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Even if you are having fertility problems, in vitro fertilisation (IVF) may not be the first step. Many women are given a drug called Clomid to boost ovulation – including, famously, Jools Oliver, who used it successfully each time. If that doesn’t work, you may be offered is intrauterine insemination (IUI). It’s minimally invasive – high quality sperm are selected and placed in your uterus close to the time of ovulation, meaning there’s more chance of an egg being fertilised. But it’s not for all patients, especially if you have a blockage in a fallopian tube.
If you are referred for IVF, there are considerations to be made. ‘I tell patients considering IVF they have to prepare themselves for that fact the first attempt is not always successful,’ says Sarah. >>Pre-conception health tips>>How to predict when you're most fertile?‘It’s best to be realistic about the process, side effects, the pressure it can put on a relationship and the devastating feelings if it doesn’t work.’ In general, there’s a 25% chance of conceiving with each IVF cycle.‘I also advise them to explore other options – fostering, adoption and surrogacy, too. Really talk honestly about what their priorities are,’ adds Sarah.Once you decide to go ahead, find out what your area provides.Each area has a Primary Care Trust, which decides how best to spend NHS funds. Some offer up to three cycles of IVF – others less and their eligibility guidelines vary. Your weight, age, time in a relationship, previous children and previous fertility treatment can all factor.The cost of going privately varies so talk to your partner about how many attempts you are willing to or can afford to try.
Work is also an important consideration. ‘With IVF and intracytoplasmic sperm injection (ICSI) you don’t have control over the timing of procedures,’ says Sarah. ‘It’s impossible to plan around egg collection and implantation and it won’t wait for an important business meeting. You may also need to take a day off here and there because you can be a bit sore after procedures so you need an understanding boss or maybe a sabbatical.’
Types of treatmentIVF – (in vitro fertilisation) Eggs are removed from the ovaries and fertilised with sperm before being placed in the woman’s womb. ‘Generally this is used for unexplained infertility or tubal problems,’ says Gillian. It involves daily injections and side effects can range from hot flushes to more serious ovarian hyper-stimulation. It’s invasive and can lead to multiple births but has a higher success rate than IUI.Find out how to increase your success rate from IVF treatment here.
>>Infertility: Know your options if you’re struggling to get pregnant>>Fertility treatments explained IUI – (intrauterine insemination) ‘This is used when there is a mild male factor or ovulatory problems but it is no good if tubes are damaged. The best quality sperm are inserted into the woman’s womb when she is ovulating. It is less invasive than IVF with a lower success rate.DI – (donor insemination) Sperm from a donor can be used if you don’t have a partner, your partner is unable to produce sperm or has a high risk of passing on an inherited disease. ICSI – (Intracytoplasmic sperm injection) A single sperm is injected directly into an egg. The fertilised egg is then transferred to the womb. For a woman, the process is similar to IVF but it is used for serious male problems.GIFT – (gamete intrafallopian transfer) With this the preparation and growth of eggs is identical to IVF but the eggs and sperm are placed together in the fallopian tubes and fertilisation takes place in the body.Official guidelines do not recommend it in preference to IVF. IVM – (In vitro maturation) Eggs are removed from the ovaries when still immature and matured in the lab before fertilisation. It is for women who are at risk of ovarian hyperstimulation with the drugs. The downside is there may be fewer viable eggs.Find out more about in vitro fertilisation here.>>Trying for one to three years?>>The big decisions
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