Friday, July 1, 2022

Where to Actually Start with Fertility Treatment & What You Need To Know BEFORE Booking An Appointment

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Capsule x Fertility Associates

Choosing to have a baby is a massive decision – but when nature’s process doesn’t work as quickly as you might like it to, it can be frustrating at best, and heartbreaking at worst.

It’s also hard to tell whether or not good things are just taking time, or if you might need a little help in the fertility department – and once you’ve accepted said help, what does it all mean!?

To help break down fertility treatment 101, Capsule chats with Fertility Associates’ Nursing Director Michelle Parris-Larkin about the ins and outs of what asking for help conceiving actually means, and what you can do beforehand to help your journey to parenthood along.

Capsule: When is the right time to first engage help with your fertility?

Michelle: If you’re under 35 and have been actively trying to conceive for 12 months or more without success, make an appointment with a fertility doctor. If you’re over 35, wait only six months before getting help.

Let’s talk about AMH – is this the first place to start? 

AMH (Anti MÜllerian Hormone) is produced by the medium-sized immature eggs in the ovaries. It is a powerful test because it gives an indication of likely menopausal age, likely reproductive time frame and likely response to drugs in an IVF cycle (how many eggs you are likely to get). AMH also can be used to confirm Polycystic Ovary Syndrome and gives a guide to egg quality. However, what AMH cannot tell you is whether you are going to have a baby.

Why might someone need help with their fertility in the first place? 

There are different causes of infertility that may lead a couple or individual to come and see us. Infertility is usually defined as not becoming pregnant after one year of trying, but some couples may have concerns much sooner, for example if the woman is not having regular periods or ovulating. 

Infertility is equally attributable to male and female issues – in about 40% of infertile couples the problem is a female factor, in about 40% it is a male one, and for the remaining 20% there is a joint problem, or the cause is unknown.

Common causes of infertility in women:

  • Tubal problems
  • Endometriosis
  • Ovulation disorders
  • Polycystic ovaries
  • Recurrent miscarriage
  • Hormonal problems
  • Autoimmune (antibody) disorders

Common causes of infertility in men: 

The cause of most male infertility remains unknown. Known causes can include the following:

  • Failed vasectomy removal
  • Retrograde ejaculation
  • Blocked ducts
  • Absence of vans deferens
  • Undescended testes in childhood
  • Autoimmune (antibody) disorders

What’s the process of beginning fertility treatment like? 

The general treatment (but not limited to) process for the average couple that comes to Fertility Associates includes three steps: ovarian stimulation, egg retrieval/ semen collection, and then embryo transfer, but there are other options too. But the general treatment goes as:

Step One – Ovarian Stimulation:

This is where you will take a short course of medication to help promote the growth of the follicles which contain eggs. This phase generally takes between 10 – 14 days but takes longer in some patients. The response of your ovaries is monitored with regular scans and blood tests. The stimulation phase will end once your ultrasound shows that the number and size of the follicles are adequate. You will then discontinue your stimulation drugs. Once your nurse confirms your procedure theatre time she will advise you when to take your trigger injection. This is the final injection that helps the egg’s final maturation. 

Step Two – Egg Retrieval and Semen Collection 

You will be given a light sedation for your egg retrieval. The doctor passes an ultrasound-guided probe, with a fine needle attached, through the vaginal canal and into each follicle in the ovary. The fluid in the follicle is then aspirated into a test tube and studied under a microscope to look for eggs. On the day of your egg retrieval, your partner will produce his semen sample either in the clinic or at home. On some occasions, there may be a need to freeze sperm before the retrieval. 

The eggs and sperm are then mixed together and placed in an incubator overnight to allow them to fertilise. They are checked the following morning by one of our embryologists who will then contact you and let you know the outcome. The fertilised eggs are then kept in the incubator and checked until the day of your embryo transfer.

Step Three – Embryo Transfer

Embryo transfer usually takes place between day two and five. The transfer is a quick process that takes a few minutes and is usually painless. The embryo is placed into the uterus using a fine catheter that is passed through the cervical canal. You will now be using progesterone medication that helps maintain a healthy lining. You will perform a blood test 10 days later to check for pregnancy. 

What’s the most common procedure/route that potential parents take to conceive a baby? 

The most common route is the one described above. However, some women might try a procedure called IUI (Intrauterine Insemination) first. This is where sperm is specially prepared and then placed into your uterus. You will have ultrasound scans and blood tests to work out what the optimal time is to perform your IUI. This wouldn’t be suitable for all women and the success rates tend to be slighter lower. Your fertility doctor will usually advise what the best option is for you. 

When people come to see you guys, odds are they’ve been trying for a while, and it can be very mentally draining – what should prospective patients keep in mind when trying to first conceive a baby? 

Fertility treatment can be a difficult and overwhelming process and the reality is that treatment can be hard. It is important to practice self-care and find support so that you can thrive through your fertility journey, and become informed about your fertility and your treatment. Your nurse should be able to support and guide you through your treatment and help with questions that you have. We also have trained counsellors who specialise in fertility who can help you navigate through the emotional aspects of treatment. 

How can you help your fertility chances before engaging fertility treatments?

When trying to conceive, there are some important changes you can make to your lifestyle to increase your chances of having a healthy baby:

Adopt a healthy lifestyle well before commencing treatment. 

Don’t smoke or drink alcohol. Smoking reduces your chance of pregnancy and affects the quality of eggs and sperm. Alcohol is also known to have a negative impact on fetal development. 

Being overweight can mean that you will need more stimulation drugs and your response may in fact be reduced. Just a small weight loss can be beneficial. 

Medications – please let us know if you are taking any prescribed or over-the-counter medication as this can interfere with your fertility medications. However, do make sure that you are taking regular folic acid before trying to conceive as this reduces the chance of spina bifida in babies. 

A good well-balanced diet with plenty of fresh fruit and veg is recommended alongside a healthy balanced exercise regime. In essence, we would advise that if something is safe in pregnancy it is safe for treatment. 

Fertility Associates offers free nurse consultations – click here for more information

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