Eight-month-old twins from Hayward Heath, West Sussex, recently met the surgeon who saved their lives even before they were born. The BBC reports how their mother, Katerina Ahouansou, at six months pregnant, during a routine scan, uncovered a serious issue with their development and blood supply.

Doctors diagnosed the twins with twin-to-twin transfusion syndrome or TTTS. It is a condition where one twin received more blood and nourishment than the other due to uneven blood vessel distribution in the placenta. In case there is no medical intervention, it could be fatal for both the twins.

A Specialist Steps In

This is when Ahouansou was referred to Professor Kypros Nicolaides at King’s College Hospital in London. Professor Nicolaides is a pioneer in fetal medicine and he specializes in a laser procedure that redistributes blood supply between twins in cases of TTTS.

When Ahouansou was scanned, Nicolaides observed that one of the twins were significantly smaller than the other. "There was a very high chance that if we did not intervene, both twins could die," he recalled.

An Operation No Less Than A Miracle

The life-saving laser surgery was performed and within a week the doctors saw an improvement with the twin who was smaller in size. When the twins were born, they weighed 1.5kg and 1.7kg. To recognize the efforts by the surgeon, Ahouansou named them Kai Kypros and Asher Nicolas after Professor Kypros Nicolaides.

Ahouansou also expressed deep gratitude for the professor's expertise and called him "proof that miracles can be performed by people who are devotees to their profession."

Professor Kypros Nicolaides has been at King’s College Hospital since 1980 and is widely regarded as a leader in fetal medicine. His groundbreaking research and development of screening and surgical techniques have saved countless lives.

Through his dedication, Professor Nicolaides has given many families hope, demonstrating how medical advancements continue to improve survival rates for complex fetal conditions like TTTS.

More about Twin-to-twin Transfusion Syndrome

As per the John Hopkins Medicine, TTTS is a rare pregnancy condition that affects identical twins or other multiples. It happens in pregnancies where twins share one placenta and a network of blood vessels that supply oxygen and nutrients essential for development in the womb. These pregnancies are known as monochorionic.

Sometimes, the blood vessels in the placenta are unevenly distributed, causing an imbalance in blood flow between the twins. The donor twin loses more blood than it receives, leading to malnutrition and potential organ failure. Meanwhile, the recipient twin gets an excess of blood, putting strain on the heart and increasing the risk of cardiac complications.

Impact on the Donor Twin

The donor twin loses blood volume (hypovolemia), reducing kidney function and urine production. This leads to low amniotic fluid levels (oligohydramnios) or, in severe cases, a complete absence (anhydramnios). Without proper blood circulation, the donor twin faces cardiovascular issues, increasing the risk of death.

Impact on the Recipient Twin

The recipient twin experiences excess blood volume (hypervolemia), causing increased urination and excessive amniotic fluid (polyhydramnios). The overworked heart struggles to handle the surplus blood, leading to cardiovascular dysfunction, heart failure, and, in extreme cases, death.

For many women, fertility can feel like a ticking clock, whether you’re planning to start a family soon or considering delaying pregnancy. One of the most useful tools for understanding your fertility potential is the AMH test, which measures the Anti-Müllerian Hormone in your blood.

But one question that often comes up is: “How often should I get my AMH levels checked?”

In this blog, we’ll break it down, explore what AMH tells you about your fertility, and provide practical guidance for testing frequency.

What Is AMH and Why Does It Matter?

AMH is a hormone produced by small follicles in the ovaries. Its levels reflect your ovarian reserve, essentially the number of eggs remaining in your ovaries. While it doesn’t measure egg quality, AMH is a reliable indicator of egg quantity, making it a critical part of fertility assessments.

Key points about AMH:

• Stable throughout the cycle: Unlike hormones like FSH, AMH can be measured on any day of the menstrual cycle.

• Predictive of ovarian reserve: Higher levels indicate more eggs; lower levels suggest fewer eggs.

