London IVF Genetics Centre Blog | Fertility & IVF Clinic London
The London IVF and Genetics Centre provides an unparalleled attention to detail - irrespective of how simple or complex your medical history might be. We commit ourselves to provide the best possible success rates - regardless of where you are in your assisted fertility journey. London IVF and Genetics Centre Blog POSTS Regular articles and videos prepared by London Fertility Expert, Ms Shipra..
What is an IVF Success Story? On 25th July 1978, the world’s first IVF baby, Louise Brown, was born at Oldham General Hospital, Manchester. It is a success story built on many failures and triumphs. It is a fruit of decades of painstaking but ground-breaking research by Professor Bob Edwards and Professor Patrick Steptoe. This achievement was a significant milestone in the research in this area, which included earlier attempts, some going back to early 1950s, by many scientists the world over to achieve in vitro fertilisation in animal studies. Since then, IVF clinics in London and the world over have specialised in a range of fertility treatments.
IVF or Infertility Treatment Milestones
Since the birth of Louise Brown, there were further developments that expanded the boundaries of the field and offered more choices to the patients
The first IVF birth was a natural cycle IVF. It had its own challenges. Later developments included use of controlled ovarian stimulation using clomiphene or commonly known as Clomid. This helped in planning IVF egg collection and possibly having more than one egg for insemination.
This was helpful as this could avoid starting the treatment again in case the one of the few eggs was not suitable for insemination or did not fertilise. This led to rolling out of IVF from research laboratories to later becoming a common treatment for infertility
The Development of IVF Clinics & Treatment
In early 80’s successful frozen embryo transfer was undertaken. This was another giant leap as we could then think of avoiding risks of multiple stimulation and improve embryo utilisation.
It also paved way for fertility preservation for men and women faced with conditions that could compromise their fertility or render them permanently infertile. This then also led to planned fertility preservation, such as egg or sperm or embryo freezing. This was especially helpful for women, so that they could at least try and avoid the impact of biological age. This potentially could help them in planning pregnancy at their own will to a certain extent.
However, to be able to utilise to the full potential, the freezing techniques required improvement. This became a reality when ‘flash freezing’ or ‘gamete (eggs or sperms) or embryo vitrification’ became a reality.
IVF Clinics in the 1990’s
In early 90’s there was little help for men faced with male infertility, such as low sperm count or motility or even azoospermia (absence of sperms in semen).
Until then, the only available option was to use donor sperm. In 1992, a research team in Brussels led the development of first Intracytoplasmic sperm insemination or IVF/ICSI or ICSI.
This opened a new chapter in assisted reproductive treatments or technology (ART). Besides IVF treatment, now we could help more men suffering from low sperm count in having a genetically related child. This led to dramatic fall in artificial insemination with donor sperm.
IVF Clinics and Technology
As we entered 21st century, the assisted reproductive technology or ART treatments had another ground breaking development. Professor Bob Edwards and other scientists for decades have been thinking about possibilities of testing embryos for chromosomal or genetic normality. This led to development of preimplantation Genetic Diagnosis (PGD) or Preimplantation Genetic Screening (PGS). This would help patients or couples in preventing transmission of genetic or chromosomal disorders to the next generation.
In 2010, Professor Bob Edwards was awarded Nobel prize of physiology or medicine. Until now, more than five million babies have been born worldwide using assisted fertility treatments such IVF or ICSI. This is indeed a true success story where science has helped humanity in overcoming natural barriers. The IVF treatment pregnancy rates per embryo transfer has increased tremendously ever since the first embryo transfer in late 70’s. Despite the IVF or IVF/ICSI success over last few decades, all fertility specialists and scientists will continue to provide IVF treatments in the best interest of their patients.
The future for assisted fertility treatments is exciting and bright. The new innovations will continue to improvise the treatment outcomes for our patients and generations to come. So, it is indeed a year of true celebration for all who worked tirelessly in making in vitro fertilisation or IVF a reality.
IVF success!! You are now one of the many people who can celebrate pregnancy as a result of successful IVF treatment. Without a doubt, this marks the start of some of the happiest days of your life. Despite this, it is not uncommon for couples to feel anxious at the beginning of the pregnancy. The IVF success rate, as an average amongst all age groups across all fertility clinics; both private and NHS, is around 30%. Some clinics have a much higher IVF clinical pregnancy rate compared to others. Also, certain patient groups will have a much better chance of successful outcome, such as younger women or those who have had successful pregnancy previously.
