Infertility: Know your options if you’re struggling to get pregnant

If you’ve been unsuccessful so far in natural conception and you’re struggling to make it happen, hope doesn’t stop here

By askamum

Couple holding hands

So you've been trying to conceive for a while and you're thinking about other options. With fertility treatments becoming more advanced and readily available, here's a breakdown of assisted fertility options should you decide to seek further help.

Fertility drugs
Fertility drugs are generally the first port of call for women who aren't ovulating. Imitating the body's own hormones, they work to trigger the ovaries into releasing eggs. This method sometimes leads to conception 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.

>> Read: Calculate when you're most fertile with our ovulation calculator
>> Read: Could it be your diet? Foods to avoid if you're trying to conceive

Assisted reproduction treatments

Intrauterine insemination (IUI)
What is it? Intrauterine insemination, or artificial insemination, inserts sperm into the womb at the time of ovulation using a catheter (a very fine needle or probe).
What does it treat? Unexplained infertility, premature ejaculation, erection difficulties.
What’s the success rate? Ten to 15 per cent per cycle.

In vitro fertilisation (IVF)
What is it? Eggs and sperm are collected and fertilised in the laboratory before the resulting embryo is transferred to the womb. Once mature, they're collected by the doctor, using ultrasound to guide the collecting tube. A sperm sample is produced by the man, which is put with the eggs in a Petri dish and left for a few days in the hope that fertilisation takes place. If a healthy embryo develops, a catheter places it in the womb.
What does it treat? Unexplained infertility, blocked fallopian tubes, endometriosis, PCOS.
What’s the success rate? Approx. 25 per cent per cycle.
Find out how to improve your chances of IVF success here.

Intracytoplasmic sperm injection (ICSI)
What is it? A single sperm is injected into the centre of a single egg, which is then transferred to the womb using the same process as IVF.
What does it treat? Male factor infertility, such as low sperm count, poor motility or abnormally shaped sperm.
What’s the success rate? About 25 per cent per cycle, sometimes more.
ICSI worked for one couple, read more with our real life success story.

>> Keep on top of your health with our health check guide
>> Foods to avoid if you're trying to conceive

Gamete intrafallopian transfer (GIFT)
What is it? Gametes (eggs and sperm) are collected similarly to IVF. Instead of combining sperm and eggs together in the laboratory, they're instantly transferred to one of the woman's fallopian tubes for fertilisation to take place inside the body. Only a few clinic in the UK offer GIFT.
What does it treat? Unexplained infertility.
What’s the success rate? Lower than IVF. It can be offered to couples who’ve had no success with IVF.

Sperm extraction
What is it? 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.
What does it treat? In cases where a man can't produce sperm. I.e. after a vasectomy or failed reversal.
What’s the success rate? When used in ICSI, about 25 per cent per cycle.

Embryo freezing
What is it? The HFEA (Human Fertilisation and Embryology Authority) specifies no more than two embryos may be transferred to the womb at a time in fertility treatments. As IVF normally creates more embryos than can is possible in a single cycle transfer, most clinics will freeze any remaining healthy embryos for future IVF treatments, with the patients' consent.
What does it treat? To avoid further fresh IVF cycles involving invasive processes of egg stimulation and collection.
What’s the success rate? Usually only 60 per cent of embryos survive the freeze/thaw process. Those that do survive have a lower rate of implantation and offer a lower pregnancy rate than fresh embryos.

>> Use our ovulation calculator to increase your chances
>> Talk to other mums with fertility problems on our forum

Other options
A growing number of clinics are beginning to use two newer techniques that may boost the chances of pregnancy for some couples.

Blastocyst transfer
A blastocyst transfer may be recommended if the embryos fail to implant in the womb in IVF treatment.  This process involves letting the embryo develop for five or six days before being transferred to the womb. Because the embryo is more developed and transfer occurs closer to the time that implantation would occur naturally, the pregnancy rate is usually higher. However, some embryos will not survive, so the amount of embryos available for transfer and freezing will be fewer. As a result, this is usually only offered to women who produce a large number of good quality embryos.

Assisted hatching
An embryo has to hatch from a gel-like membrane before attaching itself to the wall of the womb. This membrane can be tough, and some fertility experts believe it can hinder implantation of the embryo in the womb. To assist the embryo to break through, the embryologist makes a tiny hole in the membrane before being transferred to help the hatching process.

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