You may have an unresolved medical issue that is causing your infertility and may even prevent IVF from working too. This is why it is so important to get a full diagnosis of your infertility issues before embarking on the IVF process.
It’s wrong to think of IVF as the first choice as soon as you are having difficulty in conceiving. It’s complex, intrusive, psychologically draining and eats up time and money. You may have an issue that with treatment may allow you to become pregnant naturally. On the other hand, with conclusive tests and a clear idea why you need it, IVF can offer you the chance to have children when you wouldn’t otherwise be able to do so.
Don’t wait two years
If you have been unable to conceive naturally for a year, why not arrange an appointment to discuss next steps with your doctor. There may be an underlying issue that needs to be resolved and is preventing pregnancy.
Some clinics may immediately suggest IVF if you fail to ovulate or have been trying to get pregnant for a while without success, but this is wrong. IVF is not the only answer to infertility and it doesn’t solve the reason or reasons why you or your partner may be infertile.
Dr Robert Winston says that “an important reason for making a diagnosis is that most people who fail to get pregnant find they gain considerable comfort from knowing what is wrong.”
Don’t waste invaluable time and until you have been trying for a baby for two years.
Check your family history
If your family has a history of polycystic ovary syndrome (PCOS), endometriosis, fibroids, early menopause or genetic disorders, tell your doctor or consultant so that they can organise relevant tests.
Give up smoking, limit the alcohol and coffee
As you’d expect, there are the usual suspects to avoid. Smoking can age your eggs by a few years and lower IVF success rate, so if there’s ever a time to quit it’s now. Most doctors say stay away from alcohol and to limit your caffeine intake (if you can survive on a cup a day you should be fine).
Get tested for infections and STDs
Sexually transmitted diseases can affect fertility and some don’t reveal any symptoms, such as chlamydia. Cystitis and thrush may also cause problems, so make sure you and your partner are tested so you can cross this off the list.
Watch out for toxins
Some plastics can affect fertility in men and women, even those found in Tupperware and cling film, so limit how much you expose yourself to toxins this way when you are trying to get pregnant.
Talk to your doctor about organising blood tests. The tests can help to analyse what’s causing the infertility and if an issue is discovered, it may be able to be successfully treated with medication or surgery. If the issue is resolved, you will be able to continue trying for a baby naturally.
AMH, or anti-Müllerian hormone is a protein that can reveal whether IVF may be successful or not. Some doctors believe it’s more revealing than the age of a patient because what matters is the quantity and quality of follicles in the ovary and how they develop to become eggs. It’s known as the ‘ovarian reserve’.
AMH is produced in the follicles as they grow and the test shows how much AMH is in your body. Too much AMH can also indicate polycystic ovary syndrome (PCOS) – cysts which cause infertility. If AMH levels are within the normal range, your body may respond well to medication to stimulate the ovaries to produce eggs.
The AMH test is not available in some areas on the NHS, the cost to have this done privately is about £80 to £200.
Like the AMH test, a scan can reveal if drugs will work to stimulate your ovaries, but they can do much more. Clinicians will be to assess fallopian tubes for blockages, view the uterine cavity to check for polyps, fibroids and scar tissue which can prevent conception. It can also help to diagnose PCOS (see AMH test), assess any other risks and see what’s needed to help achieve pregnancy (IVF or not).
You may or may not be able to have a scan in the UK on the NHS, but waiting lists are likely to be long. Private clinics charge anything from £200-£400.
IVF is not (yet) a completely efficient process and many of the embryos that are used do not lead to pregnancy. A new test allows clinics to screen embryos to select those that have the best chance of implanting in the womb. But beware, it’s not cheap – around £2000-£3000.
Viral screening tests
Clinics offer tests to detect HIV, Hep B, Hep C, Chlamydia and Rubella. The EU says couples undergoing infertility treatment using their own eggs and sperm should be tested for HIV and the liver infections hepatitis B and C.
Download and use our pretreatment checklist on First Steps if you’re considering IVF.
Take this to your doctor to discuss your next steps and to ensure you have the essential tests and scans prior to embarking on the IVF process.