Early Stages of Pregnancy
Now that you have passed the initial hurdle, your focus should be on looking after yourself well in the early days of pregnancy. There are many do’s and don’ts about what one can and cannot do after having taken a positive pregnancy test. There is little scientific evidence in support of many of these pieces of advice that are rife in the media. However, in my experience, most women would be willing to do anything to avoid any remote possibility of affecting the wellbeing of the pregnancy. Many would wish to avoid having anything to blame themselves for if they were to suffer miscarriage.
Maintaining a Healthy Lifestyle whilst Pregnant
Once you have taken a positive pregnancy test, make sure that you still maintain healthy a lifestyle. Some women may experience morning sickness. In such cases, make sure that you are well hydrated and try frequent small meals. It is best to ensure that you can maintain as much food and fluid intake as possible. Others may have food cravings or avoidance for certain food products. Most of the time, it is best to eat as you desire whilst making sure that you are consuming adequate calories and addressing nutritional needs. If you find you are struggling to keep anything down, then you should seek help from your doctor or fertility specialist. During early pregnancy, you should also avoid undercooked or raw meats; and soft cheeses such as brie, camembert or blue veined cheese. Other healthy lifestyle measures such as avoidance of smoking, alcohol or use of recreational substances should of course be maintained. It is best to restrict caffeine consumption or consider decaffeinated drinks.
Light Exercise for Pregnant Women
Even when pregnant, you should keep up with light exercise such as walking. You should also speak to your personal trainer or fitness instructor about the exercise that may be allowed in early pregnancy. If you have experienced previous early miscarriages, then it will be reasonable to avoid exercise. If you are feeling anxious, then do consider mindfulness or meditation. Adequate rest is helpful and you should strive for six to eight hours of sleep every night.
Taking Medications during Pregnancy
If you have been through IVF treatment, then you should continue with the medications advised by your IVF specialist. All pregnant women should take folic acid. You can take 400micrograms of folic acid every day up until the 12th week of pregnancy. There are many supplements available over the counter. There is no evidence to suggest that taking extra supplements would change the course of pregnancy. Also, inform your GP and arrange to see a midwife to initiate the prenatal care. If in doubt, you should speak to your doctor or fertility specialist at your IVF clinic for further advice.
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Do’s and don’t’s after embryo transfer. Now that you have had the embryo transfer there is an anxious wait over the next few weeks. Most couples have found that these few weeks after the IVF embryo transfer are the most difficult period. Most patients are anxious of not doing anything that would harm their chances of getting pregnant.
What can I do after IVF Embryo transfer?
Do I need to bed rest after IVF embryo transfer? At London IVF clinic we do not offer patients a prescribed list of do’s after embryo transfer. But, it is important that you continue to remain reasonable about the activities you engage in for the couple of weeks immediately after transfer. There is no scientific evidence that has conclusively shown that taking strict bed rest would improve the IVF success rates. Hence, you should engage in light physical activities and take plenty of rest when possible.
Can I return to work after IVF embryo transfer? If you are working, then you should review the nature of work and check how supportive your work may be about you going through IVF fertility treatments. If you have a physically demanding job, then you may want to speak with your employer to consider temporarily changing to commitments that may be less physically demanding. Or you may want to speak to your doctor or fertility specialist and consider taking time off for the next few weeks. On the other hand, if you consider work a useful distraction, then there is no reason why you should not return to work after embryo transfer.
Can I exercise after embryo transfer? Besides work, engaging in light physical activity such as walking is acceptable and encouraged. However, you should refrain from excessive physical activity or new forms of physical activity at least until you have taken a pregnancy test.
What should I eat after IVF embryo transfer? You should eat a healthy balanced diet and drink plenty of fluids to maintain adequate hydration. Avoid sugary or fizzy drinks, smoking, alcohol or excessive caffeine intake.
If you have had fresh IVF or IVF / ICSI embryo transfer, then you may be still at risk of developing ovarian hyperstimulation syndrome. So, watch out for any signs and symptoms such as bloated sensation, sickness or feeling sick, shortness of breath. If you do develop any of these symptoms in the days following embryo transfer, you should inform your fertility specialist or clinic and seek advice.
Can I take any pain killers after IVF embryo transfer? It is generally best to avoid medications during fertility treatment, after embryo transfer and in early pregnancy. However, should you suffer from symptoms such as headaches or pains, then simple analgesia like paracetamol can be safely taken. You should also speak to you Doctor or fertility specialist if you develop symptoms that are not relieved with simple pain killers.
Besides these, you should continue taking prescribed medications and folic acid. You can continue with routine daily activities whilst taking care to be sensible with yourself. It would be helpful to manage stress in a healthier way. So, consider mindfulness or meditation during IVF treatment and continue after embryo transfer.
