Most of us take it for granted that once we decide the time is right to start a family, conception will duly happen. However. for an estimated one in seven couples, or approximately 3.5 million people in the UK, pregnancy doesn’t occur as expected.
Some couples may already be aware of an underlying issue which might be contributing to this inability but for others it is completely unexpected and distressing, and it can be difficult to know when is the right time to seek advice.
It is a good idea for couples to look for help if they have not conceived after one year despite having regular unprotected sex, and in the first instance this usually means visiting their GP.
Women who are over the age of 35, or couples who are already aware of some possible fertility problems, should not wait.
There are many possible causes for an inability to conceive – some female, some male, some a combination of both female and male factors and for around 20% of couples, no definite cause can be identified.
Common female causes of infertility are ovulation disorders, hormone imbalances, period problems, damaged or blocked fallopian tubes, endometriosis, fibroids, uterine abnormalities or genetic problems.
Common male factors include sperm problems, hormone imbalances, genetic abnormalities and ejaculatory problems.
GP’s can perform some basic tests before referring patients on to a fertility consultant if necessary. The consultant will then carry further investigations on one or both partners, where appropriate, to help decide whether there is any intervention that can be given to help the couple conceive naturally, or whether they will need to consider moving on to an assisted conception technique such as IVF (in vitro fertilisation).
In some cases, such as where the female partner is found to have fibroids, or an abnormality in the structure of the womb, a surgical procedure can be carried out to correct or remove the problem. Unless the cases are complex or severe, it is usually possible to carry these out as day cases using minimally invasive surgery, which means hospital stays and recovery times are much quicker than in the past.
The most likely candidates for needing assisted conception are women whose fallopian tubes are either blocked, damaged or absent, or who have severe pelvic endometriosis, or hormone imbalances; men who have either no sperm or sperm which is abnormal, and couples who are known to be at risk of carrying a genetic disorder.
The most well known assisted conception technique is in vitro fertilisation (IVF), where the sperm and eggs are mixed in the laboratory, and if fertilisation is successful, the created embryo is transferred back into the female partner’s womb.
However, there are many more technologies available to complement IVF and enhance the chances of a successful pregnancy, for example techniques such as ICSI (intracytoplasmic sperm injection) where a single good quality sperm is injected directly into the egg, and IMSI (intracytoplasmic morphologically selected sperm), which uses a more powerful microscope to help ensure the best available sperm are used for the fertilisation process.
Once embryos are created, they can now be cultured in an incubator to a later more mature stage of development (known as a ‘blastocyst’) before being transferred back into the womb. Another recent development is EEVA (early embryo viability assessment), a ground breaking innovation which utilises time lapse video monitoring of the developing embryos to see which ones are most likely to develop to the blastocyst stage.
A simple procedure called an ‘endometrial scratch’, carried out in the outpatient clinic and taking only 15 minutes to perform, has been found to increase the chances of the embryo successfully implanting in the womb and leading to a successful pregnancy.
All of the above techniques are now available at Reproductive Health Group’s brand new state of the art facility, the Centre for Reproductive Health, conveniently located just off Junction 11 of the M56 at DaresburyPark. A dedicated team of counsultants, specialist nurses, embryologists and counsellors provide consultations, comprehensive diagnostics, day case surgery and the full range of assisted conception treatments under the one roof without the need to travel elsewhere.
If you have been experiencing fertility problems, had unsuccessful treatment elsewhere or would just like to talk to a specialist to see if the time is right for further investigations, call to book a free fertility advice consultation.
Clinical Director, Centre for Reproductive Health
Subspecialist in Reproductive Medicine and Surgery
Luciano is a consultant gynaecologist, reproductive endocrinologist and surgeon, and the clinical director for the Reproductive Health Group at the Centre for Reproducitve Health. He trained in Italy, London and Manchester before being appointed as consultant in gynaecology and reproductive medicine at St Mary’s Hospital, Manchester, where he worked until 2011. He has published widely on many aspects of fertility and assisted conception, and has delivered in excess of 100 lectures worldwide.
Lead Embryologist, Centre for Reproductive Health
Bert has been an embryologist since 1988. For the past fourteen years he had been the scientific director for one of the most successful groups of clinics in Australasia and has also worked as an ICSI inspector and clinic inspector for the HFEA (Human Fertilisation and Embryology Authority).