You’re not ‘ovary-acting’ with Dr Natalie Getreu
The lack of knowledge about the female body is shocking, with most of the research focused on the male body. Our pain and our issues are dismissed by the healthcare system - we are told our bodies are "too complicated" as our health conditions remain elusive or misdiagnosed. We have been ignored in every aspect of life. Despite being treated like second-class citizens and our bodies being used as props for the male gaze, people like Dr Natalie Getreu (COO) and her sister Deirdre O'Neill (CCO) say enough is enough. Hertility was born out of necessity, helping us take back control of our health.
Dr Natalie and Deirdre are bringing reproductive science out of the lab and into the hands of every single woman worldwide. Hertility is setting a new standard in scientific rigour and education for female health - empowering a new generation of people who are empowered by their bodies and choices.
I spoke to one-half of this change-making duo about their home test kits and mission to better female healthcare.
MR: I worked for a fertility clinic and I was shocked to find out how hard it was to get support from the NHS for fertility testing and treatment. I was even more shocked to find out that the LGBTQ+ community were denied access altogether. Why do you think there are so many stipulations on the NHS when it comes to fertility testing and treatment?
NG: In general, there is a prevailing perception that fertility issues and female reproductive health, in particular, aren’t as urgent or significant as other medical conditions and often viewed as a “nice to have” rather than a “need to have”. Coupled with a lack of financial resources – lots of fertility treatments can be incredibly expensive which means that accessing fertility testing and treatment can be incredibly challenging
For the LGBTQIA+ community, which relies heavily on fertility treatment on their journey to parenthood, there are even more barriers to access, inherently because most healthcare systems are still very heteronormative, and the vast majority of policy and funding is directed towards heterosexual couples.
MR: I actually thought about requesting a fertility test before I got married because I have always had this fear of being baron but I talked myself out of it and frankly I didn’t know where to begin. Do you think that making it more accessible for people with ovaries has given us more autonomy and understanding about what is going on with our bodies?
NG: In a nutshell, that is Hertility’s mission. We want to arm women with all of the information they need about their own bodies so that they can make more informed decisions about their healthcare, their needs and their futures when it matters and not when it’s too late.
It’s crazy that we go through so much of our lives not knowing what is going on with our reproductive health and just hoping for the best. I think with lots of people there is an element of fear, the ‘what if it’s not the news I want to hear’. But something we hear often at Hertility is women coming to us saying how relieved they are – relieved that someone listened and relieved that they now have a diagnosis, even if it wasn’t one they hoped for.
Knowledge can be incredibly empowering.
There is also the perception that if something is wrong, you automatically require fertility treatment. However, sometimes it’s fairly easy to implement lifestyle changes that can make a big difference to your overall reproductive health and fertility.
MR: When I was pregnant with my daughter I was shocked to find out I had fibroids - I have always had “normal periods” with minimal cramping so I didn’t expect it. When I asked my doctor if it was common for someone to have fibroids without symptoms they couldn’t give me a clear answer. I left feeling unsatisfied with the information I was given. What advice would you give to other people with ovaries who find themselves in similar situations? What questions should we be asking?
NG: Unfortunately, this isn’t a unique experience. In 2023, we conducted a study that looked at the experiences of people who had received a PCOS diagnosis. We asked them how
satisfied they were with the information they’d been provided during consultations. The majority reported being unsatisfied and feeling ill-equipped to manage their condition.
No one should be leaving a doctor's consultation feeling let down or with more questions than they went in with. If you’re not being listened to or given enough information, definitely seek a second opinion. It can help to prepare a list of questions before your appointment and you’re also entitled to ask for a referral to a specialist, although waiting lists can be very long. At Hertility we have Private Gynaecologists that anyone can book an online consultation with.
Charities or NGOs that specialise in particular conditions often have detailed resources and also community forums where you can get more information.
MR: At what age should we start taking fertility health seriously?
NG: At Hertility one thing we always advocate for is knowing your options. So even if starting a family is still a while away for you, being proactive about your fertility and checking in on your hormones and reproductive health, even as early as your early to mid-20s, can help you to understand what family-forming options, or fertility treatments if necessary, are available to you.
Hormonal health and fertility are intrinsically linked. Often lots of people only start thinking about their fertility just before or even when they’re trying to conceive. Which can be problematic if they discover they have an undiagnosed reproductive health or hormonal imbalance. Fertility also begins to decline significantly after your mid-30s, which is when a lot of people are thinking about having children.
There’s often a lot of emphasis on female fertility, but fertility isn't just a concern for people with ovaries. Men also have a biological clock and factors such as sperm quality and quantity can decline with age. If you have a male partner, it’s a good idea to also get their fertility checked.
MR: I love the convenience of your home test kits but what really stood out to me was the very thorough health assessment and explanation of your results. I think information is important, but understanding what you’re being told isn’t always thought about. People love to regurgitate information using technical jargon without clearly telling you what anything means. What did you do when building Hertility to ensure the information would translate?
NG: One of our main motivations for founding Hertility was to provide accessible information and services to women. We experienced this problem time and time again and even as scientists we didn’t understand what was going on with our bodies.