What can’t I do after IVF embryo transfer?
There are a few things that you shouldn’t do after embryo transfer. It is best to avoid alcohol, fizzy drinks and excess caffeine consumption. You should also avoid lifting heavy objects or engaging in strenuous physical activity. Whilst there is no scientific evidence that suggests hot baths reduce the IVF success rate, it is still a common suggestion to avoid hot baths. The period after embryo transfer can be stressful, and so it may be helpful to engage in rest. In general, you should continue with daily life as normal, taking reasonable precautions.
Click here to find out more about the types of fertility treatment offered at London IVF & Genetics Centre.
Fertile period or fertile window is the period around the ovulation. Your chances of conceiving is at its highest if you try to conceive during this period. Almost eighty percent couples will get pregnant within a year of having regular unprotected sex. Another fifteen per cent will conceive by two years of having started actively trying to conceive.
It is important that you are aware of your fertile period (also called fertile window) in order to maximise your chances of getting pregnant naturally.
How to understand your fertile days
To know your fertile days or peak fertility window, the first step will be to keep a menstrual diary. It will be useful to identify the variation in cycle lengths. If you know the expected date of your next period, then you deduct 12 days from it and add another four days.
These four days will be the fertile days when your ovulation is expected. Regular sex during this period will maximise your chances of conceiving each month.
Besides this, you can also look for signs of ovulation every month. These are the changes that take place in response to the hormone changes each month. You can chart your body temperature and check for the rise in temperature following ovulation. You may also notice increase in clear vaginal discharge.
These days most women will use an app or an ovulation calculator. You can access ovulation calculators either online or on a smartphone. There are many versions of both android and iPhone apps. You will have to input some information such as your age, cycle lengths and dates of menstrual period. This may differ slightly from one app to another.
You can also use a urine ovulation prediction test to identify the fertile days or periods of peak fertility. You can choose either a digital and non-digital version. Both of these are just as sensitive in predicting fertile period or fertile window. You can buy these over the counter without prescription.
If you are still unsure of the fertile window or period of peak fertility, then you can arrange an appointment at London IVF clinic for follicle tracking. This gives an in-depth analysis on the development of follicle and ovulation.
Ovulation Tracking for Irregular Periods
If you have irregular periods, then you may be suffering from ovulatory dysfunction. This means that you are not ovulating every month, which in turn would be preventing you from getting pregnant. This can be easily treated with ovulation induction at a London Fertility Clinic. Ovulation induction can be achieved with pills such as clomiphene (Clomid ®) or Letrozole; or gonadotrophin injection such as Gonal F, Menopur, Fostimon or Merional.
Besides identifying fertile window or period of peak fertility, you should also focus on general aspects of health and lifestyle to maximise your chances of getting pregnant without having to go through IVF treatment.
At London IVF Clinic, we look for ways of maximising your fertility and hopefully avoid complex fertility treatments like IVF. Hence, preconception preparation is important. So, make sure that you are eating healthy diet, taking regular exercise, maintaining healthy weight or body mass index (BMI) and minimising stress. Overweight or obesity can lead to ovulation dysfunction and irregular periods. Smoking can affect the ovarian reserve. Hence, you should quit smoking or at least switch to e-cigarettes.
By just taking that little extra care, majority of couples should be successful in conceiving naturally. However, if you are less than thirty five years and have been unsuccessfully trying for one year, then you should arrange an appointment at a London fertility clinic. If you are over thirty five, then may want to see a fertility specialist after six months of having actively tried naturally.
In vitro fertilisation or IVF is one of the fertility treatments that has helped millions of couples in becoming parents. Over forty years ago, Sir Bob Edwards and Patrick Steptoe successfully undertook the first IVF treatment after more than ten years of painstaking research and failed attempts. This led to the birth of world’s first IVF baby, Louise brown, on 25th July 1978 at Oldham General Hospital. IVF now contributes to nearly two per cent of the live births in UK.
1. Find the Best IVF Clinic
The first step before starting IVF treatment is to choose the best IVF clinic or the best Fertility specialist that meets your criteria. Every patient or couple has differing requirements or criteria based on their circumstances. These can be anything, such as proximity to your home or work, or the fertility clinic’s experience in dealing with your cause of infertility, or the IVF success rates. Many London fertility clinics or IVF clinics will offer open evening clinics or meetings. This is an excellent opportunity to see the clinic. Where such an opportunity does not exist, then you may want to book an initial consultation to discuss why you are facing difficulties with conceiving and also discuss the results of fertility tests or an MOT that you may have already taken.
