We look at the different options when you can’t conceive naturally, so you can decide if IVF is right for you.
IVF can be a wonderful thing. Since the first ‘test-tube baby’ was born more than 40 years ago, it’s thought around eight million babies have been conceived by assisted reproduction worldwide, and the practice has become so normalised around 20,000 babies are born using IVF in the UK each year.
This number doesn’t detract from the emotional and financial investments of fertility treatment, however, nor the physical price of the minefield-like-process. Only recently, comedian Amy Schumer revealed to her 9.5 million followers on Instagram she was “a week into IVF” and feeling “really rundown and emotional”.
Understand your options
Your doctor may recommend in vitro fertilisation (IVF) if you’ve been trying to conceive for longer than six months or a year. It’s important you understand all your options before going ahead, because not everyone needs IVF — some problems with ovulation may be corrected with drug treatment alone. Deciding whether to use IVF is a very personal choice — you’ll need to weigh up the physical and emotional pressures involved as well as any potential financial costs. And there’s no guarantee of success; the cause of infertility in more than a third of cases remains unknown.
Assessment and timing
In the first step a fertility assessment for both you and your partner will be recommended. A third of all fertility problems are due to a low sperm count, but the factors that influence fertility are many: illnesses, injuries, chronic health problems and lifestyle choices all play a role.
Timing is also important when trying for a baby. An ovulation test can help predict when you’re most likely to be fertile, and you should take an ovulation test a few days prior to when you anticipate ovulation. Or you can ask your doctor or specialist to monitor your cycle with blood tests and an ultrasound, then checking your blood progesterone level.
An X-ray test called a hysterosalpingogram (HSG) can also be done to look inside the uterus, fallopian tubes and the area around them to pinpoint where the problem might lie. Similarly, a saline ultrasound to evaluate the uterus and the shape of the uterine cavity will achieve similar results.
Your chances of becoming pregnant can be increased by taking the oral medication Clomid, which makes the body think oestrogen levels are lower than they really are, triggering the processes in the body to stimulate the ovary to produce an egg follicle, or multiple follicles, that will develop and be released during ovulation.
You may also be recommended human chorionic gonadotropin (HCG), a hormone used in combination with other fertility drugs to increase a woman’s chance of pregnancy. Having HCG injections to force ovulation and maximise your cycle can also help. Artificial insemination can be done at the same time if you wish.
The treatments available
It’s worth asking your GP about whether you’re eligible for NHS treatment — it’s generally offered to under-43s who have been having regular unprotected sex for two years or had 12 cycles of artificial insemination (it’s not normally recommended for women over 42). Your GP can refer you to a private clinic if taking the NHS route is not an option, or you may want to look into these options yourself. Private treatment prices can vary, but on average you’re looking at around £5,000 for one cycle. There are often additional costs for drugs and consultations, so it’s important to get a full breakdown before committing.
As there are many treatments available, it’s important to research which is the most appropriate. Conventional IVF — where a woman’s eggs are fertilized in a lab and placed back inside the womb — is a lengthy process, taking around four to five weeks from the first drugs taken to stimulate the egg release, to embryo placement and pregnancy blood tests. Natural IVF swerves stimulation drugs and works with your natural menstrual cycle to collect an egg that’s been organically matured by your body. Natural Modified IVF is less drug intensive with around three to four days’ worth of drug taking, as is mild IVF, where you’ll also receive a lower dose of fertility drugs.
The success rate of IVF varies with every couple — it’s dependent on your age and whether the cause of infertility is known. Between 2014 and 2016 the percentage of treatments resulting in a live birth, for women using their own eggs and partner’s sperm, using the per embryo transferred measure, were 29% for under-35s, 23% for ages 35-37, 15% for ages 38-39, 9% for ages 40-42, 3% for ages 43-44, and 2% for ages 44+ according to the NHS.
IVF can be emotionally and physically challenging as it’s common to need more than one IVF cycle. Side effects such as hot flushes and headaches are common, but there’s also the possibility of multiple births, ectopic pregnancy (when a fertilised egg implants itself outside of the womb, usually in one of the fallopian tubes) and ovarian hyperstimulation syndrome, where too many eggs develop in the ovaries.
Your chances of success are unique to you. Leading a healthy lifestyle, keeping a healthy weight and avoiding caffeine, alcohol and cigarettes during treatment will all help with your chances of having a baby. No matter what the success rates of clinics are, the power of positive thinking can make all the difference to the outcome. Contact others going through the same thing or take advantage of the counselling services available to you if you need to talk to a professional. The help is out there to support you on your journey to starting a family.