• Useful for planning: AMH helps women understand fertility potential, guide IVF treatment, or decide whether to freeze eggs.

However, it’s important to remember that AMH is just one piece of the puzzle. Egg quality, age, lifestyle, and overall reproductive health also play crucial roles in fertility.

Factors That Affect AMH Levels

AMH levels vary from woman to woman and can be influenced by several factors:

Typical AMH Levels by Age

Here’s a general guide to what AMH levels mean at different ages:

How Often Should You Check Your AMH?

There is no universal answer, as testing frequency depends on your age, fertility goals, and medical history. Here’s a practical guide:

Women Planning Pregnancy Soon

Under 35 and healthy: A single AMH test may be sufficient to establish a baseline.

Considering IVF or egg freezing: Your doctor may recommend repeating the test every 6–12 months to track ovarian response.

Women Over 35 or With Fertility Concerns

AMH declines more rapidly after 35, so annual testing is often advised.

Women with known fertility risks (e.g., endometriosis, previous ovarian surgery) may need testing every 6–12 months.

Women With PCOS

AMH is often elevated, which can mask fertility issues.

Testing may be less frequent unless undergoing fertility treatment.

Women Undergoing Fertility Treatments

AMH testing may be repeated every cycle to tailor medication dosage and predict egg retrieval numbers.

AMH and Fertility Planning

AMH levels can guide several important decisions:

Practical Tips for AMH Testing

• Consistency: Always use the same lab for follow-up tests when possible.

• Complementary tests: Combine AMH with antral follicle count (AFC) via ultrasound for a complete picture.

• Lifestyle matters: Maintain a healthy diet, exercise regularly, and avoid smoking or excessive alcohol to support fertility.

• Consult a specialist: AMH results should always be interpreted by a fertility expert who can guide next steps.

By discussing your results with a fertility specialist at advanced centers like Birla Fertility & IVF, you can make informed, personalized decisions about family planning, IVF, or egg freezing.

Limitations of AMH Testing

While AMH is valuable, it has its limits:

• Doesn’t measure egg quality: Older women may have a lower chance of conception even with normal AMH.

• Can fluctuate slightly: Lab differences and health conditions can cause variations.

• Not a guarantee of conception: AMH indicates quantity, but pregnancy depends on many factors.

Conclusion

AMH testing is a powerful tool for understanding ovarian reserve and guiding fertility decisions, but it’s not a standalone predictor of fertility. For most women, testing every 6–12 months is sufficient, with more frequent testing only in specific circumstances.

By knowing your AMH levels and consulting with a fertility specialist at centers like Birla Fertility & IVF, you can make proactive, informed choices about your reproductive health. Fertility may not wait for life to line up perfectly, but with the right guidance and planning, you can take steps toward your family goals with confidence.

Remember, AMH testing is a guide, not a verdict. It’s one step in understanding your fertility journey and making empowered decisions about your future.

In a study led by researchers at Mass General Brigham, pregnant individuals who stopped taking popular GLP-1 weight loss medications either before or early in their pregnancy were found to gain more weight and face higher risks of diabetes and hypertensive disorders during pregnancy.

They were also more likely to deliver preterm compared with people who had never taken GLP-1 drugs. The study, published in JAMA, shows that women who had used these drugs may face increased risks of preterm birth, diabetes, and pregnancy-related high blood pressure conditions such as preeclampsia compared with those who had not taken them.

Is It Safe To Consume GLP-1 Drugs In Pregnancy?

GLP-1 medications include brands like Ozempic, Zepbound, Victoza, Trulicity, and Wegovy. They were originally developed to manage diabetes and control blood sugar but have become widely used for weight management and obesity treatment. These medicines may also help with conditions such as sleep apnea, improve heart and kidney health, and lower the risk of strokes.

Drugs like Ozempic and Wegovy belong to a class called glucagon-like peptide-1 (GLP-1) receptor agonists, which promote weight loss by mimicking a hormone that reduces appetite.