2. Fertility Tests
If you have had fertility tests already then you can discuss starting IVF treatment. Otherwise, you and your partner will have to go through fertility tests to understand your cause of infertility. The initial fertility tests are ovarian reserve tests, semen analysis and tests to check the fallopian tubes. Before starting IVF fertility treatment, all patients and their partners will have to take tests to check for viral infections such as HIV, Hepatitis B and Hepatitis C. There may also be other infection screen tests that will be advised from time to time depending on your assessment.
3. IVF Orientation or Co-ordination Appointment
Your IVF specialist or nurse will see you for a pre-treatment orientation appointment to discuss your treatment plan. It is important that you understand all aspects of the treatment such as IVF monitoring tests, number of visits required, whether you need to take time off work, side effects from medications and any associated risks.
You will also be shown how to administer fertility medications. Most fertility drugs are in the form of injections which most patients administer themselves. Also, before starting IVF treatment make sure you have received all the prescribed fertility drugs. Most fertility treatments, including IVF, have to be timed to certain days of your menstrual cycle. Hence, your fertility specialist will tell you about the start dates for fertility injections.
5. Follicular Tracking or IVF Monitoring
During treatment you will be seen a couple of times for follicle tracking. Follicle tracking is a process which monitors the development of follicles and their response to IVF drugs. This is done by regular transvaginal scans or internal vaginal scans and blood tests. The exact number of these appointments will depend on how you are responding to fertility drugs.
6. Egg Collection
Once the follicles are thought to have reached the right size, then the eggs will be harvested. The egg collection or egg retrieval is a minor operation which is done under sedation. The eggs and sperms will be inseminated and then checked regularly to see how the embryos are developing. If you are facing difficulties with conceiving because of low sperm count or low sperm motility, then you will require intracytoplasmic sperm insemination or ICSI or IVF/ICSI. With ICSI, the eggs will be injected with a carefully selected sperm.
7. Embryo Transfer
The embryos will then be transferred a few days later. This is a minor gynaecological procedure very similar to having a smear test.
8. IVF Outcome Pregnancy Test
A few weeks later, you will need to take a pregnancy test. This may be a urine or blood pregnancy test.
Before starting the first IVF treatment cycle or any fertility treatment, this may all feel intimidating. For a more simplified, step by step illustration of your fertility treatment appointments at a London IVF clinic, visit our your Journey page.
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The best way to understand your fertility options is to have a quick chat on:
The history of IVF or in vitro fertilisation goes back over half a century. Over forty years ago, Sir Bob Edwards and Patrick Steptoe successfully undertook the world’s first IVF treatment that led to the birth of world’s first IVF baby, Louise brown, on 25th July 1978 at Oldham General Hospital. IVF now contributes to nearly two per cent of the live births in the UK.
Causes of Infertility
One in six couples will face difficulties when trying to conceive. At least a third of them will require assisted fertility treatments such as IVF. The difficulties when trying to conceive may arise from either male or female causes of infertility. Sometimes, there is no identifiable cause, which is referred to as unexplained infertility. The various female causes of infertility can be irregular ovulation or ovulatory dysfunction. This is commonly seen in women suffering from polycystic ovarian syndrome or PCOS, obesity and thyroid problems to name a few. In others, blockage of one or both fallopian tubes can result in difficulties when trying to conceive. In men, abnormal semen analysis may result in difficulties with getting pregnant. This may be due to low sperm count or low motility (sperm movement) or low normal morphology (sperm shape). This may be a result of lifestyle factors, medical illnesses or any treatments for such an illness, obesity, stress or exposure to chemicals in your immediate environment. Sometimes, there may be certain hereditary conditions, such as Klinefelter’s syndrome, which can lead to very low sperm count or, in rare cases, azoospermia.
What does IVF involve?
IVF or IVF/ICSI treatment involves controlled ovarian stimulation. You will be taking fertility medications to stimulate the development of multiple follicles. You go through a monitoring process of follicle tracking until the eggs are ready for harvesting. At this point you will undergo egg collection to harvest these eggs. Egg collection or egg retrieval is a minor operation done under sedation. Most women recover fairly quickly within a day or two. The eggs and sperm are then fertilised by IVF or are inseminated using intracytoplasmic sperm insemination or ICSI. The embryos are monitored every day. At the right stage, embryo transfer is done to replace one or more embryos. Embryo transfer is a minor procedure very similar to having a smear test.
