FAQs to support you and your fertility journey

Many people have no idea that they have fertility issues until they start trying for a baby, and the causes of infertility can sometimes be hard to establish. However, at this stage, signs and symptoms can indicate issues. For women, irregular, painful or heavy periods could indicate a problem. For men, it may be an inability to ejaculate properly or problems with their sperm count, for example. For those unable to conceive, the most crucial element to understand is that infertility is simply a symptom.

The causes of infertility are numerous, and identifying the specific barrier to conception is of paramount importance.

Infertility cannot be officially confirmed until you have been trying to conceive through unprotected sex for at least a year, at which point you can see a GP who may refer you to a fertility specialist.

There are a number of treatments available once your specific problem has been identified. Fertility drugs are usually the first treatment for women who aren’t ovulating.

Sometimes assisted reproduction treatments are also suggested, including the most well-known treatment, IVF (In Vitro Fertilisation), when eggs and sperm are collected and fertilised in the laboratory before the resulting embryo is transferred to the womb.

Each of our fertility centres offer a range of investigations and treatments. Patients are normally referred to our fertility centres either by their family doctor (GP) or consultant gynaecologist. In addition to this all BMI Fertility Centres accept self- referrals. 
All patients will have a personalised treatment plan designed by their consultant to suit his or her personal requirements.  This treatment plan will be tailored to the individual’s medical history and patient’s wishes in order to maximise the chance of a successful outcome.

Discovering that you have difficulty conceiving can impact on all aspects of life and cause unfamiliar, painful emotions. Many people feel lonely and isolated, particularly when friends and relatives seem to be able to have children with ease.

Feelings of frustration, confusion, sadness, hopelessness and even anger may surface, whilst others may have the feelings of guilt and shame. These are all understandable and normal reactions to a situation where a patient feels out of control, with their autonomy threatened.

Infertility can be one of the most difficult situations you will face in life. Appreciating it as a common condition affecting many couples, and understanding that you are not alone are the first steps to coping with your emotions.

Learning more about your condition and the treatments available will help towards a better understanding and enable informed choices. Our fertility teams are here to help and advise, either during a formal consultation or simply a chat over the phone. Do not be afraid to ask questions, however trivial they may seem. Written information will be supplied to back up treatment options and discussions.

Before starting fertility treatment, all patients are encouraged to take the opportunity of receiving counselling. All BMI fertility centres have trained counsellors available to offer support focused on helping to cope with the physical and emotional difficulties associated with infertility. Counselling provides emotional support at times of particular stress, and an opportunity to discuss any concerns about your treatment with an impartial person. It is available as part of your initial decision making and at any stage of your treatment.

Apart from the counselling available through our centres, you may also find it helpful to contact one of the national support groups who may put you in touch with others who have had similar treatment. Each fertility centre will be able to provide you with details of local and national support groups.

When trying for a baby, either naturally or with the assistance of fertility treatment, it is important to ensure that you are in the best of health as this will improve the chance of a successful outcome. There are several specific areas that should be addressed:

Lifestyle and exercise

Maintaining a healthy lifestyle, with a balanced diet and appropriate amount of exercise, improves the chances of conceiving.

Weight

If a woman is within a normal weight range she is more likely to have a ‘normal’ response to medication. If a woman is overweight she may have an ‘abnormal’ response to the medication used to stimulate her ovaries and, as a result, may produce either too few or too many eggs. This reduces the chance of a pregnancy and increases the rate of complications in treatment.

Each fertility centre will encourage overweight patients to lose weight prior to commencing treatment. Each,has a slightly different criteria for treatment and may decline to treat patients whose body mass index is too high, deferring treatment until a target weight is achieved. There is an increased likelihood of overweight women developing complications such as:

  • Monitoring treatment is more challenging, as it is difficult to obtain a clear scan picture. This makes making egg collection potentially hazardous.
  • There are more likely to be difficulties during anaesthesia.
  • If a woman does become pregnant whilst overweight the chance of a miscarriage is higher. There can also be more complications in the pregnancy, particularly with high blood pressure and gestational diabetes.
  • Women who are underweight may also have problems with their response to medication and are at risk of complications in pregnancy.

Smoking

Smoking has been shown to reduce the chances of conceiving naturally, increase the chance of miscarriage and to lower the success rates of IVF treatment. In men, smoking is known to affect the sperm quality and quantity so therefore increase male infertility. It is recommended that both of you cut down your smoking as much as possible, or preferably stop altogether before treatment.

Alcohol

Alcohol has an adverse effect on female fertility. It can cause hormone imbalances which cause disruptions to the menstrual cycle, and it increases the risk of early miscarriage. For men, excessive alcohol can depress sperm production and affect sperm motility. There may also be a reduction in testicular size, impotence and a decrease in libido. Sperm takes approximately 72 days to develop, so the effects of alcohol take a long time to reverse – it is not sufficient to stop alcohol consumption just as your treatment starts, but several months beforehand.

Recreational drugs

Cannabis and cocaine can severely affect sperm quality and the chance of fertilisation. All patients are advised not to take any recreational drugs.

Folic acid

Folic acid is a vitamin which has been shown to greatly reduce the risk of an abnormality of the brain and spinal cord (anencephaly and spina bifida) in an unborn baby. We recommend that every woman takes 400mcg of folic acid daily from the start of treatment up to the 12th week of pregnancy.

Rubella status

All women considering having a baby should ensure they are immune to Rubella (German measles) to avoid contracting the infection during early pregnancy. If Rubella is contracted in early pregnancy it can cause miscarriage, severe birth defects and stillbirth. Your Rubella status can be checked with a simple blood test. If you are not immune you will require a vaccination at least one month before starting treatment.

As previously discussed, IVF treatment is where eggs are removed from the woman and mixed with sperm in order to create embryos for transfer into the uterus.

In order to maximise the chances of success, the woman takes a number of different medications. The aim is to stimulate the ovaries to develop a number of eggs for collection. Without drugs, in a woman’s natural cycle, normally only one egg, or very occasionally two, would develop.

Stimulation of the ovaries, and monitoring of the woman’s response to treatment, is carried out on an outpatient basis and can usually be achieved with visits to the clinic every few days. This monitoring is in the form of trans-vaginal ultrasound scans and sometimes blood tests. The preparation for IVF involves daily injections for approximately 11 days which most patients administer themselves.

We keep a stock of medication in each of our centres for purchase. If you qualify for NHS funding, you may be required to pay the standard NHS prescription charge per item.

For those of you who are required to purchase medication on a private basis, we are able to offer you a competitive rate.

Fertility medication may have severe side effects that can vary from patient to patient, both in their nature and severity. Many patients undergoing fertility treatment experience fluctuations in their moods and emotions, and it is difficult to know whether they are drug-related or perhaps due to the inevitable stress that accompanies treatment.

Details of the individual’s medication required for your treatment will be provided and discussed with you prior to commencing treatment.