From the beginning, we focused on a user-centric design approach. This means ensuring we deeply understand our users, their perspectives, needs and concerns. We always make a conscious effort to simplify medical terms, use everyday language and avoid unnecessary technical jargon.
In addition to our report results, we also offer educational content within the platform. This content is tailored to each user's specific results and provides detailed explanations of what each result means, why it's important, and what actions can be taken if needed.
We also actively gather feedback from users to continuously improve our offerings. This includes feedback on the clarity of information, ease of understanding, and any areas where users may have felt confused. This iterative process allows us to refine our approach and make ongoing improvements.
Our goal is for our community to ultimately feel empowered by the information they’re receiving.
MR: Do you offer additional support for patients who may be a little squeamish or unsure about what to do when administering a blood test at home?
NG: Yes, we understand that not everyone may be comfortable with or experienced with at-home testing. We strive to make the process as easy, comfortable and stress-free as possible for all users.
Each test kit includes a detailed step-by-step, instruction leaflet which guides you through taking your test. This includes diagrams that visually illustrate the process and give tips for preparing to take your sample. We also provide a link to video tutorials that demonstrate how to take your finger prick test.
“There are currently half a million people on the NHS waitlist for gynaecology services, with the average wait time being 2+ years. Some of these people are currently living with pain and are completely in the dark about any potential diagnoses. But with a service like Hertility, you can get your results in as little as 10 days from testing at home. This in itself is radically reducing the time to diagnosis and improving patient outcomes for thousands of women.
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If anyone is unsure about any step in the process, has questions or needs reassurance, they can always contact our customer support team via phone, email, or live chat. For anyone who is struggling to take a sample or is particularly squeamish, we can also arrange for a nurse to come to your home to take your sample like a regular blood test.
MR: What happens if you receive an abnormal result?
NG: We are helping more women take charge of their health. Around 60% of people who take our tests have found at least one hormone out of range.
Every set of test results is reviewed by our doctors, who write a comprehensive follow-up report, which includes personalised recommendations for each individual. Our doctors will review your health assessment, which includes extremely detailed information about your cycle, symptoms and medical history, combined with your blood work, to advise you on your next steps.
These will depend on your specific results but could include recommending further investigation, like an ultrasound scan or additional testing, specific lifestyle changes or a follow-up consultation with a private gynaecologist or specialist. Our doctors can also support you with a specialist referral to a fertility clinic.
MR: Do you think the at-home testing market will improve the medical and health industry and can home testing be seen as a viable alternative to other forms of traditional testing?
NG: There are currently half a million people on the NHS waitlist for gynaecology services, with the average wait time being 2+ years. Some of these people are currently living with pain and are completely in the dark about any potential diagnoses. But with a service like Hertility, you can get your results in as little as 10 days from testing at home. This in itself is radically reducing the time to diagnosis and improving patient outcomes for thousands of women.
At-home testing is also significantly more convenient and accessible. It allows for testing outside of traditional healthcare hours – which is great for those with busy schedules. It also decreases barriers to access for those with limited mobility, living in remote areas or those who may avoid traditional testing because of cultural stigma.
In some cases, at-home testing can also be a lot more cost-effective for the individual than traditional testing. Especially when considering factors like transport costs, time off work and copays.
MR: Channel 4 Broadcasting recently started offering their staff new fertility support. Do you think this will open the window for further female health support as we have seen in Spain with the new menstrual leave policy?
NG: We’re really proud to be working with Channel 4 and supplying our at-home Hormone & Fertility Testing for their employees. The importance of fertility and reproductive health benefits, including menopause benefits, for the workplace, is making significant ground. More and more employers are recognising the benefits, not only for employee wellbeing but for reducing absenteeism and productivity.
It’s a huge part of our mission to support organisations, not only with testing but also with CPD-accredited educational workshops and progressive policy implementation support. There is still a long way to go with recognising reproductive health as a core pillar of health, but as we have seen with the rise of workplace mental health benefits. With our Reproductively ResponsibleTM program, we are aiming to make the workplace more accessible to everyone.
MR: What are some of the most common misconceptions when it comes to fertility?
NG: Probably one of the most prevalent, that I mentioned earlier, was that infertility only affects women and that male fertility doesn’t decline with age. When in reality, anyone can be affected by infertility or reproductive health conditions and men similarly have a ‘biological clock’ of sorts, where their sperm quality and quantity declines with age.
Another common misconception is that if you’ve already had a baby, infertility or fertility struggles won’t be an issue for you if you want to have another child. Secondary infertility affects around 10% of people, so being mindful of your fertility even if you’ve not had any previous issues is important.
Finally, a really common query we get is will hormonal contraception negatively impact my fertility? It’s not true – there’s no evidence to suggest hormonal contraception, even long-term use, will impact your fertility.
We’ve got a great article on this topic on our blog too.
Until now, people with ovaries have been underserved by the healthcare system. Healthcare wasn’t designed for us, but organisations like Hertilty have taken steps to change that.
Here's to a future where we matter.