Some of you may be opting for natural IVF. Unlike stimulated IVF, in natural IVF or natural IVF / ICSI, you do not take fertility drugs or injections for controlled ovarian stimulation. Hence, it is gentler as there are no side effects from fertility drugs and this avoids the risk of ovarian hyperstimulation syndrome or OHSS. Then there is also mild or modified IVF or IVF Lite. In mild IVF, modified IVF or IVF Lite, you do have to take stimulation drugs even though it may be a lower dosage compared to that in appropriately stimulated IVF or IVF/ICSI.
IVF Success Rates
The success rates of IVF and IVF/ ICSI have improved significantly over years. Almost two thirds of those who start the treatments should realise their dreams after four or more attempts. It has helped millions of couples worldwide in achieving parenthood. However, even after multiple attempts, there will be a few couples who may fail and have to face childlessness.
Millions of babies have been born worldwide as a result of IVF. As such, it is considered safe enough that fertility specialists can offer such treatments to those couples who are facing difficulties in conceiving or to same sex couples in helping build their families. During treatments, women may face side effects from fertility drugs. These are not life threatening, but can affect day to day quality of life. However, these are temporary and usually disappear once the fertility drugs have been stopped. Then there can be other risks of IVF such as ovarian hyperstimulation syndrome or OHSS, miscarriage, ectopic pregnancy or multiple pregnancy. Most of the studies about the health of babies born from IVF treatment have been largely reassuring.
With forty years of experience, it is safe to say that assisted fertility treatments like IVF or IVF /ICSI are safe. There is no reason to withhold these treatments from couples for whom this may be their only option for getting pregnant. On the other hand, it is only prudent to remain cautious and offer such treatments responsibly only to those where other options have been exhausted. To discuss your options, please get in touch with our London fertility clinic.
How Soon After IVF can a Pregnancy Test be Performed?
In vitro fertilisation or IVF is an assisted fertility treatment that has helped millions of couples worldwide who face difficulties when trying to conceive. Almost one in six couples will seek help and a third will need some form of fertility treatment to help them in getting pregnant.
Couples may face difficulties with conceiving for a variety of reasons. A third of these are related to female causes of infertility. Another third are related to male causes of infertility and the remaining third are unexplained. The various female causes of infertility can be irregular ovulation or ovulatory dysfunction. This is commonly seen in women suffering from polycystic ovarian syndrome or PCOS. Besides PCOS, irregular ovulation may occur due to other causes such as hypothalamic hypogonadotropism, obesity, etc. Those women who have fail to conceive with clomiphene or gonadotrophin ovulation induction may have to undergo IVF. Tubal disease or blockage of fallopian tubes can be successfully treated with IVF. Low sperm count or abnormal semen analysis can be treated with IVF / ICSI. In Intracytoplasmic Sperm Insemination or ICSI, one sperm is injected into each collected egg.
IVF or IVF/ICSI treatment involves taking fertility medications to stimulate follicles. Once these follicles are considered to have reached the right stage of development then you will go through minor procedures of egg collection and embryo transfer. Most patients will be asked to take a pregnancy test fourteen to eighteen days after egg collection. This depends on whether you are taking a urine pregnancy test or a blood pregnancy test. The urine pregnancy tests are very sensitive in detecting early pregnancy. There are many brands available over the counter. These may be digital ones that show the result as number of weeks of pregnancy. Others simply show the result as whether you are pregnant or not. Both of these tests are just as sensitive. It is usually suggested that you take these tests early in the morning with the first urine sample. If you are taking a blood test, you can do so without having to fast. The results of the blood test are usually available the same or next day. Sometimes you may have to repeat the test depending on the level of pregnancy hormone, beta human chorionic gonadotrophin (beta hCG). If your pregnancy test comes back positive, then inform your fertility specialist or fertility clinic and continue with the prescribed medications. You will also be booked in for a pregnancy scan in a few weeks time. Most early pregnancy scans are transvaginal or vaginal ultrasound scans.
IVF success rates have been improving and at least a third of patients should be able to achieve a successful outcome. The success rate depends on a variety of factors. At London IVF and Genetics Centre, our pregnancy rates are amongst the best IVF clinics.
During the first twelve weeks, there is a risk of early pregnancy problems such as miscarriage and ectopic pregnancy. Hence, if you experience pain or bleeding then you should inform your gynaecologist or fertility specialist. Those patients who have experienced repeated complications may want to have a reassurance scan. You can contact London IVF and Genetics Centre for more advice on IVF or early pregnancy or miscarriage support.
Almost one in eight couples will seek help when trying to conceive. It is expected that more couples will need help with either starting or completing the family. It would be helpful for men and women to be able to do a self-check and know if their fertility might be at risk. It is well known that diagnosing conditions at an early stage may result in timely advice and treatment. This in turn reduces the emotional stress on the individuals, couples and relationships. There are a variety of factors that can affect male and female fertility.
