An expert view on IVF
6th July 2018
While the wide range of fertility treatments now available is incredible, it can sometimes be a little overwhelming – a sea of acronyms and pros and cons. In our new blog series we break down the myths, medical jargon and statistics to give a comprehensive guide to treatments for infertility. We start by taking a look at IVF.
What is IVF?
During IVF, a healthy egg is removed from a women’s ovary and fertilised with sperm in a laboratory – hence the phrase Test Tube Baby (IVF stands for “in vitro” – latin for ‘in glass’ fertilisation)! Once an egg has been successfully fertilised (which sometimes involves something called ‘ICSI’ – injecting the sperm directly into the egg), the embryo is then returned to the uterus to develop. While this specific IVF procedure may sound simple, there are actually quite a few steps that need to be taken before arriving at this point. When you decide to undergo IVF you will firstly take medication to suppress your natural menstrual cycle as well as medication to boost your egg supply. After careful monitoring to ensure that your eggs have matured, doctors will then collect or ‘harvest’ your eggs. The eggs will be collected from your ovaries via your vagina. Once the eggs have been collected, they are fertilised and any viable embryos are put back in the womb. The NHS then advises waiting 2 weeks to take a pregnancy test, to see if the procedure has worked.
Is it right for me?
IVF can be an effective treatment for a wide range of fertility problems including low sperm count and issues with ovulation, for example due to PCOS and endometriosis. Many women decide to try IVF often after other fertility treatments, such as hormone medications (more on these in a later blog), or conceiving naturally have proved unsuccessful. It is important to remember that it’s normal to take up to 12 months to conceive naturally (when having sex 2-3 times a week). It’s a very personal decision, so it’s important to discuss whether it’s the right course of action for your with your doctor, your partner and your support system.
What are the risks?
As with all medical procedures, there are certain risks and side effects that come with IVF. Many women going through the treatment will have minor side effects to the medication prescribed, such as headaches, hot flushes and fatigue. The main serious complication is called Ovarian Hyper-Stimulation (OHSS) in which your ovaries become too large, and it can cause a dangerous amount of bodily fluid retention. This can occasionally require you to be admitted to hospital. IVF also increases your risk of both ectopic pregnancy and multiple births (twins or triplets).
IVF can be a physically and mentally demanding process, so looking after yourself and your mental wellbeing should be a high priority.
How can I access IVF?
The NHS guidelines advise that three cycles of IVF should be offered to women under 40, and one cycle to women aged 40-42 (providing there is no evidence of low ovarian reserve) who have been trying to conceive naturally for 2 years, and have no children. However, what is offered varies according to where you live, and is constantly changing, – and sadly only 12% of commissioning groups across the UK are able to offer this – with the majority only offering one cycle.
You should speak to your GP about what is available in your area, and can also consult the website www.fertilityfairness.co.uk. Often, the criteria only require you to have been trying for one year over the age of 35 – so you should consider seeing your GP sooner if you’re approaching 40.
If you’re not eligible for NHS treatment or you decide to pay for IVF, you can have treatment at a private clinic. The cost of private treatment can vary, but one cycle of IVF usually costs at least £5,000.
How successful is it?
The success rate of IVF often depends on the cause of infertility, and tends to decrease as you get older. For women under 35, the rate of successful pregnancies is around 29% and this drops to 15% when you are in your late thirties. The NHS will generally not advise women over 42 to undertake the treatment, as the success rate is low (3%), however private clinics will conduct the procedure with women who are much older. Almost all pregnancies above the age of 45 involve donor eggs.