It's not all about IVF - understanding all your fertility treatment options
Unfortunately, having trouble falling pregnant is common; one in six couples are not pregnant after 12 months of trying.
If you are having difficulty conceiving, it is important to make an appointment to see your GP for a check-up. You will most likely then be referred to a fertility specialist for further advice.
As fertility specialists we use IVF as a last resort. For many couples, advice or simple measures may be all that is needed to allow you to fall pregnant naturally.
Seeing a fertility specialist
At your first consultation your fertility specialist will take a detailed history concerning you and you partners health. Testing may involve blood tests, including ovulation testing, a pelvic ultrasound to visualise the shape of the uterus and ovaries for any abnormalities, and for the man a sperm test. From this specific advice regarding your situation can be given to you and your partner and a plan can be drawn up to help you conceive.
Starting with the basics
There are things you can do to improve your chances of falling pregnant. It is important to lead a healthy lifestyle when trying to conceive and during your pregnancy. Limit alcohol intake, cease smoking or using illicit drugs, get adequate sleep, ideally eight hours a night, eat a balanced diet and be active – regular exercise or walking are beneficial.
Sometimes things are simple and advice on timing their fertile window is all that is needed. The ideal time of your cycle to try to conceive starts four days prior to the day of ovulation. You doctor will help you pinpoint this window based on your cycle.
If you are not ovulating regularly a simple medication (Letrozole or Clomid) taken for five days a month may help you ovulate, allowing you to fall pregnant naturally.
Some women need surgery to check for endometriosis, remove growths from the uterus or ovaries or to check for fallopian tube functioning. This involves a laparoscopy, placing a small 5mm telescope camera through the belly button, to visualise the pelvis, and a hysteroscopy, a small telescope placed into the uterus via the vagina to check where the baby grows.
What about sperm
At least one third of the time there will be sperm abnormalities found on sperm testing. Lifestyle factors are important for the man also – limiting alcohol, ceasing smoking and maintaining an ideal body weight.
For some couples insemination of sperm (Intrauterine insemination or IUI) into the uterus via the vagina and cervix can allow them to conceive. This allows the sperm to be placed closer to the fallopian tube – where the egg sits after ovulation.
IVF as a last resort
IVF is a really useful tool to help couples fall pregnant if the simpler methods don’t work. Couples with some conditions such as blocked fallopian tubes or significant sperm abnormalities need to go straight to IVF but for the majority of couples the use of simpler methods may be all that is required for you to realise your dream of having a baby.