12 Frequently Asked Questions about Fertility and IVF
My periods are irregular is this affecting my chances to get pregnant?
If a woman has irregular menstrual cycles then she may not be releasing her eggs reliably and it will be more difficult to fall pregnant. There are several reasons why women have irregular cycles and your GP can investigate this with some simple blood tests. Checking your thyroid and pituitary gland hormones will help diagnose the problem and exclude the common causes of irregular periods. PCOS is a common condition affecting 1 in 10 women of child bearing age. It causes irregular periods and as a result women will not ovulate as regularly which can affect their chances of falling pregnant.
I have painful periods will this affect my fertility?
Painful periods are a common problem for many women and occur for different reasons. Some patients pass very large clots when they have a period and this can cause increased pain. Some patients with painful periods might have a condition called endometriosis. Endometriosis can cause scarring and adhesions in the pelvis but it is unlikely to affect your chances to fall pregnant in most cases. If you are not falling pregnant and these symptoms affect you then always consult a doctor.
Does my partner need to have his sperm test?
Almost 30% of couples who struggle to fall pregnant will have an issue with the sperm. This important factor is often forgotten so if you have fertility delay for more than 12-months it is essential that you see your GP to request your partner have a sperm test.
I have had chlamydia does this affect my fertility?
Chlamydia is often described as the ‘silent’ sexually transmitted infection. It is spread by sexual contact but may remain untreated for a while before it is diagnosed. A chlamydia infection has the potential to damage your fallopian tubes and so if you have ever had this type of infection and are struggling to fall pregnant then you may require a test to check if your tubes are working normally.
I don’t have periods am I still be releasing my eggs?
A woman should have at least 3-4 periods a year to ensure the womb lining remains healthy. Some patients either have very irregular periods or none at all. The absence of periods makes it highly likely that you are not releasing your eggs each month. However, it is important to consider why a patient has absent periods. Always consult a doctor if you have no obvious underlying reason for a lack of periods as this may be important for your general health and for your future fertility.
I have had abdominal surgery will this affect my fertility?
Patients who have had an operation in their abdomen will usually have no problems with their fertility, but it depends on the type of surgery undertaken. Surgery can cause adhesions to form in the abdomen between different tissues and in some types of surgery this is more common than others. If you are not falling pregnant after 12-months and have had major surgery in your abdomen you should consult your doctor to discuss the next steps.
I have endometriosis will this make it difficult to fall pregnant?
Endometriosis affects around 10-20 percent of women of childbearing age. It occurs when the womb lining grows outside of the womb and commonly around the pelvis. Endometriosis can cause woman to have painful periods and pain during sex. In severe cases it may affect the ovaries and tubes and can affect a woman’s chances to fall pregnant. A woman’s eggs are stored in her ovaries so if she has endometriosis that affects them then cysts can develop and these are destructive to the ovary. In some cases the endometriosis causes scarring and adhesions and block the fallopian tubes.
My partner has had a vasectomy what should we do as we want to have a baby?
A man who has had a vasectomy will have two options to consider when trying for a baby. The first is to have a vasectomy reversal procedure and this will have varied success depending on how long it has been since the initial vasectomy procedure. The patient will need to see a private urologist to seek advice about this type of surgery as it is not provided on the NHS. If the patient wants to avoid this procedure then a small operation can be performed on the testicles under sedation to aspirate sperm directly. The sperm can then be used in in an IVF cycle.
We have been told we need IVF treatment what does it involve?
In an IVF cycle a woman will inject a series of medications to help grow a few of her eggs to maturity. These eggs are then collected during a small operation under sedation. The eggs are mixed with sperm in a licensed laboratory. If the man has sub-optimal sperm parameters then a technique called Intracytoplasmic Sperm Injection (ICSI) may be used to inject a single sperm into the ‘jelly-like’ centre of each egg. If the the eggs fertilise then they should continue to develop into embryos in an incubator. Once the embryos have developed fully then after 5-6 days a single embryos will be selected and transferred back into the womb. Two weeks later you will check if you are pregnant with a urine pregnancy test.
We are a same-sex couple what are our first steps to try for a baby?
A same-sex female couple wanting to start a family will usually begin with intrauterine insemination (IUI) treatment using donor sperm. There are a number of steps that patients will need to go through to achieve this. Things usually start with a consultation with a fertility doctor and then a counselling session to discuss the implications both legally and emotionally of using donor sperm. The sperm donor will have to be chosen from a licensed sperm bank and then the sperm is transported frozen to the fertility clinic where it is thawed and used for insemination treatment.
A same-sex male couple will tend to look at using a surrogate in order to have a child together using either of the couples sperm. There are several important legal steps to consider here but most couples will meet with a fertility expert to explain the treatment in more detail. Fertility clinics are not legally allowed to help patients to find a surrogate but there are a number of agencies that can help with this search. The the intended parents will need to go through counselling, a surrogacy arrangement and eventually an IVF cycle using donor eggs fertilized with their sperm to create embryos that can then be replaced into the womb of the surrogate.
I am a single lady and would like to have a baby on my own what are my options?
It is increasingly common for single women to try for a baby on their own today. Usually women will self fund intrauterine insemination (IUI) treatment in a licensed fertility clinic with sperm from a donor. The steps required involve implications counselling with a trained fertility counsellor before a suitable sperm donor is selected. The sperm is placed inside the womb shortly after ovulation and this is an effective treatment option with around a 20% success rate. Additional medication can be used to boost ovulation and this is referred to as ‘stimulated’ IUI though it is not always required. This treatment option is not funded on the NHS. After a few IUI treatment cycles you may be advised to progress to IVF treatment if unsuccessful.
I am a single lady what are my options to preserve my fertility?
Egg freezing is readily available in fertility clinics across the UK and is by far the most reliable option available to women wishing to preserve their fertility. Freezing technology has advanced so much that a woman can now attempt to preserve her fertility for the future. Egg freezing is more successful the earlier it is done in a woman’s life and certainly before reaching 30-years old it would be considered optimal.
There are a number of steps to the ‘egg freezing’ process to consider. A fertility clinic will first check your egg reserve using a simple blood test called AMH (Anti-Mullerian Hormone), which helps to predict how many eggs are likely to be retrieved in an egg freezing cycle. The AMH level also helps determine how much drug is required to safely stimulate the ovaries.
The initial treatment is all about preservation and involves stimulation of the ovaries, egg collection and then egg freezing (by vitrification). The second phase of treatment involves thawing these eggs, insemination of eggs with sperm and hopefully fertilisation. This part comes many years later or not at all, as often patients choose to freeze eggs as an insurance policy but may not come back to use these preserved eggs. The chances of success from this technique is quoted to be around 25-30%.
This article was produced by Total Fertility