Age is one of the most important factors to influence female fertility. The golden age of female fertility is between 25 and 30 years. It slowly continues to decline and gathers pace around thirty five onwards. Women over forty two would have a very small chance of conceiving naturally. Age does not influence male fertility to the same extent, though it is now believed that age may affect male fertility much later in life.
When self-assessing your fertility profile, one should also take into consideration any medical illnesses or related treatments. In women, conditions such as polycystic ovarian syndrome, endometriosis, pelvic inflammatory disease or PID, fibroids, to name a few, may affect fertility. These conditions may either result in irregular ovulation, blockage of fallopian tubes or affect womb lining resulting in failure of implantation. Other medical conditions such as inflammatory bowel disease (crohn’s or Ulcerative colitis), uncontrolled diabetes, thyroid dysfunction, autoimmune conditions, etc may affect both male and female fertility. Any pelvic or abdominal operations have a potential to affect female fertility by causing blockage of fallopian tubes or affecting ovarian reserve. In men it can be, undescended testis, operations to correct undescended testes, torsion of testis, operations to fix inguinal hernia, use of steroids in gym, or cancer treatments, especially where there has been exposure to chemo-radiotherapy. Besides these, sexually transmitted infection such as chlamydia may affect both male and female fertility.
There are many lifestyle factors that can affect fertility. It is well known that moderate to heavy smoking can affect both male and female fertility. Excess consumption of alcohol, caffeine and recreational substances can affect fertility. Morbid obesity (body mass index of more than 35) may affect both male and female fertility.
If you identify any one of the above factors and have not completed your family, then you should either speak to your Doctor or a fertility specialist. If you are seeing a specialist for your condition, then discuss with your specialist about the effect of the condition on fertility. Also, one should discuss with the specialist managing your condition the effect of any medicines that you have been prescribed. Besides prescription medicines, you should specifically ask about the impact of any planned operations on fertility where relevant. There are also some things that individuals can address on their own such as weight management, smoking cessation or cutting down on alcohol consumption.
It is very much possible to do an overall fertility self-assessment. If there are any identifiable factors or for those individual who prefer to be informed about their health, then it may be worthwhile seeing a fertility specialist and taking some basic fertility tests. Couples who are thinking of starting a family may also consider taking a basic fertility check as part of their proactive approach. Those who are thinking of delaying starting or completing their family would also benefit from such tests. For women, the fertility check can be either a full assessment of basic fertility or a more directed approach. The full basic fertility assessment will include tests to check the ovarian reserve and fallopian tubes. The directed approach may be considered based on the individualised assessment by a fertility specialist. In men basic semen analysis serves as an initial screening test.
For most individuals or couples, a normal fertility assessment is reassuring. A normal fertility assessment means that there is no reduction in their chances of getting pregnant when they actively start trying to conceive. However, a normal fertility test does not guarantee fertility. Hopefully, in future there may be tests that would give clearer answers so that individuals and couples can make better informed decisions.
Male fertility: how a fertility specialist can increase your chances of conceiving
Almost one in eight couples will seek help about their fertility or difficulties when trying to conceive.
A third of these may have male fertility related issues that could be preventing the couple from getting pregnant. As such, it is crucial that men think about their fertility and seek help when needed.
Factors that can affect male fertility
Male fertility can be affected by a variety of factors. These include smoking, heavy or binge alcohol consumption, use of recreational substances such as cocaine or cannabis, excessive caffeine intake, an unhealthy diet, exposure to hot temperatures, tight clothing, obesity, stress or exposure to chemicals in your immediate environment. If you suffer from any medical illness or are taking medications for an illness, then there is a possibility that this will affect your fertility. Sometimes, there may be certain hereditary conditions, such as Klinefelter’s syndrome, which can lead to very low sperm count or, in rare situations, azoospermia. Azoospermia refers to complete absence of sperm in the seminal fluid. These are just a few of the factors and not an exhaustive list.
Impact on sperm count
It is important to understand how these factors can affect sperm health or male fertility. The sperms are produced within highly specialised structures or tubules in testis. The process of development and maturation is delicate and intricate. It takes many days for an immature sperm cell to develop into a mature sperm cell capable of fertilising an egg. It can be influenced by various environmental or health-related factors. When affected it can lead to low sperm count, low sperm motility or low sperm movement. It can also lead to a higher proportion of abnormally shaped sperms causing low normal sperm morphology. All of these aspects can affect sperm function and ultimately lead to male infertility.
