What is infertility?
Most experts define infertility as not being able to get pregnant after at least one year of trying. Women who are able to get pregnant but then have repeat miscarriages are also said to be infertile.
Is infertility a common problem?
About 1 in 6 couples have difficulty getting pregnant or carrying a baby to term.
Is infertility just a woman’s problem?
No, infertility is not always a woman’s problem. About a third are problems in the female partner, and about 25% is thought to be due to male factors (ie sperm quality). The remaining cases are caused by a mixture of male and female factors or by unknown factors.
What causes infertility in men?
Infertility in men is most often caused by:
- Problems making sperm – producing too few sperm or none at all
- Problems with the sperm’s motility, or ability to swim to reach the egg and fertilise it
- Abnormal sperm shape or structure, preventing it from either swimming or fertilising the egg
What increases a man’s risk of infertility?
The number and quality of a man’s sperm can be affected by his overall health and lifestyle.
Some things that may reduce sperm number and/or quality include: alcohol, drugs, environmental toxins including pesticides and lead, smoking, chronic health problems, medicines, radiation treatment and chemotherapy for cancer, age, and steroid abuse.
Is there any medicine or dietary change that can be used to improve sperm?
There are a number of products sold as ‘fertility supplements’ for men which contain specific vitamins and antioxidants. However, there are very few good quality scientific trials to show that these are any better than a good diet or taking vitamins from the local supermarket.
What causes infertility in women?
Problems with ovulation account for most cases of infertility in women. Without ovulation, there are no eggs to be fertilised. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.
Less common causes of fertility problems in women include: blocked fallopian tubes due to pelvic inflammatory disease, endometriosis, or surgery for an ectopic pregnancy, physical problems with the uterus, or uterine fibroids.
How do I get to see a fertility specialist?
Usually your GP will send (refer) you to the fertility service. If you live in our health region (Nottinghamshire), you will probably be sent to the NUH service. If not, your doctor will let you know where you can go.
How long should we be trying to conceive before we consider treatment?
Normally we recommend you try for 12 months. However, if there is anything in your medical history which may suggest a higher risk of infertility (such as pelvic inflammatory disease in the female or testicular injury/illness or surgery in the male) then an earlier referral should be considered.
Will I have to pay for the service?
Usually the NHS will pay for any investigations required and a limited amount of treatment, but only if you meet the current NHS funding criteria. Please ask the fertility service for more detail if you are uncertain.
What if I am not in this health region or do not wish to go through my GP?
If you wish to access our services privately, then you can get direct access to the consultant or nurse specialist. In this case, you would have to pay for this service as well as any investigations and treatment required.
How long will I have to wait before I’m seen?
Normally, the wait is around 4-6 weeks. It will never be less than this, because we ask the GP to organise a few basic tests and ask you to complete some paperwork beforehand.
This means that the appointment with the consultant will be much more useful and ultimately saves time in the long run.
Will I get everything on the NHS?
Most couples get funded for investigations and some treatments, providing you are referred from a GP in Nottingham or the surrounding region.
However funding depends on your age, as well as other criteria you need to meet. Click here for more details.
Why do the NHS use BMI as a funding criteria?
Women who are either significantly over or under weight have a higher chance of infertility and increased risk of something going wrong during pregnancy.
I need a sperm donor – how long is the wait for one ?
It depends on what you require. The wait is very short for Caucasian (White UK) donors, but if you require a specific ethnic group it will take longer and sometimes we may not be able to provide what you want.
Where do NUH Life source their donors from?
All NUH Life donors are from Nottinghamshire, Derbyshire, Lincolnshire or Leicestershire. They are often students, but older men are also recruited.
What tests does my GP need to do before I can get referred?
Usually these tests consist of blood tests on the female partner and one or more semen analyses on the male partner.
Can we do anything to improve our chances of getting pregnant naturally?
Try to stick to a healthy diet to moderate your weight, stop smoking and moderate alcohol intake.
There is no evidence that specific nutritional supplements can boost your fertility.
How often do I have to attend during treatment?
We like to see you as a couple, but we understand that it’s not always possible.
For the female receiving IUI or DIUI, there may be around 3-4 scan visits during a treatment cycle, as well as the treatment. None of the appointments take long, but they can be quite disruptive.
The male partner needs to visit for semen analysis, provide a sample for treatment, and occasionally come in for a counselling visit.
Who are the HFEA?
The HFEA are the Human Fertilisation and Embryology Authority and are the government regulators of fertility treatments.
They inspect licensed centres like ours regularly, and give us a license to practice (see WWW.HFEA.gov.uk for more information).
Is it true that IVF is more effective than IUI?
IVF is definitely more effective for certain problems, especially any potential problems with the Fallopian tubes. IVF may also achieve a pregnancy more quickly than IUI in cases where there is no obvious cause for the infertility (unexplained infertility).
However IVF is more expensive and more complex, and the evidence in support of IVF over IUI in couples with unexplained infertility is controversial and largely depends on how successful the particular IUI or IVF service is.
Our own calculations using our cost and pregnancy rates show that IUI is more cost-effective for unexplained infertility than IVF for patients under 38 years of age. Click here for more information on this subject.