If going to see a fertility specialist and thinking you will automatically end up doing IVF makes you freeze with fear, then you can defrost because I am pleased to tell you otherwise. There is a range of early fertility treatment options to consider before you consider IVF.
Our statistics show that only about 20 to 30 per cent of our patients who see our fertility specialists go on to IVF treatment.
Often IVF is not required as several simpler fertility treatment options can substantially improve a person’s chances of pregnancy. These include lifestyle factors, timing, ovulation induction (OI), intra-uterine insemination (IUI), surgery, and hormone therapy.
Factors affecting conception
Conception Lifestyle factors
Several lifestyle changes can be implemented to maximise your chances of conception and give your baby the best start in life. When trying to conceive, the male and female's reproductive health is equally important. Factors like weight, stress, diet, alcohol, caffeine, medications and other habits can be assessed to determine if they are impacting your chances of success.
Timing of ovulation is critical to successfully conceiving. The general rule is ovulation usually occurs about two weeks before your period starts. With the help of a specialist, you may be able to more accurately pinpoint your ovulation dates as it is very individual and dependent on how long the menstrual cycle is and will not always be on day 14.
Ovulation induction involves stimulating the ovaries to encourage or regulate ovulation. Various fertility medications are available for ovulation induction, and your physician will choose the drug or combination of stimulation drugs that is best in each case. The two most common methods of ovulation induction are:
Clomiphene citrate involves using medication (Clomid or Seraphine) to stimulate the ovaries and encourage or regulate ovulation. This medication is prescribed to women with infrequent periods and long ovulation cycles.
Follicle-stimulating hormone (FSH): Ovarian stimulation is stronger with this method, stimulating the development of the fluid-filled sacs containing the eggs. At City Fertility Centre, we are very careful to regularly monitor our patients to minimise possible complications relating to overstimulation.
Intra-Uterine Insemination (IUI)
Intra-uterine insemination is a procedure in which treated sperm is inserted into a woman’s uterus directly to improve the likelihood of fertilisation. IUI can involve fresh sperm (from the partner) or frozen sperm (from the partner or a donor). It can be useful in diagnoses of irregular ovulation, unexplained infertility or sexual dysfunction.
Surgery to increase conception chances
For women, surgery can often improve the chances of conception when the cause of infertility can be traced to past inflammation or infections that have created scarring or conditions such as fibroids, endometriosis and other tubal or uterine issues. The surgery aims to remove or minimise any issues preventing successful conception. For men, surgery for a condition known as varicocele can sometimes help. This condition is where the veins of the scrotum become abnormally enlarged and may be surgically treated by clipping or tying the veins.
Hormone therapy for men
Hormonal imbalances that affect sperm development can be treated by gonadotrophin therapy. Gonadotrophins are protein hormones sometimes used to treat unexplained male infertility in cases of abnormally low sperm counts or when less than 40% of sperm are mobile. Other drug treatments include using antibiotics to treat infertility caused by infections. Careful consideration should be made when deciding which treatment options are right for you, and these can be discussed with your fertility specialist. If you have not achieved pregnancy after a year (or six months if you are over 35) of unprotected intercourse, you should seek medical advice from your GP or a specialist.
Dr David Wilkinson is Parents You've Got This Fertility and IVF Expert from City Fertility. Dr David is a fully accredited fertility subspecialist (FRANZCOG CREI phD) with extensive experience in infertility diagnosis and treatment. Dr David presents at Parents You've Got This Ready to Conceive Masterclass.