Preventing problems with male fertility
Like any other aspect of health, prevention is better than cure, so maintaining a healthy lifestyle and looking after your health is important.It is important to assess and review your lifestyle to identify if any aspect of it may compromise your fertility. It is important to address these factors not only with regard to fertility but also to take care of your long-term health. It is well known that smoking can affect male fertility and lead to low sperm count or sperm motility or sperm morphology on semen analysis. If you are a smoker, then you should quit smoking. You can either do this on your own or participate in the smoking cessation programme at your Doctor’s surgery. You should limit alcohol intake to just a few units each week. Besides smoking and alcohol, you should think of reducing your caffeine intake. Obese men with higher body mass index or BMI may have poorer sperm health such as low sperm count or low motility or low normal sperm morphology. Therefore, maintaining regular exercise is beneficial not only for your general health but also for your fertility. Overly vigorous exercise, especially when wearing tight clothing for prolonged periods of time, may affect sperm health.
Speak to a fertility specialist
If you suffer from a medical illness, it is important that you check with a fertility specialist or GP whether it could affect male fertility. If you are taking regular medicines, again you should check with your doctor or see a fertility specialist find out whether it may lead to oligozoospermia or low sperm count.
If you suffer from a medical illness or take prescription medicine, then it may be worthwhile speaking to your Doctor or fertility specialist to check your fertility. This can be done either before you have started or after you have been trying unsuccessfully for some time. In rare cases, especially with serious illnesses or where treatment has the potential to affect fertility, you may consider freezing sperm as a back-up or for fertility preservation, especially if you wish to have more children. If you have other family members who have faced difficulties conceiving, then again you may want to discuss this with your Doctor or Fertility specialist.
It is common for couples to get themselves checked out even before they have started trying to conceive. This can be arranged as part of couple fertility MOT or Male fertility MOT. The sperm health can be checked by doing a basic semen analysis. A semen analysis can be arranged by contacting a fertility clinic in your area. Most NHS fertility clinics will do semen analysis only for those couples who have been unsuccessfully trying for at least a year.
If you identify any one of the factors and have not completed your family, then you should either speak to your Doctor or to a fertility specialist. If you are seeing a specialist for your condition, then discuss the effect of the condition on fertility with the specialist. Also, you should discuss with the specialist managing your condition the effect of any medicines that you have been prescribed. Besides prescription medicines, you should specifically ask about the impact of any planned operations on fertility where relevant. There are some things that individuals can address on their own such as weight management, smoking cessation or cutting down on alcohol consumption.
It is very much possible to do an overall fertility self-assessment. If there are any identifiable factors, or for individuals who prefer to be informed about their health, it may be worthwhile to see a fertility specialist and take some basic fertility tests. Couples who are thinking of starting a family may also consider going for couple fertility tests or fertility MOT. Those who are thinking of delaying starting or completing a family may also benefit from such tests. For women, the fertility check can be either a full assessment of basic fertility or a more directed approach. The full basic fertility assessment will include tests to check the ovarian reserve and fallopian tubes. The directed approach may be considered based on the individual assessment by a fertility specialist. In men, basic semen analysis serves as an initial screening test.
For most individuals or couples, a normal fertility assessment is reassuring. A normal fertility assessment means that there is no reduction in their chances of getting pregnant when they actively start trying to conceive. However, a normal fertility test does not guarantee fertility. Hopefully, in the future, there will be tests that can give clearer answers so that individuals and couples can make better-informed decisions.
I am not sure whether stress causes infertility, but surely infertility causes stress.
The triggers for stress differ from patient to patient and during the course of the process. Such as cause of difficulty in conceiving, when taking the first step to see a fertility specialist, the fertility treatment itself, failed IVF treatment and the support available to the couples faced with such situations. Hence, it is important that patients develop an awareness of stressors and stress when faced with difficulties in conceiving.
Anxiety When Trying for a Baby
It is not uncommon to feel anxious about being out of control. When experiencing the emotional ups and downs related to infertility, you may feel constant fatigue or lack of energy, low threshold to snap at people close to you, sleep disturbances, low mood, extreme sadness or difficulties in concentrating or focusing on day to day tasks.
Some may feel ‘numb’ or be ‘in denial’ especially after repeated unsuccessful attempts at various fertility treatments. This is especially more so in couples facing primary infertility as against secondary infertility. Whilst others may feel a ‘sense of loss’.
It is not uncommon for couples to feel a sense of failure in achieving that is expected to happen naturally. One or both partners may experience a feeling of guilt in helping their partners achieve parenthood. This is especially the case when the cause of infertility is well known. It is sometimes associated with feeling of either taking blame upon yourself or blaming your partner.