Many people regain weight after stopping these drugs, but pregnant women are generally advised against taking them. This has raised questions about how to safely help women wean off these medications around conception without increasing other health risks linked to obesity or diabetes.

Weight Loss Drugs Before Pregnancy Linked To Greater Weight Gain

The research team, led by Dr. Jacqueline Maya, looked at health records for nearly 1,800 pregnancies between 2016 and 2025, mostly among women with obesity. They found that women who stopped GLP-1 medications before or early in pregnancy gained an average of 7.2 pounds (3.27 kilograms) more than those who had never taken these drugs.

“The popularity of weight loss drugs has grown dramatically, but guidelines recommend stopping them before pregnancy because there isn’t enough safety data for unborn babies,” said Dr. Maya, a pediatric endocrinologist at Mass General Brigham for Children, as reported by Science Direct.

Women in the GLP-1 group also had a 32% higher risk of exceeding recommended pregnancy weight gain, a 30% higher risk of developing diabetes, a 29% higher risk of hypertensive disorders, and a 34% higher chance of preterm birth. Interestingly, there were no differences in C-section rates or babies’ birth weight and length.

Dr. Camille Powe, an endocrinologist and co-author of the study, noted that more research is needed to understand the benefits and risks of using GLP-1 drugs around pregnancy. “We need further studies to find ways to manage weight gain safely and reduce pregnancy risks when stopping GLP-1 medications,” Powe said, according to Science Direct.

Can You Take Ozempic Or Wegovy During Pregnancy?

Currently, there’s no safe role for GLP-1 use during pregnancy. No GLP-1 drugs are approved for expectant mothers.

Dr. Michael Snyder, MD, medical director of the Bariatric Surgery Center at Rose Medical Center and FuturHealth’s in-house obesity specialist, explains that human data on GLP-1s during pregnancy is very limited. Animal studies indicate potential risks including fetal growth restriction, pregnancy loss, and skeletal abnormalities at higher doses.

When someone takes a GLP-1 drug, their appetite changes, and it’s not yet clear how this could affect a pregnant person’s nutrition.

Parenting test that ensures that individuals are ready to take responsibility of a child sounds good, until its turns into a trauma of lifetime, where not scoring enough or failing that test leads to separation of the child from his parents. So is the case of many parents in Denmark, who have to undergo this parental scrutiny. Keira, being one of them, had just given birth to her daughter last November, but she knew that she only had two hours before her newborn would be taken into care.

She tells BBC, “Right when she came out, I started counting the minutes,” she recalls, adding that she couldn’t stop looking at the clock to see how long they had together. When the moment came, Keira says she sobbed uncontrollably, whispering “sorry” to her baby. “It felt like a part of my soul died”

She is a Greenlandic parent, among many, living in Denmark, who are now fighting to get their children back after they were removed by social services. In many of these cases, authorities have relied on the competency assessments, known as FKUs. This test determines where parents are fit to raise their children.

What Is the Danish Parenting Competency Test?

The FKU, or “parenting competency test,” was a psychometric assessment used by Danish child protection authorities to evaluate whether parents were fit to raise their children. In theory, the test aimed to protect children by identifying families in crisis or parents unable to provide adequate care. In practice, however, it became a tool of controversy—especially when applied to Greenlandic families.

The test assessed parents in a series of areas, such as their responses to imagined scenarios, self-concept, physical and mental well-being, outlook on life, and plans for the future. Most importantly, it was based on Western conception of good parenthood and delivered in Danish, with minimal attention to Greenlandic language, customs, or kinship systems. This incompatibility resulted in regular misinterpretations of the capacity of Greenlandic parents and sometimes led to children being taken from their parents.

Greenlandic children have traditionally been disproportionately represented in Denmark's child welfare system. Approximately 7% of Greenland-born children and 5% of children who have at least one Greenlandic parent are placed out-of-home. That's in sharp contrast to only 1% of the general Danish child population.

