Been trying to get pregnant naturally for a while without success? Don’t stress! It could be time to consider your fertility options...
If you’ve been trying to conceive without any luck so far, chances are you’ve thought about when to talk to your doctor about whether fertility treatment is right for you.
But even before you get to that point it’s worth knowing just which options fall under the fertility treatment umbrella.
Fertility drugs are generally the first port of call for women who aren't ovulating. Imitating the body's own hormones, drugs such as Clomid, work to trigger the ovaries into releasing eggs.
This method sometimes leads to pregnancy success after a few months without further interference. Other drugs can also be used to help control the menstrual cycle or thicken the womb’s lining to prepare it for pregnancy.
Your clinic may recommend trying fertility drugs if:
• you have a very irregular cycle and your ovulation is totally unpredictable
• you are producing few eggs or none, or
• your infertility is caused by failure of the pituitary gland (this controls your hormone production).
Intrauterine insemination (IUI)
A tube containing best quality ‘washed’ and treated sperm is inserted into the woman’s vagina through the cervix and into the uterus. Insemination is carried out during the most fertile part of the woman’s cycle, sometimes two or three days in a row.
Your clinic may recommend IUI if:
• you have unexplained infertility
• you have ovulation problems
• you partner experiences impotence or premature ejaculation, or
• you do not have any known fertility problems but may not have a male partner and are trying for a baby using donated sperm.
The success rate is 10 to 15 per cent per cycle.
In vitro fertilisation (IVF)
IVF treatment involves the fertilisation of an egg (or eggs) outside your body. Eggs are gathered from the woman’s ovaries and mixed with sperm. Fertilisation takes place in a flat glass dish (not in a test tube as many believe).
The fertilised egg or embryo is then transferred to the woman’s uterus via an embryo transfer. A single treatment cycle can take anything between six weeks and two months and may include phases where you have to have injections every day and regular ultrasound monitoring.
Your clinic may recommend IVF if:
• you have been diagnosed with unexplained infertility
• your fallopian tubes are blocked
• other techniques such as fertility drugs or intrauterine insemination (IUI) have not been successful
• the male partner has slight fertility problems – more severe problems are treated with intra-cytoplasmic sperm injection (ICSI)
The success rate is approx. 25 per cent per cycle.
Intracytoplasmic sperm injection (ICSI)
This is a relatively new technique where a single sperm is injected directly into the centre of the egg. ICSI differs from conventional IVF in that the embryologist selects a single sperm to be injected directly into an egg, instead of fertilisation taking place in a dish where many sperm are placed near an egg.
It means men whose sperm quality or quantity was previously too poor for IVF treatment, now have a chance of fertility treatment success.
Your clinic may recommend ICSI if:
• your partner has a very low sperm count
• other problems with sperm have been identified, such as poor morphology (abnormal shape) or poor motility (poor swimming)
• during previous attempts at IVF there was failure of fertilisation or an unexpectedly low fertilisation rate
• your partner has had a vasectomy and sperm have been collected from the testicles or epididymis
The success rate is about 25 per cent per cycle, sometimes more.
Gamete intrafallopian transfer (GIFT)
GIFT is similar to IVF except that fertilisation occurs inside rather than outside the body. Once egg collection is complete the eggs are assessed by an embryologist and up to three of the ‘best’ are mixed with around a hundred thousand motile sperm. The eggs and sperm are then immediately placed in the woman’s fallopian tube in the same operation. Only a few clinic in the UK offer GIFT.
Your clinic may recommend GIFT if:
•You have unexplained infertility.
•You’ve had no success with IVF but only a few clinics in the UK offer GIFT.
The success rate is lower than IVF.
This is a minor operation where sperm is extracted from the epididymis (the tube where sperm mature) or the testicles (where sperm cells are made) for use in ICSI or another treatment. There are several different methods of sperm extraction; TESE “testicular sperm extraction” which involves taking a small piece of tissue from the testicles and examining it under a microscope, to see if it contains sperm.
These sperm can then be extracted and used in fertility treatment. PESA “percutaneous epididymal sperm aspiration” involves using a fine needle to suck sperm out of the epididymis (the place where sperm is stored).
Your clinic may recommend sperm extraction if:
•Your partner can’t produce sperm i.e. after a vasectomy or failed reversal.
The success rate is about 25 per cent per cycle.