlike my follicle count, it's one no fertility test can answer.

Mischa Anouk Smith is the News and Features Editor of Marie Claire UK, commissioning and writing in-depth features on culture, politics, and issues that shape women’s lives. Her work blends sharp cultural insight with rigorous reporting, from pop culture and technology to fertility, work, and relationships. Mischa’s investigations have earned awards and led to appearances on BBC Politics Live and Woman’s Hour. For her investigation into rape culture in primary schools, she was shortlisted for an End Violence Against Women award. She previously wrote for Refinery29, Stylist, Dazed, and Far Out.