Fertility and IVF - First Steps

Infertility and IVF - first steps

If you have just been diagnosed with infertility, and IVF treatment has been brought up in your consultation, it is really important to take a moment, to understand why you can’t conceive, and to talk to your doctor about the IVF process and whether it is the right way forward for you.

What is infertility?

Female infertility can have many potential causes, but predominantly fall into the following categories:

irregular or no ovulation
problems with the uterus, ovaries or fallopian tubes
hormonal imbalances
woman’s age which affects ovarian reserve.

Male infertility may be caused by problems with sperm production, hormone related issues or congenital abnormalities (generally present at birth).

(Take a look through this article to understand more about the causes of infertility).

Diagnosis is key

It is essential to get an accurate diagnosis before you embark on IVF.

Take a fertility test to give you an idea of your egg or sperm health.

Download a copy of our pre treatment checklist and use this to discuss next steps with your doctor.

The more you know, the more prepared you are to take the next step with confidence, starting treatment or getting another opinion.

Diagnosis can save you time, money and emotional struggle.

What can you afford?

Regardless of where the cause comes from, the diagnosis of infertility raises many questions and forces you to make important choices. One way to start planning is by looking at your finances.

Unless you have access to free treatment on the NHS in the UK or covered by insurance in the US, fertility treatment is not cheap. Work out what you can afford. One cycle of IVF costs around £5,000 in the UK, plus the cost of medication. In the US it can be up to US$ 18k in total. ICSI will set you back around £1,000-1,500. IUI (sperm injection into the womb) is around £1,000.

Another thing to consider is if your employer offer fertility benefits for employees?

What are your next steps?

Here's some key advice and what to be aware of

Maximise your chances of success

How will you reach your end goal – having a child – in the quickest time, if that’s what matters to you? If you are over 40, the success rates of IVF treatment using your own eggs are lower. If your consultant has discovered that your eggs are lower quality, perhaps consider putting that money towards using an egg donor and your chances of having a child increase significantly.

Everyone’s fertility profile is unique. There is no crystal ball that will reveal your best way to get pregnant, but its important to review results from your blood tests and scans, analyse success rates of treatments and work out with your doctor what’s best for you.

Get more than one opinion

Getting a second or third opinion can be money well spent, because it’s important that you find a clinic that works for you.

They all work differently. Some stick rigidly to their tried and trusted methods. Others are innovative. A caring approach is more important in some clinics than others. Don’t just go to the nearest practice and expect it to be right. If it’s possible to see the top specialist in your area who may be an hour or more distance from you rather than your second or third choice who is 20 minutes away, visit the top consultant first. Perhaps the less convenient option, but worth it in the long term.

Watch out for this red flag

You should be able to walk away from the appointment, although perhaps a little overwhelmed, generally feeling energised

Prepare a list of questions to ask before you make an appointment. Remember that not all infertility cases require IVF. Clomid and timed intercourse, thyroid treatment, removal of a polyp or adhesion may resolve the issue naturally. If a clinic seems to jump straight to IVF without having reviewed or carried out the relevant blood, sperm tests and scans, that’s a major red flag.

A great rapport with your consultant is also not enough. It’s important to assess:

What diagnostic tests does the clinic plan to perform?
Are the staff warm and inviting or are they too keen?
Do they see patients seven days a week?
How accessible are they after hours?
How many embryos do they recommend transferring?
Do they have any schemes to help with the financial burden?
Are they thinking of you (not just their success rates) and do they offer counselling or complementary therapies like acupuncture or meditation?

Investigate clinic success rates

If you cannot easily find the clinic’s success rates, do not bother investigating further. Where their success rates are shown, are these based on pregnancies achieved through IVF or live births? The live birth rate gives the best indication of the clinic’s success. Ideally, the clinic should list success rates, broken down by age and number of embryos transferred and so on.

In the UK, HFEA is an independent body that publishes success rates for clinics.

It is also important to remember that these clinics are businesses, which means if they find something in their initial testing that makes you a less than perfect candidate for IVF, you may get turned away as your case may affect their success rate. It’s admirable that a fertility clinic will want a successful attempt on the first try – as long as it’s for the right reasons. Trust your instincts.

Consider your wellbeing

Infertility is tough both mentally and physically. IVF stimulation needs lots of medication. You can lose and gain weight, lose sleep and sleep too much, overeat and lose your appetite. Every IVF treatment takes its toll. It’s important to prepare yourself and ask honest questions:

Am I physically ready for this or should I wait until I’m stronger?
How can I make sure I won’t push myself too hard and suffer lasting effects?
How will my relationships cope?

For some people, infertility is an obstacle but they overcome it without too much trauma and work on how they can achieve parenthood. For others, it can be truly debilitating and affect self-esteem. Sharing how you feel with others going through the same can be just the tonic you need.

Talking about infertility and what to do next can be a real challenge. But communication is the best thing you can do. Openness and honesty put you on the best path. Regardless of what decision you make, so long as you are comfortable with it, you made the right one!