IVF Cycle Average Success Rates
Almost two in three couples who start the treatment will achieve pregnancy by the third IVF treatment cycle.
So, it is no surprise that couples are anxious about this uncertainty when undergoing fertility treatment.
In others, it could be the fear of the short and long terms effects of taking fertility drugs. Finally, in others, it could be facing the possibility that one of the partners may not have a genetically related child.
This is the case in women with very low ovarian reserve or in men with absence of sperms or Azoospermia. Finally, in others, it is about accepting childlessness after multiple failed IVF treatment.
Besides these, some couples or partners may feel a sense of shame. Shame is a painful feeling that may be associated with low self-esteem, a sense of inadequacy and helplessness.
As repeated attempts to get pregnant are unsuccessful, there is a realization that this intensely strived for goal has not been, and may never be, attained. This may be felt as low mood or chronic sadness, anguish or self-doubt.
There is a sense of failure not only in realizing their own dream to conceive, but also failing their spouse, parents, and siblings as well.
With repeated failed IVF attempts or fertility treatments, this sense of failure slowly spreads like a shadow over a person’s experience and starts affecting self-confidence in other aspects of life too.
Ensuring Wellbeing in the IVF Process
In order to ensure your wellbeing, it is important to know the stressors and stress involved with infertility and fertility treatments. One should be aware of these and learn how to take care of your emotional health. It is important that you get the support you need whether this is from your partner, family, friends, support groups or fertility counsellors. It will help to develop insight and coping strategies to manage your emotions. This will go a long way in ensuring that your self-esteem and outlook on life remains as positive as possible. There are many ways couples may think of coping with such emotional upheavals.
Coping Strategies in IVF
There are many coping strategies you may use to maintain a positive outlook even in the midst of deep disappointment. It is important to be aware of various emotional responses to infertility. So, try not to panic about such emotions. It is not uncommon to feel tearful and lonely. So, give yourself an opportunity to cry or feel angry about it. But, avoid snapping out of it as it will consume your emotional energy.
Your partner will be facing similar emotional challenges. Men and women cope differently when faced with emotionally charged situations. So, do not make your partner feel as devastated and let them express their emotions differently. Also, do not expect your partner to read your mind. Let your partner know how he or she may help you in dealing with such feelings.
Many women feel constantly pre-occupied with infertility related communication. It will be helpful to limit such conversation to maybe few minutes at a time. Remember that anger is also one of the normal responses to infertility. Sometimes these may be associated with feeling tearful or feelings of sadness.
You may find it helpful to try some of the techniques commonly used to manage such feelings. There is no “right” or wrong way to do this. Try not to force it nor expect a specific response. Some may find it helpful to write about the feelings or make a list of situations that make you angry.
Try and use ‘’I feel’’ statements so that you can acknowledge the specific feeling. Acknowledging is the first step in dealing with various emotions. Once you are aware of your feelings, then you can explore various coping mechanisms to help you deal with such feelings or thoughts. Some women may find it helpful to engage in physical exercise or engage in hobby.
Ultimately it is important to acknowledge and accept yourself and spouse/partner with the strengths, weaknesses, and failures. You should try to accept these feelings such that you no longer have to conceal these and suffer alone.
The process of coming to terms with emotional consequences of infertility is long and gradual. You should try and empathise with your own self. It will help to be self-aware of your strengths and limitations. You should be proud and credit yourself for having tried and survived this journey with all its challenges.
You can also consider practising mindfulness and meditation. There is increasing evidence about positive impact of these interventions in patients with other chronic ailments. It is important that these techniques are practised with an accredited mindfulness practitioner. Whilst the vast majority of patients will see positive benefits, there are some who may not find it notice significant benefit.
Besides dealing overall with emotional consequences of infertility, there are certain social situations that may make it worse. Be selective when accepting invitations especially where you expect there may be a lot of children or pregnant women. You should try not to feel guilty about being selective or not participating in the traditional family festivities. It is alright to give yourself time to heal.
When possible try not to pretend ‘business as usual’. Some may find it helpful to help others in need such as volunteering for a local charity. It is important that you don’t close yourself to positive life experiences. Also, try not to feel guilty of enjoying even in the midst of deep disappointment. Allow yourself to go with the emotions and feel sad, deprived or depressed. Infertility is a major life crisis, and you are entitled to those feelings.
All fertility clinics in UK offer counselling services to their patients. Check with your fertility clinic or fertility specialist about the fertility counselling services. You can also visit British Infertility Counselling association to find out about the fertility counsellors in your area. You may think of joining a local support group. In UK, Fertility Network UK organises support group meetings. If in need you can call the support helpline.