Before we move on and offer any treatments a consultation will take place to establish what tests we will need to do in order to identify the causes.
These tests include an ultrasound scan of the ovaries and womb.
Once we have a picture of what is potentially causing the problem and understand the issues we can move forward and work out a treatment plan. There are a range of different treatments available to overcome problems, so it is important we investigate first to make sure we are offering the right one.
Throughout infertility testing, ultrasound scans provide detail and information on the ovaries, endometrial lining and uterus. The ultrasound helps to evaluate the ovarian reserves, to see the uterine shape in more detail and to see if there is a block in the fallopian tubes. Ultrasound scans work by using high-frequency sound waves which then creates an image of your internal organs. We use these scans before and during treatments to keep tracking what is happening.
Follicular tracking is one of the best ways to pinpoint the perfect time to get pregnant. Follicular tracking involves monitoring your cycle by ultrasound. Ovulation can often be irregular and things like diet, stress, or illness can affect it. You may want to do follicular tracking if;
- You are having regular cycles and are trying to get pregnant but are unsuccessful
- You are having irregular cycles, this treatment will help determine the best time to conceive.
Ovulation occurs when an egg is released from the ovaries. In women with regular menstrual cycles, this happens approximately once a month.
Sometimes, the follicles that hold the eggs don’t mature regularly and so the woman ovulates irregularly, rarely or not at all so this can be the reason she is unable to get pregnant.
Ovulation induction is a straightforward fertility treatment that involves taking oral or injectable medication to stimulate regular ovulation. The medication is usually taken at the beginning of the menstrual cycle and the body’s response is monitored through the cycle using ultrasound. We can then see when you are due to ovulate and therefore the best time for intercourse or insemination.
Factors that can influence ovulation are:
- weight fluctuation
- polycystic ovarian syndrome (PCOS)
- Other gynaecological problems
If a woman is experiencing an irregular menstrual cycle, monitoring with an ultrasound scan, also known as follicle tracking, and hormone assessment may help in identifying the fertile time of the month. This then improves the chances of natural conception and no further intervention is needed. In other cases, medication and further intervention is required.
Anyone that has read anything about infertility knows that IVF is In Vitro Fertilisation, fortunately today there are a range of other options available and it is just one of the treatments used to help couples conceive.
It is a means fertilisation outside the human body. Originally IVF was offered to women whose fallopian tubes are blocked, are absent or have some damage to them.
It is a multi-stage process and it can be an emotional rollercoaster so careful assessment is needed to make sure it is the right course of action for any couple.
What happens during IVF
IVF involves 6 main stages:
- suppressing your natural cycle – the menstrual cycle is suppressed with medication
- boosting your egg supply – medication is used to encourage the ovaries to produce more eggs than usual
- monitoring your progress and maturing your eggs – an Ultrasound scan is carried out to check the development of the eggs, and medication is used to help them mature
- collecting the eggs – a needle is inserted into the ovaries, via the vagina, to remove the eggs
- fertilising the eggs – the eggs are mixed with the sperm for a few days to allow them to be fertilised
- transferring the embryo(s) – 1 or 2 fertilised eggs (embryos) are placed into the womb
Once the embryo(s) has been transferred into your womb, you’ll need to wait 2 weeks before taking a pregnancy test to see if the treatment has been successful.
Rates of success The success rate of IVF depends on a range of factors including the age of the woman undergoing treatment, the cause of the problem also plays an important factor if its understood. Stress decreases the chances of getting pregnant and the process itself can be stressful so it’s important to talk to us in detail before embarking on this journey.
Age and IVF
Statistically younger women are more likely to have a successful pregnancy.
The data from the NHS shows between 2014 and 2016 the percentage of IVF treatments that resulted in a live birth was:
- 29% for women under 35
- 23% for women aged 35 to 37
- 15% for women aged 38 to 39
- 9% for women aged 40 to 42
- 3% for women aged 43 to 44
- 2% for women aged over 44
(These figures are for women using their own eggs and their partner’s sperm, using the per embryo transferred measure.)
The Human Fertilisation and Embryo Authority (HFEA) has more information on in vitro fertilisation (IVF), including the latest success rates.
It is known that a healthy lifestyle increases the chances of a positive outcome with IVF. Maintaining a healthy weight and avoiding alcohol, smoking and caffeine during treatment may improve your chances of having a baby with IVF.
Intracytoplasmic sperm injection (ICSI)
For around half of couples who are having problems conceiving, the cause of infertility is sperm-related. ICSI is the most common and successful treatment for male infertility. It is also used as part of the treatment program with IVF.
With ICSI you only require very few sperm and the ability of for the sperm to penetrate the egg isn’t important as this is done by the injection technique. We recommend this treatment if;
- you have a very low sperm count
- your sperm are abnormally shaped (poor morphology) or they don’t move normally (poor motility)
- you’ve had IVF previously and none, or very few of the eggs fertilized.
- you need sperm to be surgically collected from the testicles or epididymis (a narrow tube inside the scrotum where sperm are stored and matured); for example because you have had a vasectomy, or you have a blockage that prevents sperm reaching the ejaculate, caused by disease, injury, or a genetic condition, or because you have an extremely low sperm count
- you’re using frozen sperm in your treatment which isn’t of the highest quality, especially if it was stored because your fertility was under threat, or following a surgical sperm retrieval.
- you’re having embryo testing for a genetic condition, and sperm sticking to the outside of the eggs would interfere with the results.
ICSI itself is very successful at helping the sperm and the egg to fertilise.
However, as in IVF there are still many other factors affecting a successful pregnancy, including the age of the woman and whether she has any fertility difficulties herself. Success rates for ICSI tend to be very similar to IVF so we don’t publish separate statistics
ICSI is an effective treatment for men with infertility.
It’s performed as part of IVF
It involves the sperm being injected directly into the egg.
Some men may need their sperm to be surgically extracted first.