Adopt a healthy lifestyle and avoid alcohol, smoking, and recreational drugs. You might also begin taking a daily prenatal vitamin. The timing of pregnancy for one couple can be very different from the timing with another couple. Your likelihood of conceiving depends on a few factors, including your:. Most couples are able to get pregnant within six months to a year. In other cases, the cause is unknown. Women have the best odds of getting pregnant in their 20s.
Fertility naturally declines with age. The older you are, the longer it might take you to conceive. As you get older, your egg supply diminishes. By age 35, you have only a 12 percent chance of getting pregnant within any given three-month period, according to a study in PLoS One.
By age 40, that number drops to 7 percent. According to RESOLVE , 1 out of every 8 couples, or 12 percent of women, have trouble getting pregnant or carrying a pregnancy to term. If you know you have a health condition that affects your fertility, see your doctor sooner. Female infertility is a factor for about one-third of couples who are trying to conceive. The most common cause is a problem with ovulation. Blocked fallopian tubes prevent the egg from meeting the sperm.
Possible causes of a blockage include:. A problem with the uterus can also make it harder to get pregnant. This may be due to an abnormal structure, or due to growths like fibroids. Male infertility is a factor for about 8 percent of couples who are trying to conceive. In about 5 to 10 percent of couples, the cause of infertility is unexplained. Not knowing the cause can be frustrating for couples.
Yet in vitro fertilization IVF and other fertility methods can still help you get pregnant. Fertility specialists offer a variety of treatments, and sometimes more than one treatment is combined. Which method your doctor recommends depends on factors like your age, health, and what caused your fertility problem.
All patients have the right to be referred to an NHS clinic for the initial investigation. If you have an infertility problem you may want to consider private treatment. This can be expensive, and there's no guarantee of success. Ask for a personalised, fully costed treatment plan that explains exactly what's included, such as fees, scans and any necessary medicine.
If you decide to go private, you can ask a GP for advice. Make sure you choose a clinic licensed by the HFEA. The HFEA is a government organisation that regulates and inspects all UK clinics that provide fertility treatment, including the storage of eggs, sperm or embryos. There's no evidence to suggest complementary therapies for fertility problems are effective. Page last reviewed: 18 February Next review due: 18 February There are 3 main types of fertility treatment: medicines surgical procedures assisted conception — including intrauterine insemination IUI and in vitro fertilisation IVF Medicines Common fertility medicines include: clomifene — encourages the monthly release of an egg ovulation in women who do not ovulate regularly or cannot ovulate at all tamoxifen — an alternative to clomifene that may be offered if you have ovulation problems metformin — is particularly beneficial for women who have polycystic ovary syndrome PCOS gonadotrophins — can help stimulate ovulation in women, and may also improve fertility in men gonadotrophin-releasing hormone and dopamine agonists — other types of medicine prescribed to encourage ovulation in women Some of these medicines may cause side effects, such as nausea, vomiting, headaches and hot flushes.
Speak to your doctor for more information about the possible side effects of specific medicines. Surgical procedures There are several types of surgical procedures that may be used to investigate fertility problems and help with fertility. Fallopian tube surgery If your fallopian tubes have become blocked or scarred, you may need surgery to repair them. The success of surgery will depend on the extent of the damage to your fallopian tubes. Endometriosis, fibroids and PCOS Endometriosis is when parts of the womb lining start growing outside the womb.
This involves using either heat or a laser to destroy part of the ovary. Read more about laparoscopy. Correcting an epididymal blockage and surgery to retrieve sperm The epididymis is a coil-like structure in the testicles that helps store and transport sperm. Surgical extraction of sperm may be an option if you: have an obstruction that prevents the release of sperm were born without the tube that drains the sperm from the testicle vas deferens have had a vasectomy or a failed vasectomy reversal Both operations take a few hours and are done under local anaesthetic as outpatient procedures.
It is the most commonly used treatment protocol because the shorter cycle makes it more convenient for patients and reduces the risk of hyper-stimulation. Starting on the second day of your period you will have a blood test and providing all your hormone levels are low, you will be advised to begin Follicle Stimulating Hormone FSH injections [Gonal-F or Puregon] that day. After four days of injections you start a second injection [Cetrotide or Orgalutron] to switch off your own hormones and prevent premature release of the eggs.
Once you are ready will we advise when to have your hCG trigger injection and schedule your egg collection 36 hours later After egg collection you will use supplemental progesterone either as a vaginal gel, pessary or subcutaneous injections until your pregnancy test two weeks later.
Today, we're gonna talk about the protocols we use in an IVF cycle. What we're trying to do is get you pregnant, and this is the way we're gonna be doing it. We start on day two, usually, giving injections of FSH. That's the hormone that normally comes from your brain to tell your ovaries what to do, and what we give you is a synthetic version of that at a much higher dose than your brain normally does so we get lots of eggs.
So we start that on day two and in most cases, that's a daily injection in your tummy, like a diabetic does for their insulin injections, with a little pen which has got a tiny little needle on it, and that happens every day.
And then at day five or six, we start a second injection. So the first one was to try and make as many eggs as possible. The second injection, which is on a daily basis, called an antagonist, a GnRH antagonist, cetrotide or orgalutran, that is to stop you ovulating, stop you releasing the eggs before we get to collect them. Obviously, it would be a waste of a cycle if you ovulated yourself before we were able to harvest them.
