The decision to have a child is an important milestone for any couple, however, approximately 3.5 million people a year in the UK face difficulties when they are trying for a baby. Infertility is obviously a concern when a woman is unable to become pregnant despite having regular unprotected sex. If you have been trying for a year or more with no success, it’s best to make an appointment to see your GP.
Common Causes
There are a multitude of factors that could lead to infertility in both men and women, and for 25 percent of couples it’s not always possible to identify the reason why.
Infertility in women can be caused by:
- Problems with ovulation, where perhaps the woman has stopped producing eggs during each monthly cycle. Ovulation problems can occur as a result of polycystic ovary syndrome, thyroid problems or premature ovarian failure.
- Damage to the fallopian tubes as a result of scarring from surgery, cervical mucus defects or endometriosis, a condition in which parts of the womb lining (endometrial tissue) is found outside the uterus, in other areas such as the ovaries. Pelvic inflammatory disease (PID) can also lead to scarring of the fallopian tubes, making it difficult for an egg to travel to the womb.
- Some medications and drug treatments, including non-steroidal anti-inflammatory drugs and chemotherapy, can have an adverse affect on a woman’s fertility. Illegal drugs like cannabis and cocaine can also seriously affect a woman’s monthly cycle.
- Age is often linked to infertility in women, and the biggest decrease in fertility begins in the mid-30s.
Infertility in men can be caused by:
- Abnormal semen caused by decreased sperm count or decreased sperm mobility can affect a man’s fertility. Sperm might also be abnormal in shape, which makes it harder for a sperm to fertilise an egg.
- Damage to the testicles can also seriously affect the quality of semen.
- Some men suffer from azoospermia, a condition in which the sperm produced in the testicles does not reach the semen.
- Testosterone is the male sex hormone that is important for making sperm. Hypogonadism is an abnormally low level of testosterone.
- Drinking large amounts of alcohol can also damage the quality of a man’s sperm.
All About IVF
Do you need IVF? It’s one of the most common infertility treatments, but why would you need it, and how does it work? Dr Debbie Falconer, Lead Embryologist, Manchester Fertility, gives some answers.
IVF, ‘In Vitro Fertilisation,’ is when your eggs are retrieved and fertilised in a laboratory using semen from your partner or a donor. The resulting embryos are then transferred into your uterus to begin growing as in a natural pregnancy. You may be offered IVF if your fallopian tubes are damaged or blocked, if your cause of infertility is unexplained, or in some cases of male factor infertility. Your consultant will decide if IVF is the right option for you which gives you the best chance of success, based on your screening tests and diagnosis. In a typical IVF cycle, there are five main stages for the IVF process—egg production, monitoring egg production, egg retrieval, insemination and embryo transfer. A typical IVF cycle can be completed in around four weeks.
Egg Production: Your ovaries are stimulated with drugs, which you usually self-administer at home, to produce mature eggs. Your dose is tailored depending on your requirements and response to the medications.
Monitoring Egg Production: You have regular blood tests and ultrasound scans to monitor your egg production to help minimise any risk of Ovarian Hyperstimulation Syndrome (OHSS), where the ovaries produce too many eggs. It typically takes 10-12 days from the start of stimulation until you’re ready to undergo egg retrieval.
Egg Retrieval: When your eggs are ready for collection, they are retrieved via a short procedure at your clinic, which is performed under sedation. You’ll be told how many eggs you have available for your IVF cycle straight away.
Insemination: Your eggs are mixed with your partner’s sperm (or a donor’s), and are then incubated overnight and checked the next morning for signs of fertilisation. If any of the eggs have fertilised, they are now embryos and continue to grow in the laboratory incubator. Your date for your embryo transfer will depend on the number and quality of your embryos.
Embryo Transfer: The best quality embryo will then be transferred back into your uterus, in a simple procedure that usually does not need any anaesthesia. Any remaining embryos not being used during your cycle can be frozen for future use.
Approximately two weeks after embryo transfer, you will be able to do a home pregnancy test. If it’s positive, you undergo an ultrasound scan at around seven weeks, to monitor the pregnancy and see if there is a heartbeat. If all looks well, you are then referred to your GP and your care continues from there. If your test is negative, you will be offered a follow-up with your fertility consultant, where your treatment will be reviewed and next steps planned.
During your IVF cycle, your clinic should also offer you counselling. Counselling is one of the most important aspects of infertility treatment. Some couples need only one cycle of IVF to have a child, others need more, and for some it may not work at all. So it’s important that you—and your partner—have access to trained counsellors who can provide you with much needed, confidential support.
Dr. Chris’s Tips for IVF
- Don’t worry if you put on a little weight during your treatment, it’s natural.
- Be prepared for hormonal mood swings—they’re part of the process and communicating with your partner about your worries will help.
- Try and schedule free time when you’re having IVF—book leave from work if possible, or work from home if you can organise it. Keep your diary empty, too—you might not feel like socialising.
- Write a checklist of things to ask your doctor in advance of your appointment—you might forget once you’re actually there.
- Don’t stop exercising—it’s good for mind and body to say active.
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