How common is infertility?
25% of infertile couples have more than one cause of infertility.
The current increase in infertility might be the result of more women choosing to delay starting a family until later in life, when their reproductive health can be affected.
The increase of some sexually transmitted diseases such as Chlamydia can result in conditions such as blocked tubes, preventing pregnancy from occurring.
When is a woman’s most fertile time?
The average menstrual cycle is 28 days – that is counting day one as the first day of menstrual bleeding then the next period is due to start 28 days later.
The menstrual period comes because an egg fails to become fertilised. The period comes about 12 to 14 days after the egg is produced.
Therefore, in the average 28 day cycle the egg is produced around day 14. Sperms can live happily 48 hours in the vagina or the uterus so the most fertile time is from day 12 to day 16.
What things increase a woman's risk of infertility?
- Her age.
- Being under or overweight.
- Moderate or heavy caffeine and/or alcohol use.
- Excessive exercise.
- Certain environmental exposures.
- Sexually transmitted infections.
- Hormonal changes, such as polycystic ovarian syndrome and primary ovarian insufficiency.
Can I get pregnant if I no longer have periods?
If in fact you are menopausal then you will need egg donation.
However, if the problem is hormonal, you may be treated with fertility medications.
Does infertility relate to the woman only?
No, infertility is not always a woman’s problem. Both women and men can have problems that cause infertility. About one-third of infertility cases are caused by women’s problems. Another one third of fertility problems are due to the man. The other cases are caused by a mixture of male and female problems or by unknown problems.
With men, declining sperm counts and testicular abnormalities, are common causes of infertility.
What increases a man's risk of infertility?
- Heavy alcohol use.
- Recreational drugs.
- Anabolic steroids and body building medications.
- Certain medicines.
- Smoking cigarettes.
- Environmental toxins, including pesticides and lead.
- Radiation treatment and chemotherapy for cancer.
- Health problems such as mumps, serious conditions like kidney disease, or hormone problems.
What causes infertility in men?
- Blockage. A blockage in any part of the reproductive system that helps deliver sperm, such as the epididymis or vas deferens, can cause infertility.
- Medications. Certain medications, such as anabolic steroids, cancer drugs, have been associated with infertility in men.
- Low sperm count. When a man produces too little sperm, it can cause problems with conception.
- Sperm problems. Sometimes sperm are shaped abnormally or move in abnormal ways, which can lead to male infertility.
- Undescended testicle. A testicle that doesn’t move down from the abdomen into the scrotum can affect sperm production. Sometimes a man is born with the problems that affect his sperm. Other times problems start later in life due to illness or injury. For example, cystic fibrosis often causes infertility.
- Varicoceles. This happens when the veins on a man’s testicle(s) are too large. This heats the testicles. The heat can affect the number or shape of the sperm.
- Medical problems. Some medical conditions, such as kidney failure, can lead to male fertility problems.
Do you do male infertility evaluations?
How long should a couple try to conceive before going to the doctor?
Or see a doctor if you have a history of:
- Pelvic inflammatory disease (PID).
- Sexually transmitted infection such as Chlamydia or Gonorrhea.
- Irregular periods.
- Surgery on your reproductive organs or intestines.
- Chronic illness such as diabetes, cancer or thyroid disease.
Can I find out earlier if I have fertility issues?
How do doctors treat infertility?
Doctors recommend specific treatments for infertility based on:
- Test results.
- How long the couple has been trying to get pregnant.
- The age of both the man and woman.
- The overall health of the partners.
- Preference of the partners.
What about fertility treatments?
Treatments can include lifestyle changes, supplements, surgery, medication, or assisted reproduction.
There are several treatments under assisted reproduction such as In vitro Fertilisation (IVF), Gamete Intra-Fallopian Transfer (GIFT), and Zygote Intra-Fallopian Transfer (ZIFT). All these procedures involve harvesting a number of eggs in the hope of fertilising at least one egg, and then inserting the fertilised egg(s) into the uterus.
How often is assisted reproductive technology (ART) successful?
- The reason for infertility.
- The age of the partners.
- The type of ART treatment.
- If the egg is fresh or frozen.
- If the embryo is fresh or frozen.
Is there a waiting list? And how long would I have to wait for the start of my IVF treatment?
How soon can we start receiving treatment?
What if my IVF attempt failed? How long will I have to wait before trying again?
What happens with my remaining embryos that are not implanted?
How long can my embryos remain frozen?
What is Intra-cytoplasmic sperm injection (ICSI)? When is it useful?
ICSI is especially useful in cases if there is a problem with man’s sperm.
Do you perform intra-cytoplasmic sperm injection (ICSI) on all patients?
We feel that ICSI should only be performed when necessary, for example when the there is a problem with the sperm or there is a prior history of poor fertilisation through IVF.
What is intrauterine insemination (IUI)?
The fast moving sperm are then placed into the woman’s womb close to the time of ovulation when the egg is released from the ovary in the middle of the monthly cycle.
Are urine pregnancy tests as reliable as blood tests?
On the other hand, blood tests are sensitive to approximately 2 mIU per mL.
Therefore, a very early pregnancy may still be detected with blood tests but be missed with a urine pregnancy test.
Can embryos from egg donors be frozen?
Can I receive treatment with donated sperm or donated eggs?
When is the best time to measure urine for ovulation?
We recommend any time after 3.00 pm.
Do you only treat married couples?
Can I come to the consultation on my own?
How much will it cost?
Do you accept single women and lesbian couples?
Are there any risks or side-effects with IVF?
Mild reactions to the drugs do occur sometimes, causing symptoms such as headaches, mood swings and hot flushes. A more severe reaction is called Ovarian Hyperstimulation Syndrome (OHSS), where cysts develop on the ovaries and fluid collects in the abdomen. Symptoms of this include swelling in the abdomen, pain, vomiting and nausea.
Sometimes it’s also possible to have an ectopic pregnancy, whereby the embryo develops in a fallopian tube, rather than the womb. If you’re having IVF and develop any unusual or concerning symptoms, then it’s important to speak to your doctor immediately.
Undergoing IVF can be emotionally challenging too, especially when treatment cycles are unsuccessful. We have counselling facilities available in our Unit. There are also other support groups available in the UK.
What support is out there?
As well as counselling you may find further ‘couple counselling’ useful to work through issues brought up by the treatment.
How long can sperm be stored?
Is freezing harmful to the sperm?
What is the procedure for using the frozen sperm?
The woman would need to be assessed by the doctor for blood tests or a current pap smear and to assess tubal patency (to make sure there are no blockages in her fallopian tubes). Some documentation needs to be completed prior to any insemination. Be sure to communicate with your doctor in advance to avoid any delays.
What is the ideal abstinence time before giving a semen sample for assessment?
What is the normal volume of an ejaculate?
How can I guarantee that I will become pregnant using the samples?
What if the initial semen quality is poor, or concentration is very low?
How can I be sure my semen sample is not contaminated with another sample or mislabeled?
What if I move out of the area?
Can we have IVF treatment if I and my partner are not married?
How many embryos can be implanted at on IVF cycle?
Normally up to 2 embryos can be implanted.
What is a blastocyst?
We now have the ability to grow the embryos for 7 days until they reach the blastocyst stage. For many patients, these blastocysts may have a greater chance of implantation, permitting us to implant fewer embryos and lower the possibility of multiple births while, at the same time, increasing the chance of pregnancy.