So you're taking two injections a day, usually at the same time, it's recommended they're taken in the evening but the time is not vital, it doesn't need to be on the same hour every day, but in the evenings on a regular basis. From that point on, you'll probably probably have one or two or three blood tests and ultrasound scans, transvaginal ultrasound scans, to watch the follicles growing and to measure the hormones that are being produced by those follicles.
Then the specialist will see those results on a daily basis and make decisions about whether to change the dosage of the drugs that you're using, or to make that final decision of it's time. It's time to collect the eggs. At that point, time is then set for the egg collection to take place. When the eggs are ready for collection, they need a final maturing injection, an injection that makes the eggs go from 46 chromosomes to It's what happens in nature, just before ovulation, so that your 23 chromosomes can meet up with the 23 chromosomes of the sperm, and that requires a trigger injection, it's called.
These days we use a synthetic version of the pregnancy hormone hCG, but we also can use hCG itself. And that is given quite precisely, and you will be told by your nurses to be precise about taking that, 'cause once we give the injection, we know the eggs are gonna be released at about 40 hours after that. So what we're doing is timing your egg collection to be between 36 and 38 hours after the injection is given.
So if we've set a time, say tomorrow morning, eight o'clock in the morning to do the egg collection, you will have had your injection at eight o'clock last night. Once you have had that injection, then as I say, you're gonna be coming to the egg collection room 36 to 38 hours later, eggs are collected, then we begin what is called luteal phase support. In every IVF cycle, to make sure the lining of the womb is good, we need to keep progesterone levels high, and that's done either with pessaries or tablets in the vagina.
That's fairly uniform throughout cycles. You can use hCG injections instead of the progesterone pessaries, but that has a risk of causing hyperstimulation, so we rarely use it. So that's the short protocol. I'll just run it again. Starts on day two, daily injections, starting on day five, another set of injections, the trigger injection, egg collection, and then luteal phase support.
That's the majority. That came to pass about a decade ago in Australia. It's called a long down-reg protocol. That begins in the third week of the cycle before the cycle that we're going to collect the eggs. So 21 days on a normal cycle, we will do a blood test to make sure you've ovulated, and after that, we will be giving you either a nasal spray or an injection to switch off the ovaries, so that when we get to the day of your period, the ovaries are quiet, there's no activity, and then we start the daily injections of the FSH.
Again, those injections will continue all the way through until the day of the trigger injection. That's about, usually, an average of 11 days of injections. Could be 10, could be up to 14, but the average is around 11 days. Same injection as we talked about in the short protocol at that point, but we've already switched off your pituitary gland with a nasal spray or the downregulation agonist injections.
Again, there'll be the same monitoring with bloods and ultrasounds, and a decision will be made by your specialists that it's time to collect the eggs and the trigger will be provided. Again, it's the same trigger, 36 hours before the operation, to collect your eggs. The luteal phase support, again, is identical to a short protocol. There are other protocols. Some people would do natural cycles where you only get one egg and you don't need any medication.
In some countries around the world, Japan's one of them, where the drugs aren't covered by Medicare, natural cycles are done a lot, but it means you need to have lots of cycles to get the same cumulative pregnancy rate as we get in Australia, so it's usually not the way to go. Some people will start the injections later to get one or two eggs only.
Again, it's a numbers game. The more eggs you have, the more chance ultimately you have of getting pregnant. In some cases, we even go as far as the long, long downregulation. So we started on day one of a cycle, not in the cycle that you're gonna be having the egg collection, but a month later. Some people do that where there's endometriosis, for instance.
It may suppress endometriosis, although in a month, it's unlikely to. So there are multiple protocols. The majority are pretty straightforward, short protocols that, as I said earlier, are much, much easier and much less burdensome than in the past. So when you sit down in front of your IVF doctor, that's what they'll probably give you, at least as your first cycle.
The dosing of those is dependent on your clinical situation, age, weight and previous history. I'm not gonna go into that today but it will vary from patient to patient, so don't necessarily compare my cycle with your cycle.
It can lead to confusion. What you want is a specialist who understands what the best is for you, someone who's experienced, and our doctors at IVF Australia are all in that category.
So thanks for watching, I hope that was useful, and if you've got any questions or comments, please make them, and please subscribe to the Fertile Minds.
Hi there, welcome to Fertile Minds. I'm Dr. Today, I'm going to be explaining how you can prepare yourself for the embryo transfer procedure. As it is a very important day in your IVF treatment. Now let's get straight into it. So let's talk about how it is done. The embryo transfer procedure is a very straightforward simple procedure. Despite the fact that IVF treatment involves so much technology and is so complicated.
So in embryo transfer procedure, we put the embryo back into the uterus using a very fine catheter, trans-vaginally via the cervix, and then into the middle of the uterus. We also use a transabdominal ultrasound to improve the accuracy of the transfer. That is why we ask you to come with a half filled bladder because that will help us in visualising the uterus on the ultrasound. Of course, before we get to that point, there's a lot of identification process that goes on because we want to make sure the right embryo goes back to the right patient, right?
So we ask you to bring a photo ID to help with that process. And then the first step of checking happens at the desk when you first check in with the office staff, and then secondly it will happen in the embryo transfer room with the doctor and the embryologist.
And then finally, you will be able to do the ID check on the embryo dish together with your doctor and the scientists via the TV monitor.
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