Facing infertility can mean experiencing many different feelings that you may struggle to cope with. It can help your understanding if you have access to some of the basic facts of infertility and infertility treatments.
Approximately, 1 in 7 couples experience issues when trying to conceive, but there are some options available to you which you may want to consider.
Infertility is usually diagnosed if a couple has not conceived after a year of trying. There are two types of infertility:
- Primary Infertility – This is when someone who has never conceived previously has difficulty conceiving.
- Secondary Infertility – This is when someone has had 1 or more pregnancies in the past but is having difficulty conceiving again.
There are a number of potential causes of infertility, however 1 in 4 causes of infertility in the UK are unexplained.
The most common cause of infertility in women is a problem with ovulation. Ovulation challenges could be because of polycystic ovary syndrome (PCOS), thyroid issues, or premature ovarian failure. Other common causes include:
- Scarring from pelvic or cervical surgeries
- Problems with cervical mucus
- Pelvic Inflammatory Disease
- Sterilisation, even if reversed
- Medicines And Drugs – some medicines, drugs and medical treatments can affect fertility such as long-term use of NSAIDS, or chemotherapy
Again, there can be a few causes of infertility in men. These can include:
- Sperm and semen quality – issues with semen is one of the most common causes of infertility in men. These issues can include low sperm count, abnormally shaped sperm, or slow-moving sperm.
- Testicular damage – damage to the testicles could be caused by injury, surgery, cancer, infection, or something present from birth.
- Vasectomy or reversed vasectomy
- Ejaculation disorders
- Hypogonadism – this is a low level of testosterone.
- Medicines and drugs – drugs such as chemotherapy, and the anti-inflammatory sulfasalazine can cause issues with sperm, however the effects of sulfasalazine are temporary. Long-term misuse of anabolic steroids are also known to affect sperm quality.
In some cases, the cause of infertility may never be identified. However, IVF is a treatment option for unexplained infertility, and you should consider speaking to your healthcare provider if a cause has not been found.
There are essentially 3 main types of fertility treatments:
- Surgical procedures
- Assisted conception
There are a number of common fertility medicines that may be prescribed. These include:
- Clomifene or tamoxifen – which both encourage ovulation
- Metformin – can be helpful for women with Polycystic Ovary Syndrome (PCOS)
- Gonadotrophins – encourages ovulation in women and may also improve fertility in men.
These medicines can have some side effects. These can include nausea, vomiting, hot flushes, and headaches.
Your doctor should advise you of the side effects of any medication they have prescribed for you.
Many of these medicines are not recommended in cases of unexplained infertility. They aren’t particularly effective in these cases.
There are a few different surgeries that can be used to treat infertility, or to further explore possible causes:
Fallopian Tube Surgery
Fallopian tubes can become blocked, or scarred, and surgery may be needed to repair them. Clearing blockages in the fallopian tubes can make it easier for the eggs to pass through them. The success rate of this will depend on the extent of the damage.
Surgery For Endometriosis, Fibroids And PCOS
Laparoscopic surgery can be used to treat endometriosis. Endometriosis is when tissue, similar to the tissue that lines the womb, grows in places that it shouldn’t. Surgery can help by removing the cysts. Laparoscopic surgeries can also be used to treat fibroids, by removing the small growths in the womb.
Laparoscopic ovarian drilling can be used to help treat PCOS. It’s a minor procedure that uses either heat or a laser to destroy part of the ovary.
Surgery For Epididymal Blockage
The epididymis is a structure in the testicles that helps to store and transport sperm. It can become blocked, which means that the sperm can’t be ejaculated normally.
Surgery may be effective in clearing the blockage. Surgical extraction is also an option. This would be done under local anaesthetic.
Assisted conception can be another treatment option for those experiencing infertility.
Intrauterine Insemination (IUI)
Intrauterine Insemination is a procedure where the sperm is artificially inserted into the womb.
The sperm is collected, washed in a special fluid, and the best quality sperm are selected. The sperm is then inserted into the womb by a thin plastic tube that is passed through the cervix.
In Vitro Fertilisation (IVF)
IVF, or In Vitro Fertilisation, is a procedure where the egg is fertilised outside of the body.
This option involves a regime of fertility medicine to encourage egg production. The eggs are then harvested, and then fertilised with the sperm in a lab. The embryo is then transferred into the womb.
Egg And Sperm Donation
In some cases of infertility, treatment using a donor egg or donor sperm may be available. This treatment would usually be done with IVF.
You may be able to get fertility treatment through the NHS. However, some areas do have very long waiting lists. The criteria for eligibility can vary too. Your GP will be able to discuss the eligibility criteria in your area with you.
You may want to consider opting for private treatment instead. Private treatment can be expensive, and it isn’t guaranteed success. If you are considering private treatment, there are some things you need to think about. You’ll need to know:
- The clinics that are available
- The treatments which are offered
- What the success rates of the treatments are
- How long the waiting lists are
- The costs of these treatments
You can ask for a fully costed, personalised treatment plan with a breakdown of what’s included, such as scans, medicines, and fees.
You can also ask your GP or healthcare provider for their advice on choosing a clinic.
Always make sure you choose a clinic that is licensed by the HFEA. This is a government agency responsible for the regulation and inspection of all UK fertility clinics.