"Not Civilized Enough To Act Like A Human Being"

These assessments, which were banned for use on Greenlandic families in May after decades of criticism, remain legal for Danish families. They often take months and involve cognitive exercises, personality testing, interviews, memory challenges, and general knowledge questions.

According to Keira, some of the questions she faced felt irrelevant and culturally disconnected. “Who is Mother Teresa?” and “How long does it take for the sun’s rays to reach the Earth?” were among the things she was asked. She also recalls being made to play with a doll and criticized for not making enough eye contact. Keira alleges a psychologist even told her the test was meant to determine “if you are civilized enough, if you can act like a human being”.

While defenders of FKUs say they offer an objective framework, critics argue the tests cannot reliably predict parenting ability and are designed around Danish cultural norms. They are administered in Danish, not Kalaallisut, Greenland’s primary language, something many say leads to miscommunication and unfair evaluations.

A Disproportionate Impact

Greenlanders are Danish citizens, and thousands live on the mainland for work, education, and healthcare. Yet studies highlight stark disparities. Greenlandic parents in Denmark are 5.6 times more likely to have their children taken into care compared to Danish parents, according to the Danish Centre for Social Research.

The Danish government announced plans to review around 300 cases involving Greenlandic children, including those shaped by FKU results. But as of October, the BBC found only 10 cases involving the tests had been reviewed—and not a single child had been returned.

Keira’s own assessment concluded she lacked “sufficient parental competencies to care for the newborn independently”. Despite the ruling, she keeps cots in her home, along with baby clothes and framed photos of Zammi. She visits her daughter once a week, bringing flowers or traditional Greenlandic dishes—“just so a little part of her culture can be with her,” she says.

No Chance Of Reviewing The Test

Unlike Keira, some parents will never see their cases reconsidered. Johanne and Ulrik, whose son was adopted in 2020, have been told their case will not be reopened. Johanne had undergone an FKU in 2019 that labelled her “narcissistic” and described her as having “mental retardation,” based on criteria then used by the WHO claims she rejects.

Their baby was also meant to be taken immediately after birth, but because he arrived prematurely on Boxing Day while social workers were on holiday, the couple spent 17 days with him. “It was the happiest time of my life as a father,” Ulrik says, describing those days of feeding, changing nappies, and helping Johanne pump milk.

When authorities eventually arrived, two social workers and two police officers, the couple begged them not to take their son. Johanne asked to breastfeed him one last time. Ulrik remembers dressing his child before handing him to foster parents: “I felt the most horrific heartbreak”.

The couple no longer have access to their son but hope to take their case to the European Court of Human Rights. Denmark’s social affairs minister told the BBC the government will not revisit adoption cases because each child is now with a “loving and caring family.”

Experts disagree sharply on the validity of FKUs. Former test administrator Isak Nellemann says the assessments “are very important, about the most important thing,” claiming that when results are poor, “in about 90% [of cases] they will lose their children”. He also argues that some components lack scientific validity.

However, Turi Frederiksen, a senior psychologist, told BBC that while imperfect, the tests remain “valuable, extensive psychological tools” and denies they are biased against Greenlanders.

Rare Union That Is The Only Ray Of Hope Of Childless Parents

Among the few who have successfully regained custody is Pilinguaq, whose daughter was returned more than four years after being placed into care. The mother still struggles to rebuild trust; even briefly leaving the room can cause her daughter to panic. “If I go to the bathroom and close the door, she will have a panic attack,” she told BBC.

Her two older children are expected to return home soon as well, decisions made by local authorities, not the national review.

Keira continues to prepare for Zammi’s first birthday by building a traditional Greenlandic sleigh decorated with a polar bear. Earlier this month she was informed that her daughter will not be coming home yet—but she refuses to give up.

“I will not stop fighting for my children,” she says. “If I don’t finish this fight, it will be my children’s fight in the future”.