If you are having problems getting pregnant, see your GP.
Your GP will look at your medical history and give you a physical examination. They may also recommend some lifestyle changes to help fertility.
Unless there are reasons that may put you at high risk of infertility, such as treatment for cancer in the past, you’ll only be considered for fertility investigation and treatment after you’ve been trying for a baby for a least a year without becoming pregnant.
Your GP will be able to refer you to an infertility specialist at the NHS hospital or fertility clinic.
The specialist will ask about your fertility history, and they will carry out a physical examination.
For women, you may have tests to check the level of hormones in the blood as well how well the ovaries are working. You may also have an ultrasound or X-ray, to see if there are any blockages or structural problems.
Men may be asked for a sperm sample to test sperm quality.
If the specialist thinks that your infertility could be treated by , IVF or if you’ve been unable to conceive for at least three years, you may qualify for funding for IVF treatment.
The specialist will advise your GP whether IVF is the best treatment for you. If it is, they will refer you to an assisted conception unit.
Once you’re accepted for treatment at the assisted conception unit, you and your partner will have blood tests for HIV, hepatitis B, hepatitis C and syphilis, and to check you’re immune to rubella (German measles). Also, your (cervical screening tests) should be up to date.
The specialist will investigate the amount of eggs in your body and their quality (your ovarian reserve). It will be assessed by measuring your anti-mullerian hormone (AMH) level. This is a blood test that can be done on any day of your cycle. It will show if there’s likely to be any difficulty in obtaining eggs.
Additional semen samples may be required.
The specialist will then discuss your treatment plan with you in full detail.
You will need to sign consent forms giving permission for the use or storage of your eggs, sperm or embryos throughout the procedure.
You may find that you need support and guidance while going through this process. Some people find counselling helpful. For more information, go to www.HFEA: benefits of counselling and how to access it .
IVF treatment becomes less successful with age. In addition, the risk of miscarriage and birth defects increases with the age of a woman having IVF treatment. Your doctor will discuss the increased risks that come with age, and can answer any questions you may have.
In 2013, the national Institute for Health and Clinical Excellence (NICE)
Published new guidelines about who should have access to IVF treatment on the HNS in England and Wales.
Women under 40
According to the guidelines, women under 40years should be offered three cycles of IVF treatment on the NHS if:
- You have been trying to get pregnant through regular unprotected intercourse for two years, or
- You have not been able to get pregnant after 12 cycles of artificial insemination
However, if tests show IVF is the only treatment likely to help you to get pregnant, you should be referred for IVF straight away. If you turn 40 during treatment, the current cycle will be completed, but further cycles should not be offered.
Women aged 40 to 42
The guidelines also say that women aged between 40 and 42 should be offered one cycle of IVF on the NHS if all of the following four criteria are met:
- You have been trying to get pregnant through regular unprotected intercourse for a total of two years, or have not been able to get pregnant after 12 cycles of artificial insemination.
- You have never had IVF treatment before
- You show no evidence of low ovarian reserve (this is when eggs in the ovary are impaired or low in number)
- You have been informed of the additional implications of IVF and pregnancy at this age.
Again, if tests show that IVF is the only treatment likely to help you get pregnant, you should be referred for IVF straight away.
The success rate of IVF depends on the age of the woman undergoing treatment as well as the cause of the fertility (if it’s known). Younger women are more likely to have healthier eggs, which increases the chances of success.
IVF isn’t usually recommended for women above the age of 42 because the chances of a successful pregnancy are thought to be too low.
In 2010, the percentage IVF treatment resulted in a live birth (the success rate) was:
- 32.2% for women under 35
- 27.7% for women aged 35-37
- 20.0% for women aged 38-39
- 13.6% for women aged 40-42
- 5% for women aged 43-44
- 1.9% for women aged over 44
For more information on IVF: